Adding medical cannabis to standard pain treatment improved outcomes in fibromyalgia patients | Research

The takeaway

In 31 fibromyalgia patients with low back pain, adding medical cannabis to standard analgesic therapy led to significantly greater improvement in pain, function, and range of motion compared to standard treatment alone.

Fibromyalgia patients with low back pain and pain management clinicians.

Significant improvement in all outcome measures with added cannabis

What the researchers found

Standard analgesic therapy (oxycodone/naloxone + duloxetine) produced minor improvement over baseline. Adding medical cannabis allowed significantly higher improvement in all patient-reported outcomes (FIQR, VAS, ODI, SF-12) at 3 months, maintained at 6 months. Lumbar range of motion improved after 3 months of cannabis therapy and continued improving at 6 months.

Why it matters

Fibromyalgia with low back pain is difficult to treat, and standard medications often provide incomplete relief. This cross-over design allows within-patient comparison.

The numbers in context

31 patients. Standard therapy: oxycodone/naloxone 5/2.5mg BID + duloxetine 30mg daily for 3 months. Cannabis therapy: minimum 6 months. Improvement in all PROs at 3 and 6 months of cannabis. ROM improved progressively.

How the study worked

Observational cross-over study of 31 patients. After screening, patients received 3 months of standardized analgesic therapy (oxycodone/naloxone 5/2.5mg twice daily plus duloxetine 30mg daily), then could opt into medical cannabis therapy for a minimum of 6 months.

What this study cannot tell us

Not randomized or blinded. Patients self-selected into cannabis arm (bias toward those expecting benefit). No placebo cannabis control. Small sample. Cannot separate cannabis effects from placebo or time effects.

How to read the evidence

Observational cross-over without blinding or randomization; patient self-selection introduces significant bias.

When this study was published

2019 study.

The bigger picture

The cross-over design is a strength, as each patient serves as their own control, but the lack of blinding and potential placebo effects are important caveats.

Questions still open

How much of the improvement is due to placebo effect or patient expectation? Would a blinded trial show the same magnitude of benefit?

Common questions

Does medical cannabis help fibromyalgia pain?

In this observational study, adding medical cannabis to standard pain medication improved pain scores, function, and range of motion in 31 fibromyalgia patients, though the study lacked blinding and a placebo control.

Can cannabis replace opioids for fibromyalgia?

This study added cannabis to existing opioid therapy rather than replacing it. Patients showed greater improvement with the combination than with standard analgesics alone.

Read the original research

Effect of adding medical cannabis to analgesic treatment in patients with low back pain related to fibromyalgia: an observational cross-over single centre study.

Clinical and experimental rheumatology, 37 Suppl 116(1), 13-20

View on PubMed ↗

Citation

Yassin, Mustafa; Oron, Amir; Robinson, Dror. (2019). Effect of adding medical cannabis to analgesic treatment in patients with low back pain related to fibromyalgia: an observational cross-over single centre study.. Clinical and experimental rheumatology, 37 Suppl 116(1), 13-20.