THC vs CBD for Fibromyalgia: Comparing Cannabis Varieties
What Researchers Found About Fibromyalgia and Cannabis
The Study at a Glance
Published
Pain, 2019
Researchers
Leiden University Medical Center (Netherlands)
Study Type
Randomized Controlled TrialParticipants
20 patients · Single dose crossover
Key Finding
This Dutch trial compared four cannabis varieties in fibromyalgia patients and found unexpected results: while balanced THC/CBD produced the most pain relief, adding CBD to THC actually reduced THC's pain-relieving effects. THC-containing varieties improved pressure pain tolerance, but effects were modest overall.
Key Finding: This Dutch trial compared four cannabis varieties in fibromyalgia patients and found unexpected results: while balanced THC/CBD produced the most pain relief, adding CBD to THC actually reduced THC's pain-relieving effects. THC-containing varieties improved pressure pain tolerance, but effects were modest overall.
What Researchers Studied About Fibromyalgia and Cannabis
Should fibromyalgia patients use THC-dominant, CBD-dominant, or balanced cannabis products? This rigorous Dutch study tested pharmaceutical-grade cannabis to find out.
Unlike most cannabis studies that test just one product, this trial compared four different varieties with known cannabinoid content—providing direct head-to-head comparisons.
The findings challenge some common assumptions about how THC and CBD interact for pain relief.
How This Randomized Controlled Trial Was Conducted
Researchers conducted a 4-way crossover trial with pharmaceutical-grade cannabis:
• 20 chronic pain patients with fibromyalgia • Each patient tried all 4 varieties in random order • Bedrocan: High THC (22.4mg THC, <1mg CBD) • Bediol: Balanced (13.4mg THC, 17.8mg CBD) • Bedrolite: High CBD (18.4mg CBD, <1mg THC) • Placebo: No THC or CBD • Single vapor inhalation, measured for 3 hours • Assessed spontaneous pain, pressure pain threshold, "drug high"
Fibromyalgia Treatment Results
The Main Results:
- 1Most cannabis varieties were NOT significantly better than placebo for spontaneous pain
- 2Balanced THC/CBD: 90% achieved 30% pain reduction vs 55% placebo (p=0.01)
- 3THC varieties significantly increased pressure pain threshold vs placebo
- 4CBD-only variety did NOT improve any pain measure vs placebo
- 5CBD appeared to REDUCE THC's analgesic effects when combined
- 6Pain relief correlated with feeling "high" (r=-0.5)
By the Numbers
| Statistic | What It Means |
|---|---|
| 90% | of balanced THC/CBD patients achieved 30% pain relief |
| 55% | of placebo patients achieved 30% pain relief |
| 4 | different cannabis varieties tested |
| Minimal | benefit from CBD-only variety |
of balanced THC/CBD patients achieved 30% pain relief
of placebo patients achieved 30% pain relief
different cannabis varieties tested
benefit from CBD-only variety
What This Means for Fibromyalgia Patients
This trial reveals important nuances about cannabis for fibromyalgia:
Surprising finding about CBD: CBD alone (Bedrolite) did NOT improve pain measures compared to placebo. Even more surprising: when combined with THC, CBD appeared to reduce THC's pain-relieving effects. This challenges the assumption that CBD always "enhances" THC.
What worked best: The balanced THC/CBD variety (Bediol) had the highest response rate—90% achieved meaningful pain relief vs 55% with placebo.
The "high" connection: Pain relief was correlated with feeling "high," suggesting the psychoactive effects may be tied to the pain-relieving effects. This might explain why CBD alone didn't work.
Objective vs subjective: THC varieties improved pressure pain tolerance (objective test), but effects on spontaneous pain were more modest.
Practical takeaway: For fibromyalgia, a balanced THC/CBD product may work better than CBD-only. But effects are modest with single doses—longer-term use may be needed.
Quick Answers: Fibromyalgia and Cannabis
Direct answers based on the findings of this study:
Research Summary: Answers are based on published peer-reviewed studies and represent research findings, not medical recommendations. Individual results may vary. Always consult a healthcare provider before making treatment decisions.
Should I use THC or CBD for fibro pain?
THC appears more important for fibromyalgia. A Dutch trial found CBD alone didn't beat placebo, while balanced THC/CBD had 90% of patients achieve meaningful relief. CBD may actually reduce THC's pain-relieving effects (van de Donk et al., Pain, 2019).
Source: van de Donk et al., Pain, 2019 (PMID: 30585986)
Does CBD alone help fibromyalgia?
No, CBD alone didn't work in a controlled trial. A 2019 study testing CBD-only cannabis found it did not improve any pain measure vs placebo for fibromyalgia. You likely need THC for pain relief.
Source: van de Donk et al., Pain, 2019 (PMID: 30585986)
What strain is best for fibromyalgia?
Balanced THC/CBD strains work best according to a 2019 trial—90% of patients got meaningful pain relief vs 55% on placebo. High-THC also helped, but CBD-only did not beat placebo.
Source: van de Donk et al., Pain, 2019 (PMID: 30585986)
This is educational content, not medical advice
The research summarized here is for informational purposes only. Individual results may vary, and what works in studies may not work the same way for everyone. Always consult with a qualified healthcare provider before making changes to your treatment plan or starting medical cannabis therapy.
Important Limitations
This study has some caveats to keep in mind when interpreting the results:
- Single-dose study—long-term effects may differ
- Small sample size (20 participants)
- Vapor inhalation only—oral products may work differently
- Short observation period (3 hours)
- High placebo response rate (55% achieved 30% relief)
The Bottom Line on Cannabis for Fibromyalgia
This head-to-head comparison of cannabis varieties delivers surprising insights for fibromyalgia patients. CBD alone did not outperform placebo, and CBD actually appeared to diminish THC's pain-relieving effects. The best results came from balanced THC/CBD cannabis, with 90% of patients achieving meaningful pain relief. The correlation between pain relief and feeling "high" suggests the psychoactive effects may be part of how cannabis relieves pain. For fibromyalgia patients, this suggests THC-containing products may be more effective than CBD-only options.
Do You Qualify for Medical Marijuana?
If you're living with Fibromyalgia, you may qualify for a medical marijuana card. Our licensed physicians can evaluate you from home via telehealth.
Related Research & Resources
Related Research
- Medical Cannabis for Fibromyalgia: What 367 Patients Experienced
- Cannabis for Chronic Pain: A Critical Look at 104 Studies
- THC Cannabis Oil for Fibromyalgia: A Controlled Trial
- Clinical Practice Guidelines: Cannabis for Chronic Pain & Co-Occurring Conditions (2024)
- Cannabinoids for Arthritis and Rheumatic Pain: Insufficient Evidence
Condition Research
Get Your Card
This condition qualifies for medical marijuana in:
Source
van de Donk T, Niesters M, Kowal MA, et al. "An experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronic pain patients with fibromyalgia" Pain. 2019. DOI: 10.1097/j.pain.0000000000001464
Important Information
Study Age: This study was published 7 years ago. Newer research may have updated or refined these findings.
Not Medical Advice: This research summary is for educational purposes only. It should not be used to diagnose, treat, cure, or prevent any disease or medical condition. Always consult a qualified healthcare provider before starting or changing any treatment.
Individual Variation: Research findings represent group averages. Your individual response to cannabis may differ based on genetics, other medications, underlying conditions, and many other factors.
Last reviewed: January 24, 2026
Important Notices
Research Summary Disclaimer
This content represents our interpretation of published scientific research for educational purposes. It should not be used to make treatment decisions without consulting a qualified healthcare provider. Individual results may vary from study findings.
FDA Notice
These statements have not been evaluated by the FDA. Cannabis is not intended to diagnose, treat, cure, or prevent any disease. The FDA has not approved cannabis for any medical condition except specific prescription medications.
Copyright & Fair Use
Research summaries are provided under fair use (17 U.S.C. § 107) for educational purposes. We provide brief summaries with attribution, not full reproductions. All studies remain the intellectual property of their respective authors and publishers.
Data Sources
Study information sourced from PubMed®, U.S. National Library of Medicine. Inclusion does not imply endorsement by NLM, NIH, or the federal government.
For complete information, see our Terms of Use and Research Content Policy.
FAQs: Cannabis for Fibromyalgia
Is THC or CBD better for fibromyalgia?
THC appears more important. This trial found CBD alone did not beat placebo, while balanced THC/CBD worked best (90% achieved meaningful relief). CBD may actually reduce THC's pain-relieving effects.
Does CBD help fibromyalgia pain?
Surprisingly, CBD alone did not improve pain measures compared to placebo in this study. The researchers found that CBD may actually antagonize (reduce) THC's analgesic effects.
What type of cannabis is best for fibromyalgia?
Balanced THC/CBD worked best. This study found balanced THC/CBD varieties performed best, with 90% of patients achieving 30% pain relief vs 55% with placebo. High-THC alone also improved pressure pain tolerance.