Fibromyalgia is a pathology characterized by chronic pain, of which about two million Italians suffer.

It’s a disorder with a complex diagnosis, almost in all cases the approach towards the patient is interdisciplinary, different professionals working on different aspects of the pathology.

There aren’t many studies analysing the effectiveness of Cannabis and its extracts in the treatment of fibromyalgia syndrome, however important signals are arriving, as for the first time in Italy a public institution, the Emilia-Romagna Region, has issued a wide-ranging document on the pathology, guidelines for the “Diagnosis and treatment of fibromyalgia”, designed with the objective to give a definition and a classification of the disorder and to indicate defined and appropriate intervention methods. In the guidelines Cannabis was introduced.

“Towards the future - Daniele Conti, director of AMRER Onlus, Associazione Malati Reumatici Emilia-Romagna (Association for Rheumatic Patients Emilia Romagna), states – the view that the working Group intends to propose with the document is promoting and encouraging research, in particular on cannabinoids and the interactions with nutrition, the only tangible way to respond adequately to the needs of the patients and contrasting the extreme proliferation of ‘imaginary’ cures which damage health and wallet of individuals affected by fibromyalgia”.

"A last aspect, on which it is important to put a spotlight, is represented by the use of these guidelines to recognize the rights linked to the impact of fibromyalgia in terms of civil disability and handicap; regarding this fundamental right, we from AMRER are ready right now to take firm action”  

What is Fibromyalgia?

The term fibromyalgia means pain in the muscles and in the fibrous connective structures like ligaments and tendons. Fibromyalgia often confuses, as some of its symptoms can be found in other clinical conditions as well.  

Researchers demonstrated that inflammation is not a significant part of this syndrome. The definition fibromyalgia or fibromyalgia syndrome is therefore more accurate and has widely replaced the old terms used.

Fibromyalgia mainly involves the muscles and there insertions on the bones. Even though it can seem similar to a joint pathology, it isn’t arthritis and it doesn’t cause deformations of the joint structures. Fibromyalgia is a form of extra-articular or soft tissues rheumatism.   

Fibromyalgia syndrome is hard to identify in laboratory, in fact, the diagnosis depends mainly on the symptoms reported by the patients.

However, through case studies the guidelines for diagnosis have been defined.
These studies have demonstrated that some of the symptoms, like musculoskeletal pain throughout the body, and the presence of specific algogenic areas identified through finger pressure are detectable in patients affected by fibromyalgia syndrome and normally not in healthy people or in patients affected by other painful rheumatic pathologies.
 

What does Medicine say?

“Fibromyalgia is the second most common form of rheumatism and is a frequently occurring health condition in clinics of general medicine and rheumatology, its prevalence is comprised between 2-3% and 8%, the incidence is of about 7-11 new cases every 1.000 persons, each year”, Carlo Salvarani states, Professor of Rheumatology at the University of Modena and Reggio Emilia in an interview.

“The impact by this disorder on the quality of life of the patient is very heavy due to the fact that the main symptom characterizing it, is pain, chronic and present throughout the body, associated with tiredness, sleep disturbance (non-restorative sleep), cognitive problems (regarding attention and memory), mental problems (in particular depression)  and a wide range of somatic and neuro-vegetative symptoms”.

The study conducted in Israel “The consumption of cannabis  by fibromyalgia patients”

The team of the Laniado Hospital and Rheumatology Clinic of the Nazareth Hospital and Faculty of Medicine, has sent a questionnaire to three large Facebook fibromyalgia groups.

The anonymous questionnaire included demographical questions,  clinical questions regarding the use of cannabis, included the obtainment of an authorisation for the use of medical cannabis (as required by the Israeli law), the quantity of cannabis used, the necessity to buy cannabis beyond the medical indemnity, effects on pain, sleep, depression and anxiety, adverse side effects of cannabis, sense of addiction to cannabis or to other medical drugs, involvement of members of the family, propensity to drive after the use of cannabis; and employment and social disability.

The results of the questionnaire

Out of 2.705 individuals, 383 (14%) replied to the questionnaire, with a medium age of 42,2. Amongst the interviewed, 84% reported they consumed cannabis and 44%  of them received an authorisation to do so.

The medium quantity of cannabis consumed per month was comprised between 16 and 31 grams, and 80% of the consumers smoked pure cannabis or cannabis mixed with tobacco.

The relief from pain was reported by 94% of the interviewed individuals, while 93% reported an improvement in the quality of sleep, 87% reported an improvement in depression and 62% an improvement in their anxiety state.
55% of the interviewed people bought cannabis on the black market, besides the medical deductible. Adverse side effects were reported by a 12%, while just an 8% reported addiction to cannabis.

The major part of the interviewed individuals, 64%, worked full-time or part-time and 74% reported to have driven their cars “as usual” with the use of cannabis.
The team reached to the conclusion that “almost everyone reported the favourable effects on pain and sleep and only a few mentioned adverse side effects or a sense of addiction to cannabis”.