Kristi Spry, RN, BSN
Fibromyalgia is a condition that is characterized by widespread amplified pain in different parts of the body. Additional symptoms of FM include fatigue, insomnia, memory and mood problems. What role does the endocannabinoid system play in the manifestation of this debilitating condition? Dr. Ethan Russo, Medical Director of Phytecs believes that there might be a deficiency in the bodies naturally occurring endocannabinoids. He refers to this condition as Clinical Endocannabinoid Deficiency Syndrome.
Patients with Fibromyalgia may have imbalances or altered activity of various neurotransmitters mediating pain transmission, which may affect mood, memory, fatigue and sleep. (Clauw, 2014). The role of the endocannabinoid system in our body is to maintain homeostasis, and in the case of FM, there seems to be a hyperalgesia to pain stimulus that our ECS would normally “quiet down”. Patients often have difficulty adjusting to living with fibromyalgia and sometimes feel a sense of loss of identity. (Rodham, 2010) Patients have also felt isolated from healthcare professionals whom they felt had to convince that had a “real” condition to be taken seriously. (Rodham, 2010)
Dr. Ethan Russo believes that supplementing the bodies deficiency of endocannabinoids with phytocannabinoids might relieve symptoms associated with fibromyalgia. Although more research clearly needs to be done, studies done on marijuana showing promising results. The use of marijuana was associated with beneficial effects on some FM symptoms in a 2011 study (Fiz, 2011).
Fibromyalgia treatment should focus first on non-pharmacological modalities, but if there is a lack of effect, there should be individualized treatment based on patient need. (Macfarlane, 2016) Fibromyalgia patients typically have an increased risk of side-effects to medications, and experts give a strong recommendation for the use of exercise, particularly given its effect on pain, physical function and well-being, availability, low cost and safety concerns (Macfarlane, 2016). Its no surprise that patients are turning to cannabis for pain management as an alternative to addictive opioid pain medications.
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Clauw DJ. Fibromyalgia: A clinical review. JAMA 2014;311(15);1547-55.
Macfarlane GJ, et al. EULAR revised recommendations for the management of
fibromyalgia. Ann Rheum Dis. 2016; 0:1-11
Rodham K, Rance N, and Blake D. A Qualitative Exploration of carers’ and Patients’ Experiences of Fibromyalgia: One Illness, Different Perspectives. Musculoskeletal Care. 2010;8(2): 68–77.
Fiz, Jimena et al. “Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life.” PloS one vol. 6,4 e18440. 21 Apr. 2011, doi:10.1371/journal.pone.0018440
Russo, Ethan B. “Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes.” Cannabis and cannabinoid researchvol. 1,1 154-165. 1 Jul. 2016, doi:10.1089/can.2016.0009
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