Using CBD for fibromyalgia is an interesting question and bears some discussion.  The short answer is that this is the wrong question because CBD is barking up the wrong tree.  Let me explain. 

First, what is Fibromyalgia, or Fibro for short?  Fibromyalgia is a condition in which people have pain, typically in muscle beds, and often associated with Trigger Points, or specific locations that are tender to external pressure (like when a doctor is examining the patient).  Fibro is remarkably common and increasing over time. 

The cause of Fibro is not understood at present.  For much of the last 30 years, since the initial description of Fibro, we have been unable to find any causal pathology in patients who suffer from it.  The prevailing theory is that it is a form of somatization disorder where psychological stressors are manifest by pain in the body.  While this remains the current understanding, there have been recent investigations that have led to more physiological explanations like changes to the gut microbiome.  

Let me digress briefly to say that many Fibromyalgia sufferers become very irate at the notion that their pain is of psychological origin.  If that’s you, I’m sorry you feel that way.  At least from my own point of view, the pain is very real, regardless of the cause.  However, finding the accurate cause is important to prescribing an effective treatment.  In the end, that’s all that’s important to me.

Current treatments for Fibro include pain medications, muscle relaxers, and medications like SSRIs or gabapentinoids.  While these can be helpful, many find them insufficient and are looking for relief or better relief from medications like cannabinoids.  Hence the interest in CBD. 

What do we know about CBD for pain or Fibro, in particular.  Darn near nothing, unfortunately. 

There have been a bunch of studies on CBD for pain in the mouse model.  So, if you’re a mouse and find your tail on a hotplate or your femur smashed with a hammer, you can likely get some reliable relief from CBD (at astoundingly high doses).  However, since you are not a mouse, you’re out of luck.  There are almost no studies of CBD in adult humans for any use, including pain. 

Studies that we do have looking at pain in humans have all been similarly negative at the doses people are typically taking.  There certainly may be benefit to be had at much higher doses, but those have not been tested and are also so expensive at the moment as to be entirely unaffordable. 

Worse, CBD has been shown to interact with many conventional medications, from blood thinners to heart medications to over the counter drugs like Claritin. These interactions can be quite serious or even fatal.  If CBD had proven benefit, it might be worth using, but not until. 

Why is CBD all the rage right now given the lack of information?  Well, quite frankly, because Mitch McConnell make CBD legal in the Farm Bill of 2018.  This was a boon to hemp farmers (his constituents) who want to make money selling hemp and its derivatives.  It has nothing to do with whether it works, is safe, or is advisable as a medication.  To me, this is the Emperor’s New Clothing – or another example of fine American greed.

Before you stalk off shaking your head if you’re a Fibromyalgia sufferer, all is not lost.  CBD is just not the right cannabinoid for you.  We have over 50 years of good data in human beings to show that cannabis, itself, is a really effective approach to pain.  In fact, for most cases, cannabis is as effective as opioids with much less risk. 

Cannabis can be used carefully, according to best medical practices to achieve control over your pain.  This is not about getting “high” but about controlling symptoms.  All medicines have side effects and cannabis is no different.  By paying careful attention to details like route of administration, dose, and timing, we can achieve best benefit while minimizing side effects.  Just like any other medication.  Not only do most people get good relief with cannabis medicine, they tolerate it just fine. 

Further, cannabis is not without risk – again just like any medication.  Cannabis can pose risk to people with certain illnesses like some forms of heart disease, and can pose risk of misuse, dependence, and even use disorders.  This requires some careful monitoring by your physician and is why you should not use cannabis in a DIY approach any more than you’d use any conventional medication without professional guidance. 

So let’s focus on barking up the right tree.  Forget CBD for now, we’ll see how the research pans out.  In the meantime, let’s use cannabis to get the best possible outcomes.

Consult with a Qualified Boston Medical Marijuana Expert Today

Those considering using THC, CBD, or any type of medicine found in cannabis to help manage their condition should consider speaking to a trained medical expert who is knowledgeable about using cannabis therapeutically. Massachusetts medical marijuana doctor Jordan Tishler, M.D. sits on the faculty of Harvard Medical School and has years of experience helping patients treat pain and other ailments using cannabis. He and the team at InhaleMD stand ready to assist patients in determining whether medical marijuana is right for them. For more information, or to set up a virtual consultation with the team at InhaleMD, call us at (617) 477-8886 today.

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