Fibromyalgia is a common syndrome in which people experience long-term, body-wide pain and tender points in joints, muscles, tendons, and other soft tissues.
Fibromyalgia has also been linked to fatigue, sleep problems, headaches, depression, anxiety, and other symptoms.
Causes, incidence, and risk factors
The cause of this disorder is unknown. Although none have been well proven, possible causes or triggers of fibromyalgia include:
- Physical or emotional trauma. An abnormal pain response.
- Areas in the brain that are responsible for pain may react differently in fibromyalgia patients.
- Sleep disturbances, which are common in fibromyalgia patients.
- An infectious microbe, such as a virus. At this point, no such virus or microbe has been identified.
Men and women of all ages get fibromyalgia, but the disorder is most common among women aged 20 to 50.
The primary symptom of fibromyalgia is pain.
- The exact locations of the pain are called tender points. Tender points are found in the soft tissue on the back of the neck, shoulders, sternum, lower back, hips, shins, elbows, and knees.The pain then spreads out from these areas.
- The pain is described as deep-aching, radiating, gnawing, shooting or burning, and ranges from mild to severe.
- The joints are not affected, although the pain may feel like it is coming from the joints.
- People with fibromyalgia tend to wake up with body aches and stiffness. For some patients, pain improves during the day and increases again during the evening, though many patients have day-long, non-stop pain.
- Pain can increase with activity, cold or damp weather, anxiety, and stress.
Fatigue and problems with sleep are seen in almost all patients with fibromyalgia. Many complain that they can’t get to sleep or stay asleep, and they feel tired when they wake up.
Other symptoms may include:
- Irritable bowel syndrome with gas, and alternating diarrhoea and constipation
- Memory difficulties and problems thinking clearly
- Numbness and tingling in hands and feet
- Reduced exercise tolerance
- Sad or depressed mood
- Tension or migraine headaches
Our bodies naturally make pain relievers called endorphins, but they also make other substances that can trigger pain relief in the so-called endocannabinoid system. This system seems to play a key role in many processes in the body, including modulating how we feel pain. Marihuana contains cannabinoids very similar to those that occur in the body naturally.
Fibromyalgia patients typically experience body wide pain and often take multiple drugs to deal with all the symptoms of this disorder. Marihuana may treat multiple symptoms, and some patients have reported seeing results.
The two problems with herbal cannabis, Silverman and other critics say: It’s a complex natural substance that contains about 60 different compounds with potentially medicinal effects, some of which may interact with one another. The other problem is that the amount of these various compounds may vary by batch, as marihuana is not synthesized but grown.
While Silverman says he has great hopes that synthetic medicines based on individual compounds in cannabis may one day help fibromyalgia patients (after appropriate randomized controlled clinical trials have been done), he argues that the real thing today is just too inconsistent.
“We think that there’s probably a role for that class of compounds, the cannabinoids in general, and it’s just a question of working out how that’s going to be put into practice,” says Mark Ware, M.D., an assistant professor in family medicine and anaesthesia at McGill University, in Montreal, and the executive director of the Canadian Consortium for the Investigation of Cannabinoids.
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