Fibromyalgia

Fibromyalgia is a nociplastic chronic-pain syndrome characterized by widespread musculoskeletal pain, fatigue, sleep disturbance, and cognitive symptoms ("fibro-fog"), diagnosed using ACR 2016 criteria. NASEM (2017) rated evidence for cannabinoids in fibromyalgia as insufficient/limited. The Skrabek et al. trial (J Pain 2008) of nabilone in 40 patients showed significant reductions in pain and anxiety at 4 weeks, while the Van de Donk et al. experimental study (Pain 2019) comparing inhaled Bedrocan, Bediol (THC+CBD), Bedrolite (CBD), and placebo found no cannabis variety outperformed placebo on spontaneous pain, though Bediol increased pressure-pain threshold ⚠️. A 2016 Cochrane review (Walitt et al.) concluded there was no convincing, unbiased evidence that nabilone was effective. Conflicting results, small samples, and unblinding from psychoactivity limit interpretation. → See also: Nabilone, Bediol, Chronic pain, CBD, THC.