Reviewed by Cheryl Rose, RPh

Fibromyalgia is a mysterious, long-term illness that affects about four million adults, or roughly two percent of the adult population. While this wide-spread pain disorder is fairly common, we still don’t know the cause of or cure for this chronic condition. There are a variety of treatments available to help manage fibromyalgia, and some patients turn to medical marijuana.

Fibromyalgia, as defined by the Centers for Disease Control and Prevention, is a chronic condition that causes pain all over the body. It can also cause sleep disturbances, fatigue, severe headaches, and mental health issues. Because it’s not known what causes fibromyalgia, though suspected factors that contribute to the condition include genetics, infections, or physical and emotional events like a car accident, it is difficult to treat. 

“Chronic illness like fibromyalgia will require a lifetime of treatment,” says Cheryl Rose, a registered pharmacist and cannabis expert at Verilife. “Unfortunately, traditional prescription pain relievers have a risk of long-term side effects. Additionally, anti-seizure medications and antidepressants that cause drowsiness could increase the severity of the fatigue, which is already debilitating to fibromyalgia patients.”

Complementary therapies like exercise, acupressure, massage, yoga, and dietary changes may also help, but Rose says cannabis is often a go-to for her patients.

As with most other conditions, there isn’t much research to confirm cannabis as an effective treatment. Most of what we know about medical marijuana for fibromyalgia is from animal studies or self-reporting from fibromyalgia patients.

“We already use THC and CBD combinations for the treatment of pain, as well as headaches, fatigue, depression, and even bowel issues,” said Rose. “All of these symptoms typically coexist in fibromyalgia patients—we’re just waiting for the research to support the anecdotal evidence we’re already seeing.”

When advising fibromyalgia patients on the right medical cannabis products, Rose recommends a higher CBD content as this cannabinoid is used for inflammatory pain without causing daytime drowsiness. Interestingly, Rose adds “In fact, for many patients, we have seen the opposite. CBD can be fairly energizing, and this uplifting feeling has actually interfered with sleep in a small subset of patients when taken too close to bedtime.” 

In addition to what she’s seen with CBD and pain relief in her patients, Rose notes “CBD offers mood-enhancing properties as well, including a sense of whole-body well-being that is completely different from the heady psychoactive effects of THC.” 

If you’re looking for a product that has both CBD and THC, Rose recommends ensuring the cannabinoid ratio is around 1:1. “This is because too much THC could increase daytime drowsiness, and large THC doses may even increase anxiety.” 

Patients with fibromyalgia often talk about “fibro-fog,” a term that speaks to the common symptoms of poor concentration or memory loss. “Fibro-fog,” Rose notes, “can be aggravated by a large ratio of THC to CBD, which is why using a good quality medical marijuana rather than recreational strains lacking in CBD is essential.”  

Because fibromyalgia is a chronic condition, patients often have to plan to manage their pain in a variety of scenarios. Rose encourages patients to look for longer-acting products such as “oral solutions or capsules for the mainstay of your treatment or add faster-acting chewable gels or tablets.” But remember, CBD can take a while to feel the effects in the system—perhaps up to several weeks. Because of this, Rose suggests that patients “maintain at least one daily dose of CBD in a longer-acting form, even on days you feel better. The most common feedback I hear from patients is that they did not realize how much CBD was helping until they stopped taking it.”

With any medical condition, speak with your primary care practitioner before exploring medical cannabis as a treatment option for fibromyalgia. Rose also recommends reviewing your list of medications with your practitioner to identify possible contraindications.