Cannabis for fibromyalgia: surveys look promising but rigorous trials are few | Research

The takeaway

While patient surveys and retrospective studies suggest cannabis can significantly reduce fibromyalgia pain and improve sleep, only a handful of randomized trials exist, and their objectivity has been questioned.

Fibromyalgia patients, pain management specialists, and medical cannabis researchers.

Only a handful of randomized trials exist

What the researchers found

Fibromyalgia affects up to 10% of the population. Only physical exercise has strong evidence as a treatment. Few randomized cannabis trials exist for fibromyalgia, and their objectivity has been questioned. However, many retrospective trials and patient surveys suggest significant pain alleviation, sleep improvement, and symptom relief. Cannabis use carries risks including psychiatric, cognitive, developmental effects, and addiction potential.

Why it matters

Fibromyalgia is prevalent and undertreated, with most medications providing insufficient relief. Cannabis is increasingly used by patients, but the evidence gap between self-report and controlled trials needs closing.

The numbers in context

Prevalence up to 10%. Only physical exercise has strong treatment evidence. A handful of randomized trials exist for cannabis in fibromyalgia.

How the study worked

Systematic review of evidence for cannabis and CBD in fibromyalgia treatment, including pathophysiology, diagnosis, current treatments, and cannabinoid evidence.

What this study cannot tell us

Limited randomized trial data. Patient surveys subject to bias and placebo effects. Heterogeneous fibromyalgia populations make comparison difficult.

How to read the evidence

Systematic review revealing limited but emerging evidence, with a gap between observational and controlled data.

When this study was published

2020 review.

The bigger picture

The tension between enthusiastic patient reports and limited controlled evidence is a recurring theme in medical cannabis, but is particularly acute in fibromyalgia where standard treatments are so inadequate.

Questions still open

Why is the gap between patient-reported benefit and trial evidence so large? Would better-designed trials with appropriate outcomes show clearer effects?

Common questions

Does cannabis help fibromyalgia?

Patient surveys and retrospective studies suggest cannabis can reduce pain and improve sleep in fibromyalgia, but rigorous randomized trials are few and their quality has been questioned.

Is cannabis safe for fibromyalgia patients?

Cannabis carries risks including psychiatric effects, cognitive impairment, and addiction potential. Clinical judgment is needed to weigh risks against potential benefits for individual patients.

Read the original research

Cannabis and cannabidiol (CBD) for the treatment of fibromyalgia.

Best practice & research. Clinical anaesthesiology, 34(3), 617-631

View on PubMed ↗Publisher’s paper ↗

Citation

Berger, Amnon A; Keefe, Joseph; Winnick, Ariel; Gilbert, Elasaf; Eskander, Jonathan P; Yazdi, Cyrus; Kaye, Alan D; Viswanath, Omar; Urits, Ivan. (2020). Cannabis and cannabidiol (CBD) for the treatment of fibromyalgia.. Best practice & research. Clinical anaesthesiology, 34(3), 617-631. https://doi.org/10.1016/j.bpa.2020.08.010