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cbd oil for fibromyalgia pain

Cbd oil for fibromyalgia pain

A 2017 paper published in Expert Opinion on Therapeutic Targets suggested CBD as a possible way to diminish the activity of brain cells called glia, which leads to central sensitization. That’s a major feature of fibromyalgia and other central sensitivity syndromes such as chronic fatigue syndrome, irritable bowel syndrome, and migraine.

However, this topic is likely to get a lot of future attention, for several reasons.

When it comes to fibromyalgia symptoms, those three are significant.

Side Effects

A 2016 review published in Cannabis and Cannabinoid Research found evidence that CBD is effective in migraine and irritable bowel syndrome, which are related to fibromyalgia. It also stated that some cannabis-based treatments appeared effective for fibromyalgia. The authors stated that CBD is often preferable to patients due to the high and other effects associated with THC.

The website ProCon.org has information about which states have laws specific to CBD oil. A site called Governing maintains a map of where marijuana is legal in some form.

Research for Fibromyalgia

Certainly, you have a lot to consider when it comes to any treatment, and even more so when it comes to CBD. Consider the pros and cons—including the legal ones—carefully. Be sure to discuss this option with your healthcare provider to make sure you're safe, and, as with any treatment, watch for side effects.

As of mid-2018, CBD oil is not FDA-approved for any conditions. Research in the United States is in the early stages, though, since for decades, legal restrictions made it extremely difficult to study the medical benefits of marijuana or any of its components.   We may see applications submitted to the agency as research continues to move forward.

Cbd oil for fibromyalgia pain

“Fibromyalgia is not easy to treat, often involving several medications with significant side effects and modest benefits,” Boehnke explained. “Further, many alternative therapies, like acupuncture and massage, are not covered by insurance.”

Previous research shows that some people substitute medical cannabis (often with high concentrations of THC) for opioids and other pain medications, reporting that cannabis provides better pain relief and fewer side effects. However, there is far less data on CBD use.

For this study, the team focused on 878 people with fibromyalgia who said they used CBD to get more insight into how they used CBD products.

The U-M team found that more than 70% of people with fibromyalgia who used CBD substituted CBD for opioids or other pain medications. Of these participants, many reported that they either decreased use or stopped taking opioids and other pain medications as a result.

Clinically, opening up lines of discussion around CBD use for chronic pain is imperative, said Boehnke, for medication safety reasons as well as for “enhancing the therapeutic alliance and improving patient care.”

Boehnke stressed the need for more controlled research into how CBD may provide these benefits, as well as whether these benefits may be due to the placebo effect.

As the ravages of the opioid epidemic lead many to avoid these powerful painkillers, a significant number of people with fibromyalgia are finding an effective replacement in CBD-containing products, finds a new Michigan Medicine study.

Cbd oil for fibromyalgia pain

Additional weaknesses in methodological design occurred in varying configurations across all selected studies. These weaknesses affected the overall generalizability of outcomes and included problems with inclusion and recruitment criteria, lack of control groups or appropriate reference groups, short treatment duration, and small sample sizes. Randomized clinical trials with proven methodological design are a critical need in the field of cannabis research as it pertains to assessing chronic pain management in fibromyalgia patients. The growing legalization and increasing use of cannabis across all populations indicates that cannabis use, for any reason, is a significant public health concern, and empirically-based information is urgently needed.

Therefore, a key aspect in determining the efficacy and safety of cannabis agents needs to involve not only tracking the precise agent used with patient outcomes but also noting the ratio of THC to CBD in each dosage. However, identification and isolation of cannabinoids across products is challenging due to the lack of available information in this area. Moreover, as previously noted, research has shown that the mechanism of entry into the human body of different agents plays a role in efficacy and safety. Future research is needed to ascertain the most appropriate ROA for each agent, which is currently difficult due to rapidly changing cannabis-related technology.

Several different methods were used to assess outcome across the selected studies. Van de Donk et al. (2019) assessed electrical pain thresholds and spontaneous pain scores, whereas Sagy et al. (2019) measured the overall quality of life (QOL) and degree of pain intensity. Habib and Artul (2018) and Yassin et al. (2019) assessed outcome using the Revised Fibromyalgia Impact Questionnaire (FIQR), which asks only one question regarding the level of pain. Yassin et al. (2019) also used the Patient’s Global Impression of Change (PGIC) Scale (reflects a patient’s belief about the efficacy of treatment), and the Low Back Pain (LBP) scale to assess an additional category of pain. Habib and Avisar (2018) asked questions about the effect of cannabis on pain, sleep, anxiety, and depression, but did not utilize any formal assessments.

In addition, the selected studies generally failed to clearly record participant symptoms at the start of each study protocol. Symptoms such as constipation, dizziness, dry mouth, and dry eyes consistent with symptoms of fibromyalgia may also be attributable to cannabis use (Van de Donk et al. 2019). Future studies should establish a baseline for symptoms that are commonly associated with fibromyalgia so as to distinguish them from the adverse effects of cannabis. Future studies should also control for cannabis use patterns when assessing adverse side effects, establishing a control group for each category of cannabis user (past uses, current user, naïve user, and non-user).

Conclusions

Although the five critically reviewed studies would seem to suggest that medical cannabis is a safe and effective treatment option for patients with fibromyalgia, the serious methodological limitations of this research preclude drawing any strong conclusions about efficacy. Instead, we advise that the reviewed body of literature lends very little evidence in support of medical cannabis as an efficacious treatment modality for chronic pain management in fibromyalgia patients. We conclude that no studies to date have established a compelling relationship between any form of medical cannabis treatment and symptom improvement in fibromyalgia patients suffering from chronic pain.

Moreover, results have shown that, in some cases, fibromyalgia patients with multiple comorbid conditions that lead to pain respond well to centrally acting pharmacological therapies, such as cannabis (Fitzcharles et al. 2018; Phillips and Clauw 2013; Russo 2016; Walitt et al. 2016). However, there is conflicting evidence in the extant literature regarding the use of cannabis with fibromyalgia patients. Recent systematic reviews of randomized clinical trials (RCTs) examining the use of medical cannabis in the treatment of chronic pain presented limited and ambiguous evidence that cannabis exhibits analgesic properties for chronic pain resulting from fibromyalgia (Fitzcharles et al. 2018; Walitt et al. 2016). These results, in combination with rapidly changing national policies regarding cannabis use, highlight the need for an investigation of more recently published literature on this topic.

The search identified five applicable studies involving 827 participants that used six different treatments. Review suggested several methodological problems pertaining to generalizability and validity.

Agent characteristics and dosage

There was a high level of demographic variety across all five selected studies. However, minimal effort was made to minimize bias by ensuring that groups were appropriately comparable at baseline for demographic and other key factors. While diversity would generally lead to higher generalizability, when assessing cannabis use for fibromyalgia, variability across participants is not as desirable. For example, cannabis use and efficacy are highly affected by gender (Calakos et al. 2017), and while one of the selected studies controlled for gender (Van de Donk et al. 2019), the others did not. Regarding patient characteristics, methodological problems across studies included lack of consideration for comorbidities, diagnostic consistency, concurrent analgesic use, history and tolerance of cannabis use, and cross-drug tolerance.

Widely understood to be a safer alternative, recent studies suggest that vaporization of the cannabis flower may provide distinct therapeutic advantages as compared to other ROAs (Aston et al. 2019; Lanz et al. 2016; Russo 2016). Vaporization of the botanical cannabis flower should not be confused with the use of the e-cigarette (vaping), which heats a concentrated form of cannabis oil to a high temperature and has recently been implicated in vaping-related acute lung injury (VpRALI) and adverse effects on the cardiovascular system (Fonseca Fuentes et al. 2019; Qasim et al. 2017). Only one of the studies selected for this review utilized vaporization in 100% of study participants (Van de Donk et al. 2019).