A license to treat chronic pain with medicinal cannabis has been granted here for the first time, it has emerged. A 3-month agreement was given the green light by the Department of Health to use Tetrahydrocannabinol (THC) people in constant agony.
THC is the principal psychoactive constituent of cannabis. It is currently illegal to use medicinal cannabis here – but medical consultants can apply for the license on a case by case basis. A three-month license can be granted on foot of an application made directly to the Minister for Health under section 14 of the Misuse of Drugs Act.
Under guidelines from Chronic Pain Ireland, the THC would NOT be consumed via smoking. A patient would ideally take it by vaping or in their tea. Under the strict terms, a medical professional would administer a starting dose, monitor the patient, and adjust the dose accordingly, they say. Patients will be placed under constant medical supervision.
Last February, Health Minister Simon Harris announced that he would implement a Health Products Regulatory Authority recommendation that cannabis–based products be made available to some patients with multiple sclerosis and epilepsy, and those suffering nausea in chemotherapy.
However, chronic pain was not included in Mr. Harris’ plan. It was on this basis that Chronic Pain Ireland applied to the minister for a license, for one of their members, along with their medical consultant.
There were no formal application guidelines from the Department of Health, so Mr. McLoughlin created one from scratch. This is now available on Chronic Pain Ireland’s website.
The application included how THC would be administered, details of the patient’s medical consultant, and what dosage they would potentially start on.
The patient can take the medicinal cannabis either through tea or by vaping.
“Some people are desperate due to chronic pain,” said Mr. McLoughlin. “I personally know of people who use cannabis for chronic pain. Some say it works, some say it doesn’t. But you must always go to your doctor.”
Professor of pharmacology and therapeutics David Finn, who is also the co-director of the Centre for Pain Research at NUI Galway, said the granting of the license was an “important development”.
“This is a very interesting and important development which demonstrates a recognition by Irish medical professionals and the minister for health of the potential therapeutic value of medicinal cannabis for the treatment of chronic pain,” said Prof Finn.
“Chronic pain is the most researched indication for cannabinoids, and the majority of clinical studies, meta-analyses, and systematic reviews conclude that cannabis or cannabinoids can be effective in alleviating certain types of chronic pain.
“Approximately 20% of the Irish population suffers from chronic pain, and up to 40% of patients report that the management of their pain is inadequate, either due to the limited efficacy of existing treatments or unacceptably high levels of side-effects.”
Solidarity-People Before Profit Alliance TD Gino Kelly has been a longtime campaigner for legalizing cannabis for medicinal purposes and brought forward an opposition bill towards this end.
The Cannabis for Medicinal Use Regulation Bill 2016, is now entering its third stage of debate and will go before the Oireachtas health committee early next year. “The tide has now turned. It is a significant day for people with chronic pain in Ireland,” said Mr. Kelly.
It started as a dull ache right above the base of my spine.
There was no injury, no clear cause — just pain that seemed to come out of nowhere. At the time, I thought it would go away in a few weeks. I didn’t know it would turn into a four-and-a-half-year-and-counting odyssey of experimentation to battle lower back pain that simply refused to retreat.
I tried everything. I dove into twice-a-week physical therapy, daily exercises, regular walking breaks, and meditation. I bought a sit-stand desk. Nothing worked. After several months, if anything, my pain was worse.
This health problem, coincidentally, arose just as a career shift made improving US health policy my focus. After working as a consultant for hospital systems and insurance companies, I accepted a position at the federal agency that runs Medicare and Medicaid. My work focused on designing new ways to pay health care providers to reduce waste and provide higher-quality care.
Through my work, I realized just how massive the chronic pain problem is in the US. Defined as any pain lasting longer than three months, chronic pain afflicts more than 50 million Americans each year and has a net economic impact of around $600 billion. Lower back pain alone is the most common cause of disability for Americans under 45.
It struck me that policy and business leaders tackling the problem-focused almost entirely on what not to do: avoid excessive imaging studies, avoid invasive treatments and surgeries. Especially avoid opioid painkillers.
Given how common my problem was, I was surprised at how little research and policy was focused on what could be done to fix my pain.
It is certainly true that US clinicians went overboard on opioid prescribing, with horrifying repercussions. I am not going to argue here that opioids are a good treatment option — they appear not to be in most cases — or minimize the devastating effects of opioid addiction.
However, a full response to the opioid epidemic must go beyond reducing opioid use: We need to find ways to reduce pain through better treatment. Policymakers need to put more focus and public dollars toward understanding pain, and patients need to be supported in their pursuit of pain treatments that work.
Every day at work, I was learning about innovative programs to improve health outcomes for populations with chronic illnesses such as diabetes and hypertension. There was nothing similar for pain management. Chronic pain seems to be something that few doctors, let alone administrators and policymakers, really understand and know how to treat.
My own journey to find relief made the problem deeply personal. In the absence of clear knowledge and robust treatment options, patients like me are forced to spend a lot of time, energy, and money experimenting with different remedies.
I received an MRI to figure out the source of my back pain — it showed nothing. I am one of the 85 percent of low back pain patients whose pain is “nonspecific”: Doctors cannot pinpoint a cause. Of the many treatments that exist, there is not a definite winner. I tried various medications, several physical therapy regimens, and creams and injections of all sorts. I tried a small patch that sends high-frequency electrical pulses to suppress nerve activity, a treatment that actually helped a bit.
Desperate to exert control in the absence of effective treatments, I funneled my energies into remaking my office workstation. I was lucky to be able to work from home often, a privilege many lacks, so I had complete control over my environment. With the help of a specialized vendor, I fashioned a workstation that allowed me to either walk on a treadmill or lie on my side while working on two large side-by-side monitors.
My closet was full of the flotsam of tried-and-failed ergonomic cushions, massaging implements, and foam rollers. I rarely invited people over, dreading I would have to explain my bizarre apartment setup.
Eventually, I took a short trial of opioid painkillers. The pills were moderately effective but made me very tired. That, coupled with a fear of building tolerance, caused me to stop taking them after a few weeks. Fortunately for me, my pain is relatively low-intensity. The trade-off is different than for someone experiencing more pain. The crucial point is that — for me, anyway — painkillers were simply another treatment with a unique set of risks and benefits. My issue was, and remains, managing pain, not managing opioids.
Throughout my adventure of trial and error, coverage decisions from my insurance companies often seem random. Many treatments — for instance, massage or prolotherapy injections, in which a sugar solution is used to stimulate tissue repair — have been denied, on the grounds that the evidence of effectiveness is weak.
Yet other treatments with similarly weak evidence behind them, like steroid injections, are covered. I understand the reluctance to pay for a treatment that is unlikely to be effective, but this process of experimentation is all I have. I’m lucky to have the means to spend tens of thousands over the years out of my own pocket. Others don’t have that option.
On my quest to figure out why there seem to be so few good solutions to chronic pain, I discovered that less than 1 percent of National Institutes of Health research funding is dedicated to pain research.
Dr. Edward Michna, a pain specialist who works with the American Pain Society, ties this to the stigma around chronic pain. (The American Pain Society previously received funding from pharmaceutical companies that sold opioid painkillers.) “Even before opioid use became an epidemic, funders and politicians equated pain management with addiction treatment, and they ran away from funding it,” he said.
He pointed to a pervasive belief that these patients were exaggerating their pain to receive disability benefits and, in modern times, to get high on painkillers. “With some notable exceptions, it simply wasn’t an issue they wanted to get involved with.” It would be easy to dismiss his views as biased in favor of big pharmaceutical companies, but as someone who is in pain and wants help, his words resonated with me.
Pain is often a symptom of an underlying condition, which means that research into those conditions will ultimately alleviate pain. Cancer-related pain will probably improve if we find better treatments for cancer in general. But for tens of millions of Americans like me, our pain cannot currently be explained by a separate disease. We need more than just 1 percent of government funding devoted to pain research specifically.
Some researchers are beginning to embrace the theory that pain itself is a type of independent disease. They speak of “central sensitization” — the idea that in some people, for reasons yet unknown, the central nervous system changes over time to experience heightened pain. This isn’t New Age hand waving: It’s real science that demands further study.
Another important question for both researchers and health care providers in improving how we match patients to treatments. Often, when treatment ends up working, it remains unclear why it worked for a given patient and not for another, similar patient. When we say a treatment like prolotherapy injections has limited scientific evidence, that usually means that in trials, few saw benefits above placebo. If we could figure out what is different about those few who did see real benefits and identify them, the same treatment becomes more useful.
The opioid crisis — as grave as it is — threatens to overshadow these important issues. Right now, states and governing bodies are focused almost exclusively on reducing opioid prescriptions rather than finding alternatives. The National Committee for Quality Assurance, which sets quality standards for health plans, has a new measure that effectively penalizes providers who prescribe patients opioids over a certain dosage amount. Some states, like Maine, put in place caps on opioid doses.
It’s too early to tell how many patients who legitimately need opioids are having trouble accessing them as a result of these policies. But anecdotes from patients and clinicians suggest some people are suffering. Two small-business owners in Maine are suing the state over rules that require long-term opioid users to lower their dosages.
That policy was an understandable reaction to the fact that 313 people in Maine died from opioid overdoses last year. Yet we have to acknowledge the lack of good options for treating chronic pain. We should also recognize that while evidence behind opioids is weak and they are highly risky, some patients have been well-served by them.
Improving how we apply existing treatments also requires workforce training. A 2011 study found that US medical schools allotted an average of nine teaching hours to painmanagement. (The average for Canada was 19.5 hours.) Clinicians across all specialties should receive better training.
It’s not uncommon for the effects of fibromyalgia pain medications to wane over time. But what can you do about it? Here are seven different treatment options to explore.
If you are one of the approximately five million Americans with fibromyalgia, you know that pain can be severe, unpredictable, and exhausting. It can be constant for a period of time and then get better for a while — but it tends to just keep coming back.
Additionally, a painkiller that worked before may stop working, and what works for some symptoms may not work for others. Pain management needs to be constantly adjusted and may require a team of specialists who are familiar with fibromyalgia.
Common pain symptoms of fibromyalgia include stabbing, burning, shooting, or throbbing pain in any area of the body. Pain is usually worse in the morning. People with fibromyalgia may have tender areas on their neck, shoulders, back, or legs that are painful when touched.
And fibromyalgia pain can become even worse with physical or emotional stress. Common stressors that may make your fibromyalgia pain worse include a traumatic event, such as a car accident, repetitive physical traumas, or a physical illness.
Getting this pain under control is not easy. But it is possible.
Switching to a new fibromyalgiapainmedication is easier if you taper one medicine gradually before starting a new one. Always follow your doctor’s directions carefully and never stop a medication on your own.
Important options for treating fibromyalgia include finding the right pain medication, getting the proper psychological support, trying complementary therapies, and finding the right treatment team. If your fibromyalgia treatment is not working, ask your doctor to help you explore these options:
Pain medications. There are a number of medications now approved for fibromyalgia pain, including pregabalin (Lyrica), duloxetine (Cymbalta), and milnacipran (Savella). The narcotic-like painkiller tramadol (Ultram) has also been effective for fibromyalgia. “Switching between medications may be necessary and can be made easier with samples or vouchers to decrease the financial cost for the patient,” advises Dr. Abeles.
Sleep management. People with fibromyalgia often have trouble getting enough sleep — and lack of sleep can make fibromyalgiasymptoms worse. Make sure you avoid caffeine and stick to a strict sleep schedule. Ask your doctor if a sleep aid medication might help.
Social and psychological support.The stress of living with a chronic painful disease like fibromyalgia can make your symptoms worse. Research shows that increasing social support reduces fibromyalgia symptoms, such as pain. You may benefit from a fibromyalgia support group. Professional counseling to help you develop coping skills and better manage your symptoms has also been shown to be helpful.
Exercise.Exercise is an important part of feeling better if you have fibromyalgia. Studies show that exercise can help you improve your fitness level, feel better about yourself, and reduce the number of painful pressure points in fibromyalgia.
Acupuncture. One survey found that about 20 percent of people diagnosed with fibromyalgia and treated at a university-based clinic tried acupuncture within a two-year period. Some studies have found that acupuncture can help relieve fibromyalgia pain, but other reports say the effects are not long-lasting and the treatment doesn’t help with the fatigue or sleep problems common with fibromyalgia.
If you are being treated for fibromyalgia and your pain medications are not as effective as in the past, you have options. Remember that it is common for people with fibromyalgia to try different types of medications and other management strategies. It is also important to make sure you have a sympathetic, knowledgeable team of experts to help you manage your fibromyalgia symptoms.
Fibromyalgia is an unpredictable disease that requires a flexible treatment plan. One of the best things you can do is to educate yourself about fibromyalgia so that you can work closely with your treatment team and be a good advocate for yourself.
Have you come to hate talking on the telephone since you’ve had fibromyalgia or chronic fatigue syndrome? It’s a common thing with people frequently saying they have an especially hard time focusing on phone conversations.
So why is this? It hasn’t been studied, but several factors could contribute to this problem:
When you’re on the phone, you don’t get any of the non-verbal cues that come with face-to-face conversation. Communication experts agree that most of communication is non-verbal, and when you remove all those verbal cues, your brain has to work harder to comprehend what’s being said. Foggy brains may not be able to muster that level of focus.
We’re often in environments that are full of distraction. You hear a lot about “multitasking,” which doesn’t really mean that the brain is doing multiple things at once. Even in healthy people, according to experts, the brain is actually switching from one task to another. FMS and ME/CFS brains often have a hard time with multitasking.
The language problems common in fibromyalgia and ME/CFS—which includes word recall—can complicate conversation and make it stressful. If you’re afraid of forgetting common words or losing your train of thought, it may make your symptoms worse.
Holding the phone can be really painful for the hand, arm, shoulder, neck or even ear. Some phones get really hot, which can bother those who have thermal allodynia (pain from temperatures that wouldn’t normally cause pain). Fortunately, speakerphones and headsets can alleviate a lot of these problems.
It may be easier to write than talk when language impairment is acting up. Then, you can take more time with it, sort through your jumbled thoughts, and then proofread it. On top of that, when you receive written messages, you can keep them and refer back if necessary. You may remember things better when you read them, too.
When you do have to use the phone, try to eliminate all the distractions you can. Go into a quiet room and shut the door, maybe even turn out the light. If you need to relay specific information, make notes ahead of time and keep them with you. To help you remember information, take notes. That prevents frustrations like making a doctor’s appointment or plans with a friend and then forgetting the details the moment you hang up.
If you have problems communicating via telephone, it can help to let the people who speak with frequently know about it. Let them know that when you ask him to repeat something, it’s not because you were ignoring them. You may also want to encourage them to send you texts or emails instead of calling, especially if they know you haven’t been feeling well. It might be worth exploring Skype, especially for long-distance calls or conversations you expect to be lengthy.
Studies have shown that it’s a bad idea for anyone to talk on a cell phone while driving, even if it’s hands-free. While it’s not something that has been studied specifically, it seems safe to assume that those of us with communication-based cognitive dysfunction would be especially dangerous when it comes to talking while driving.
Despite the instant negative reaction to the thought of the Herpes virus and the association with sexually transmitted disease, there are a number of different Herpes viruses, including those responsible for Chicken Pox, Shingles, and Epstein Barr (mono).
Even the ones with the most negative stereotypes are much more common than people believe; around 90% of people have been exposed to HSV-1 (oral herpes, or cold sores), and the numbers for genital herpes are pretty close to the same. Once exposed to any of these viruses they can lie dormant in your body, reactivating at any time, usually as a response to stress. So, is there a connection between Fibromyalgia and Herpes?
Given the overlap in symptoms between Fibromyalgia and Epstein Barr, it’s not surprising that researchers would consider a possible connection; I know that I certainly did. I had mono when I was a junior in High school. I don’t remember much about it other than that I felt tired a lot. What I do remember was later (over the next couple of decades) that I would have what I referred to as “recurring mono” despite multiple doctors telling me that you can’t get mono more than once (something that has since been severely questioned by many doctors and researchers).
My throat would get sore, my lymph nodes would get swollen, I would feel achy (like the flu), and worn out. This was usually after I’d been running on full steam for several weeks, and I saw it as just my body crashing after I’d pushed it too hard. Back in 2006 when I was fighting strep infections every couple of weeks I actually managed to get a doctor to test me for Epstein Barr and low and behold I tested positive for an active infection (so much for not being able to get it more than once). Blood work has come a long way in two decades.
Fibromyalgia, to me, feels a lot like those episodes of mono, sometimes even including the swollen glands and low-grade fever that were common with the recurring mono. So, it’s understandable why I might question whether or not there may really be a connection between the two.
Research regarding the overlap of Fibromyalgia and Epstein Barr goes all the way back to (at least) 1987. Buchwald, Goldenberg, Sullivan, and Komaroff examined 50 patients with Fibromyalgia and tested them for Epstein Barr. The levels of the virus in their systems were not significantly different than those of the healthy and unhealthy controls.
The methods used to diagnose Fibromyalgia, at this time, were much less stringent than the 1990 guidelines called for, and probably more similar to the currently accepted guidelines. Two control groups were used for this study, one group containing healthy controls, the other patients who had been diagnosed with at least one chronic illness.
A large number of the patients (27%) reported frequent sore throats, as well as many of the other symptoms common to mono, but not common to Fibro. Testing showed no significant differences in the levels of EBV antibodies between the Fibro group and the health or unhealthy controls.
VCA-IgG indicating that the person has had the virus at some time existed in almost all participants (regardless of group). It’s important to note that many people can have Mono and never show any symptoms. VCA-IgM without EBNA antibodies indicates a recent infection; none of the Fibro patients tested positive for VCA-IgM.
EBNA antibodies indicate a past infection; this was found in most participants regardless of group. Given the results, it’s almost impossible to say that Herpes isn’t related to Fibro, or that it is. Since they tested against healthy (and unhealthy controls) and all showed evidence of past infections, it’s possible that their healthy controls were not as healthy as they thought, that the unhealthy control group may have had overlapping issues that were not diagnosed, and a number of other things, including limitations in the blood tests at that time.
Side Note – one really interesting thing in this study that jumped out at me was that even back in 1987 Rheumatologists were reporting that they believed Fibromyalgia patients may make up the largest percentage of their patients. This is back before the original diagnostic criteria were set, and long before most doctors really even believed Fibromyalgia existed. Evidently, the three doctors involved in this study did believe in Fibromyalgia. Perhaps, Fibro patients sought them out for that reason.
In 2012, Hedberg reported that latent Epstein Barr virus has been connected to many different auto-immune disorders including MS, Hashimoto’s thyroiditis, RA, Sjogren’s, Chrons, and a number of others that are often seen as overlapping disorders with Fibromyalgia. He also reported on a genetic mutation found in the blood that allows Epstein Barr to increase and maintain itself, possibly leading to autoimmune issues.
A great deal more research has been done regarding Chronic Fatigue Syndrome (CFS); both Epstein Barr and Herpes Virus 6 have been connected to Chronic Fatigue Syndrome; as many as 70% of those diagnosed with Fibromyalgia are also diagnosed with Chronic Fatigue Syndrome, and there is much debate as to whether Fibro and CFS may be two separate entities or two ends of the same spectrum.
Of course, all of that brings us to the recent findings of Dr. Duffy and Pridgen at the University of Alabama (Roll Tide!). They have been researching the possibilities of treating Fibromyalgia, chronic pain, and IBS using a combination of anti-virals usually used to treat HSV-1 (cold sores). They stumbled upon this potential treatment almost accidentally and are now on their way to stage-3 trials. This could be the thing that ties the Herpes virus to Fibromyalgia (and related conditions) and may provide significant relief for many of us.
Cannabis-infused sports creams claim to offer muscle relief. We spoke to experts to see if they’re worth a shot.
Chances are you’re no stranger tomuscle aches. Well, what if we told you that cannabis creams might help provide relief?
Yes, there’s a new type of topical ointment on the market, and it’s infused with cannabidiol (CBD) from marijuana. Manufacturers claim it can help alleviate acute pain and muscle soreness. CBD is similar to THC, except it’s non-psychoactive, meaning some researchers view it as the golden child of medicinal use.
Science has confirmed that cannabis is an effective pain reliever, reinforced in a massive new report from the National Academies of Sciences, Engineering, and Medicine. But there’s a big difference between ingesting cannabis or its individual chemicals orally and absorbing it through your skin. Here, the lowdown on this new crop (no pun intended) of pain relievers.
The ointment is made from infusing high-quality cannabis flowers in some kind of quality oil—coconut or olive typically—which extracts the active compounds, either CBD, THC, or both depending on the type of hemp used. This oil is then blended with other therapeutic herbs, like arnica or lemongrass essential oils, which are well-known pain relievers.
If you read the ingredient list, often everything in the jar is straight from mother earth. As long as that’s indeed the case with the cream you have your eye on, the formula is immensely safe, chemically, says Gregory Gerdeman, Ph.D., neurophysiologist who researches cannabinoid biology and pharmacology at Eckerd College in Saint Petersburg, FL. And since they’re formulated to be topical—absorbing into the top layer of skin—and not transdermal—which would pass through the skin and into your bloodstream—there’s no risk of getting high.
“When it comes to cannabis-based topicals for muscle soreness or other pain relief, there’s absolutely no reason why it should be a big deal to try,” he says.
They may be safe, but there’s one massive problem: There’s practically no scientific data to support the idea that a CBD-infused topical cream is any more effective than other topical pain relievers, like Tiger Balm, BenGay, or Icy Hot. Michelle Sexton, a San Diego-based naturopathic doctor and medical research director of the Center for the Study of Cannabis and Social Policy says that her patients do seem to have a great interest in CBD ointments, and roughly 40 percent of them have indeed tried one. However, these people are in her office now because the topicals didn’t work for them. “As a medical professional, my opinion is there’s little evidence to back up the claims being made—it’s all marketing for now,” she says.
There is an argument to be made for the simple fact that science hasn’t caught up to the trend (and laws) of 2017 yet. And there are doubtlessly researchers testing the efficacy of CBD–infused creams for pain relief as we speak.
The theoretical logic is there, Gerdeman says. What exactly is that thinking? Well, there are a few different ways CBD could help regulate pain—by increasing your natural endocannabinoids, decreasing your inflammatory response, and desensitizing your pain receptors (although it’s still unclear whether this stands when absorbed topically compared to orally).
Let’s start simple: Endocannabinoids are natural signals in your body that help maintain homeostasis by detecting and regulating hunger, pain, mood, and memory. CBD helps elevate your natural levels of pain-relieving endocannabinoids by blocking metabolism as they’re moving around your body.
The second method of pain relief centers around the damage you do when you work out. When you strength train, you create micro-tears in your muscles, which is why you feel sore as you heal. Once your immune cells detect damage, they release inflammatory mediators in order to repair the tissue. CBD, though has the ability to limit the release of some proinflammatory signals, thereby helping with pain without thwarting the healing entirely, Gerdeman explains.
Finally, you have receptors called TrpV1 that detect and regulate your body temperature. When activated, they put out heat, soothing your pain receptors. Using this channel, CBD makes these pain receptors hyperactive for a period of time, causing them to get hot, desensitizing them, and downregulating those pain–sensing nerve endings.
Phew—enough of that biology lesson. The real problem here is that all of this has yet to be proven in scientific studies on humans.
A study analysis in the Journal of Pain Research confirms that topical use of certain cannabinoid topicals can reduce pain in animals with inflammation or neuropathic pain. And science has found topical creams with THC and CBD help relieve pain for conditions like multiple sclerosis. But for the vast majority of chronic pain—and most certainly for acute pain like post-workout—the scientific jury is 100 percent still out. “There’s a little bit of data in support of CBD for pain relief, but to go from animal to human is a giant leap,” Sexton says.
“The pain and stiffness that comes post-workout or from overexertion certainly has a pro-inflammatory component to it, so it’s reasonable to think CBD or other cannabinoids might have benefits, but we have no research to support this yet,” Gerdeman adds.
The other issue? Topical creams will treat anatomical structures within 1 centimeter of the skin—and the muscle where your actual soreness is located is going to be deeper than that, explains Ricardo Colberg, M.D., a physician at Andrews Sports Medicine and Orthopaedic Center in Birmingham, AL.
The fatty tissue can only hold so much oil, so, theoretically, if you apply enough of a CBD–infused topical cream to your skin it might leak down into your skeletal muscle just out of diffusion, Sexton adds. But there’s no study to show this, and that means you’re going to be rubbing on a whole lot of the stuff.
This takes us to the next problem: There is no regulation around how much active CBD or THC is in each cream or how much of the compound is needed to see relief. Read: “If you have three products that say 1 percent CBD infused in coconut oil, one could be great and the other two could be crap—that’s the reality of cannabis medicine right now,” Gerdeman says.
That’s not to say CBD–infused creams definitely won’t reduce your acute pain or muscle soreness. That’s because pretty much all of these creams on the market right now have other scientifically-proven analgesic compounds, like menthol, camphor, and capsaicin which are also found in other, non-CBD topical pain relievers.
“Any cream with a heating or cooling sensation desensitizes the nerves to pain by distracting them with stimuli on top,” Dr. Colberg explains. Plus you’re often massaging the area as you apply, which improves circulation and reduces muscle spasms, he adds.
So do you need CBD? All our experts agree that until we have more peer-reviewed research, all claims are marketing hype and not evidence-based.
But there is an argument to be made for simply believing the CBD adds that special something. “Scientific literature says there’s a 33 percent chance of the placebo effect helping people, so for some, just using a cream they believe can help will provide some relief,” Dr. Colberg adds.
The short of it: Science hasn’t confirmed creams with CBD will have any greater benefit than those without, but there’s little-to-no risk in trying it out (other than wasting your money, of course). And if you believe in the power of CBD–infused creams, that may be enough to score some relief.
If your state has legalized both compounds, look for a cream with 1:1 CBD to THC as well as another cannabinoid BCP (beta-caryophyllene) if possible, which manufacturers have seen better results with, Gerdeman suggests. Try Apothecanna’s Extra Strength Relieving Creme ($20; apothecanna.com) or Whoopi & Maya’s Medical Cannabis Rub (yes, that’s Whoopi Goldberg’s line), which was designed specifically for menstrual aches and pains (whoopiandmaya.com).
If you don’t live in a legalized state, you can typically still get CBD–infused creams. Since there’s no regulation or standardized testing, your best bet is to find trustworthy brands that use creams free of toxins but with additional pain relievers like menthol, capsaicin, lemongrass, or camphor. Try Mary’s Nutritionals Muscle Freeze ($70; marysnutritionals.com) or Elixinol’s CBD Rescue Balm ($40; elixinol.com).
It’s 7:30 p.m. on a Friday night, and I’m in bed. With my husband and dogs right beside me. Nothing new here, and honestly, most of our friends are probably doing the same thing, but I really wouldn’t know.
It wasn’t the diagnosis, or even the pain really, that caused me to start avoiding party invites and happy hour texts from my girlfriends. I don’t really remember when I started drifting so far away, but I have recently realized that I miss my friends. And my sisters and brothers. And my former colleagues. I miss talking to people. I truly miss laughing out loud with my girlfriends. I even miss seeing how handsome and stunning my husband is when he’s in a crowd.
But, as for my friends and our families that we rarely see anymore, I do wonder what they think. I assume they think my husband and I (married three years in December) are still in the honeymoon phase, that our kids keep us very busy, or they may not think twice about it. But, I bet they haven’t thought for a second that I have avoided pretty much every opportunity to see them that there has been the last couple of years.
I’ve canceled or just not shown up, I’ve postponed or used my typical, “maybe,” or, “probably,” responses, which they’ve all figured out is the same as a “no.” And, when I have made it to dinner or lunch, I had probably been a nervous wreck and even considered canceling the day before.
The truth is that I’m not a good faker anymore. I hurt. More often than not lately, I hurt. Something always hurts. And, because I’m not great at pretending like I feel great these days, I’ve made the choice to let everyone I love think that I’m just really busy and head over heels in love and that they are the ones that don’t fit into my schedule anymore. And, that’s not true at all… so far from true.
I feel stuck, and I’ve never been comfortable admitting it until now. I don’t want to pretend that I am just fine anymore. But, I don’t want to moan and groan, or for people to worry or feel sorry or pity me. I don’t want to overpower the conversation when someone asks how I’ve been feeling, because I could talk all night. But, geez, I really do want to talk sometimes.
In all honestly, I have always been the person in my many circles that organized the get-togethers, ensured the girl’s free drinks from the bars that we would close down, and throw my nieces and nephews the best Christmas parties ever.
And, it sucks not being able to be that person anymore. It sucks to not even have the energy to go to dinner, let alone host one. Fibro sucks. So, if I’m being honest, I don’t feel like my old self at all. And, I guess I’m a little afraid that my friends and family may not enjoy my company anymore, that I may not be as funny as they expect me to be, or as good at conversation as I once was. I definitely won’t close the bar down if I even make it. But, I guess I should tell them that. Because, as I write this I’ve realized that if I was them, I’d want to know.
So, here it goes. I miss you, all of you. And, I’m sorry for the excuses. Instead of reaching out to you when I’ve needed you most, I’ve hidden from you and even lied to you. I’m sorry. And, if I am ever going to find myself again, I need you. So, from now on, I’ll be honest and tell you when I just don’t feel like putting a bra on to leave the house. And, maybe instead of canceling or postponing, you can just stop by. I’d love to see you. I would really love that.
I didn’t ask for this and believe me, I don’t want it. I know you roll your eyes, even when you try and hide it. I know you think I’m exaggerating or being dramatic. But this is something I wouldn’t wish on anyone.
You’re used to seeing me work and cook, clean, walk, go shopping, and even out with friends. I don’t often complain because if I complained every time I was in pain, I would have nothing else to say. If I’m complaining, just know it must be really severe.
But the truth is, I’m living a double life. I do all these things with a smile on my face because I have no choice. The only other option would be to wallow in bed and watch life pass me by. You see me take my pain meds and wonder if I’m addicted.
I take my pain meds and wonder how I will function if they are taken from me. I don’t get high, I get normal. I take those meds to feel as good as you feel when you have a cold. They are the reason I can work, cook and do all the other things you see me doing every day.
The truth is, I’m so sick of the relentless pain that I cry when you’re not looking. I wake up in the night writhing in pain while you’re sleeping. I clench my teeth when you ask me to do something physically daunting while you don’t even give it a second thought. I do 100 things a day that you don’t notice because I hide it. I hide my pain, I hide my fatigue, I hide my guilt and frustration.
The truth is, I watch you and wonder what it’s like to feel like that – to be able to do all these things without pain and fatigue. Sometimes I want to break down and scream and cry. Sometimes I get so angry I want to smash everything around me. Sometimes I wonder if I can keep going like this.
But the part that’s worse than the pain? Knowing you probably don’t believe me. Knowing that no matter how much I try and tell you, you just won’t understand. So, I keep it to myself and even when I’m surrounded by people, I’m still alone with my pain.
I’m not helpless. I don’t want you to feel bad for me. I don’t want special treatment. All I want is some empathy. Don’t get mad at me when I can’t do something. Don’t get frustrated when I can’t go somewhere. Don’t judge me when I take my meds. Don’t think I’m lazy when I sleep more often (especially since I haven’t slept the past four nights). Please just don’t make me feel guilty for having this disease.
Even if you don’t, just say, “I understand.” That’s all I want.
To the man who stayed in my life when I asked him to leave. And today we are together since 18 years of marriage. I really don’t know how that happened. Sometimes it feels like we are the same as we were 25 years old. Sometimes it feels like we are like a team that unifies together.
But today, since these 18 years we stand by in front of family and friends and made a vow to love and cherish “in good times and bad, in sickness and in health.” “In sickness and in health”. Reminding these words gives me a feeling that the past 20 years have entailed more sickness than health.
I was not the person who thought I would get my happily ever after. Maybe this was meant for other people or novels with fairytales etc. I remember all the things like when you entered into my life and see the beauty behind my flaws. It is such an amazing feeling when you trust someone so badly after you have hurt so much. Some doubts that let you awake all night, some thoughts, and then I started to have strange symptoms.
Firstly, I got Hashimoto’s thyroiditis, which was supposed to be a lifetime medication because my body was attacking itself (it was the first of many daily meds). this was an addition to the joint inflammation, hair loss, fever, fatigue, stomach problems, and consistent infections. I was in my 20s and felt like a senior. I used to hide problems in front of you and you always get them. You canceled all the plans when I wasn’t fine and say, “we will stay at home and watch a movie:” and that became our weekend routine. All gone like a hell.
Time passed and the mornings were like going to a doctor’s appointment to deal with the new symptoms and ended up calling 911 for the hospital. My limbs were not working. It was the first time anyone said a new term that is “CNS lupus”. All the things went so seriously. My future became risky as my brain was not being in control and something was attacking my brain.
I still remember that time when I was all on the machines, that beeps, the sounds, the smells, everything was scary. All I wanted was to set you free and give you a life of freedom. You didn’t deserve a life of just being a caregiver. You were just 24 and there was a life that will brighten up your future. You didn’t have to spend a life with someone whose future is at stake. We were just engaged at that time.
You refused to leave me and I failed to count the power of your love. You told me that you were staying with me ever after. You took me to the bathroom and gently washed my hair. And you did every single thing.
It really very hard to be with someone who is chronically ill. There are days when you cooked for me, being my nurse, my dad, my mom, my therapist, and a zookeeper. You are like a gum stick that holds the family together. Whenever I feel, you pick me up. You got me to the land of reality. You always set me right when I acted like a stubborn lady.
There were nights when it’s you who helped me and took me to bed. Too many nights were there when you were alone missing out on the old you since we were in bed at 9:00 p.m. there were nights when you didn’t sleep because of me just to check if I am okay. There were times when you missed every get-together, event for me because I was in the hospital and you stayed there with me. You supported our kids and advocated for me.
I am not the one who is easiest to live with. Yes, I have admitted it. I am a difficult person and stubborn at the same time. I get moody due to steroids. My weight fluctuates and still, you always look at me with love. These medications always made me feel like a useless person but you always tell me how valuable I am.
I don’t know where the future will take us. All I know is you are with me in this crazy adventure. And I am thankful for you that you didn’t listen to me and didn’t run.
The pain that remains consistent for almost three to six months is commonly known as chronicpain. This is a very common pain. Chronic pain affects millions of people every year. The pain affects various parts of the body like joints, head, back, or shoulders.
The pain can have various patterns; sometimes a person can have various shapes of the pain and at times the pain exists in a similar manner. This random pattern makes it difficult to diagnose.
We should have sound knowledge about various types and forms of chronic pain.
The nerves that are in charge of the brain for perceiving various sensations, including pain are called nociceptors, the pain caused by them is called nociceptive pain. While neuropathic chronic pain is usually caused by a malfunction of the nervous system. The nociceptive chronic pain can be superficial, deep somatic, and intuitive. On the other hand, neuropathic pains are tangential or central.
The root causes of Fibromyalgia are still unknown after a lot of research and study. There are multiple documentations on its causes but it’s still unclear whether to categorize it as nociceptive or neuropathic pain.
The disorder is caused by an imbalance of the chemicals in the human brain which affects the pain perceiving the process of the brain in a dysfunctional way. This is so far the most accepted theory about this syndrome.
The conditions are responsible for causing these imbalances are still a mystery. Somehow fibromyalgia is related to neuropathic chronic pains because most of the studies and research relate it to the physical or emotional stress or injuries suffered by the patients.
The former slowly deteriorate the cartilages of the joints while the second one causes the lining of the joints to inflame and then destroys them.
Pain, stiffness, warmth, and redness in the joints are the typical symptoms of the disorder. As the pain in joints is one of its symptoms so it is also sometimes mistaken with fibromyalgia. A complete and thorough analysis will easily clarify that which chronic pain-related medical condition is present.
This type of Arthritis that can cause muscle pain in two or more areas of the body at the same time is called Polymyalgia Rheumatica. The pain and stiffness in the shoulders, neck, upper arms, thighs, and buttocks, as well as limited range of motions, fatigue, loss of appetite, depression, weight loss, and even fever, are symptoms a person can face who is affected by this disorder. People older than 50 years have less probability for this disorder. Again due to similar symptoms it is mistaken with fibromyalgia sometimes.
One of the most painful long-term syndromes that can exist is Complex Regional Pain Syndrome and it has two types. Complex Regional Pain Syndrome is caused by some sort of illness or injury that has not affected the working of the brain directly. It is caused by injuries that have directly affected the nerves.
A very high level of persistent pain, swelling in certain affected areas, sensitivity to extreme temperatures, changes in the temperature of the skin, atrophy of the muscles, and stiffness in the joints are the typical symptoms of this medical condition.
The causes of this disorder are not properly identified. The abnormality in the movements of the intestines is the overall knowledge that is known about this defect. The usage of foods such as dairy products, soda, certain fruits and vegetables, and coffee may act as promoters in such medical conditions.
Stress is another vital cause that develops the conditions which lead to Irritable Bowel Syndrome. The most significant symptoms of this disorder are diarrhea, urination problems, severe stomach aches, fatigue, anxiety, sleeping issues, bloating, backache, headaches, and unpleasant taste in the mouth. Its symptoms are similar to that of fibromyalgia so due to the overlap of the symptoms, it is mistaken with fibromyalgia.
There are various disorders that are characterized by chronic pain. Due to the similarity in most of their symptoms, it becomes difficult for specialists to diagnose the problem. When you get a feeling of any of the symptoms, consult the doctor as soon as possible in order to properly start the treatment after a clear diagnosis.
