Under the spotlight: Aromatherapy

An ancient method of holistic healing, does aromatherapy have a place in treating arthritis today? Iona Walton investigates

Aromatherapy is the use of scented essential oils to help rejuvenate and regenerate the body, enhance wellbeing and relieve stress.
Its roots are planted 6,000 years ago when essential oils are known to have been used by a number of ancient civilisations in cosmetics, perfumes and drugs. Over the centuries our knowledge base has increased and today the oils are pure essences extracted or distilled from plants. Flowers, leaves, roots, resins, seeds and fruits of many herbs, shrubs and trees are used to provide aromatic oils, each believed to have their own healing properties. Some are reported to have balancing effects on the nervous and hormonal systems, others a powerful antiseptic action and some act as natural painkillers.
There are two ways of accessing the oils.

• Skin. The tiny molecules pass through the skin into the bloodstream, which circulates them throughout the body. This occurs through massage, a bath or compresses (when a few drops are added to water. A cloth is soaked in the aromatic water and applied to the affected body area).
• Smell. The molecules are transmitted to the part of the brain that influences the nervous and hormonal systems, and which is connected to functions such as memory and emotional behaviour. This occurs through direct inhalation (a smelling strip or bottle of undiluted essential oil is held about 10cms below the nostrils), dispersion (oils are sprinkled or sprayed onto linen, furniture and handkerchiefs) or evaporation (oils are combined with water and placed over a lit candle).

Aromatherapy in arthritis
For someone with arthritis, Lauren Allen from the International Federation of Aromatherapists recommends a topical application is the most suitable.
“As the oils are applied to the skin the scent is also inhaled,” Lauren says. “Massage application has a soothing effect that reduces the perception of pain. Alternatively, diffuse the oils in the bath.
“Differing forms of arthritis would be approached from different stances. For example the main concern in osteoarthritis is a reduction in inflammation and pain. In rheumatoid arthritis supporting the immune system is important and in fibromyalgia relaxation has been shown to be important in reducing symptoms. Different oils would be used in each case.”

Is it safe?
Aromatherapy is suitable for most people as it is a gentle therapy and there should be no side effects.
Because the oils are concentrated they should not be applied to the skin undiluted; a carrier oil is used to dilute them when they’re used in massage.
The aromatherapist will take a full medical history and if in doubt contact your GP before beginning treatment. If allergic reaction is a concern, a patch test can be applied before treatment begins. Dilutions of essential oils will vary, for example the elderly may tolerate a lower dose.

The evidence
There is no wide body of evidence showing that aromatherapy is effective for arthritis and reviews of the literature are not particularly supportive. Part of the problem is that many studies are excluded from reviews as they have been poorly carried out.
“The fundamental issue is that it’s extremely hard to test the effectiveness of aromatherapy,” explains Lauren. “When mainstream drugs are made, compounds are isolated that are proven to have certain effects. But in aromatherapy there are many natural elements that make up a plant. These can vary depending on region, climate and subspecies, so measuring precisely how effective they are (and which bits of them work best) is difficult.”
Some small studies, however, do suggest that aromatherapy has measurable benefits in people with chronic pain and arthritis.

• In 2008 a study of 59 older people with knee pain showed that massage with aromatic ginger and orange essential oil provided short-term knee pain relief (published in Complementary Medical Research).
• In 2013, a group of 40 people who received acupoint massage on periarthritis of the shoulder were found to have better pain relief and improved activity of the joint than other people who received electroacupuncture or transcutaneous electrical nerve stimulation (TENS) therapy (published in Chinese Acupuncture & Moxibustion).

“Aromatherapy helps support the wellbeing of the individual rather than focus on disease,” says Lauren. “In other words the emphasis is on increasing the body’s overall ability to heal.”

Choosing an aromatherapist
The relationship between you and the therapist plays a significant part in the success and enjoyment of the therapy.
“An aromatherapist should make a specially blended preparation for each individual,” outlines Lauren. “The therapist should be fully insured and belong to a professional association such as the International Federation of Aromatherapists or the Complementary and Natural Healthcare Council. Therapists should be happy to answer questions before committing to a course of treatment and give a realistic outline of what can be achieved.”

Cost
Aromatherapy is already widely used in hospital settings in the UK to assist patients and in some areas is integrated into the NHS system so costs are met by NHS budgets
When not available on the NHS, price varies depending on the treatment programme and where you live (London is usually more expensive than elsewhere).
Another option is a do it yourself aromatherapy session as essential oils are widely available on the high street and online. Be sure to buy from a reputable source and do thorough research into how to use them safely first.

Fran Johnson, aromatherapist and formulator of Neal’s Yard Remedies, recommends:

• Back pain – ginger, juniper, lavender, marjoram and rosemary. Combine three drops of each with 50ml of a suitable vegetable oil base and massage over the painful area.
• Cartilage injury – thyme, sweet marjoram, rosemary and lavender. Add 10 drops of essential oils to 100ml of water and soak a large piece of clean cotton or lint in the solution. Wring thoroughly and place as hot as possible (without burning the skin) onto the affected area.
• Fibromyalgia – melissa, bergamot and neroli. Add two drops to a base oil and gently massage into the skin.
• Leg/foot cramps – aniseed, basil and sweet marjoram. Add two drops to 20ml of a base massage oil and rub it into the area.
• Muscle pain – chamomile, lavender and marjoram. Add two drops to 20ml of a vegetable oil base and gently massage into the affected area. Alternatively, add one drop of each to the bath for a relaxing soak.
• Osteoarthritis – black pepper, ginger, marjoram, rosemary, nutmeg, pine or thyme. Combine with a suitable carrier oil and massage into the affected area.
• Osteoporosis – nutmeg, clove, lavender and helichrysum blended with a base oil. Gently massage to relieve pain.
• Rheumatoid arthritis – juniper or pine. Add three drops to a base oil and put in a bowl of warm water. Bathe the affected area or use as a compress. Alternatively, add three drops of benzoin, eucalyptus, lavender, marjoram and rosemary to 50ml of comfrey macerated oil or any vegetable base oil and massage into the affected area.

Dervin’s story
Told by his mother, Bonner Murphy
Dervin was a healthy 16 year old boy who went away for a weekend school trip in May 2012. We live in California in the US. He called home on Saturday and asked if he could take some painkillers because his jaw hurt. When he returned home the next day his jaw hurt more. By Monday night he had a 40.5-deg C fever, his eyes had filled with blood, his whole body was in excruciating pain and he could not open his mouth.
Welcome to rapid onset Sjogren’s syndrome, an autoimmune condition where the body’s immune system attacks glands that secrete fluid, such as the tear and saliva glands.
Sjogren’s can cause failure of the stomach, heart and lungs and it takes most people at least seven years to get the correct diagnosis because it hides itself so well as many other things. We were extremely lucky that Dr Dennis Del Paine diagnosed it early so that we could begin treatment.
Dervin was also diagnosed with lupus and rheumatoid arthritis in his feet, knees, shoulders and hands. He initially missed a month of school because of pain and exhaustion and still has days, especially in Winter, when he can’t go to school.
Dervin’s treatment regime comprises nonsteroidal anti-inflammatory drugs, hydroxychloroquine and eye drops every morning and night.
It is hard to watch your child in pain. It is hard to watch them play a sport they love and hear them say, “I keep telling my body to get up, but it won’t move.” It’s hard to watch them painfully hobble into the room because it’s cold. That’s why, in addition to his regular medication, we have tried some complimentary therapies.
I was at a school fair where I met Darlene Nyswonger who was selling essentials oils. She came to my home to talk specifically about the issues Dervin was having and we decided to try her company’s range of vitamins and aromatherapy oils.
I built up a relationship with Darlene because she could certify the purity of her oils (they are tested by the FDA), she knows what each of the oils’ effects should be and is more interested in finding out if they’re helping my child than whether I want to buy more.
Darlene taught me a nine-step massage technique and is encouraging me to get certified to ensure I am doing it all correctly.
We massage with wild orange and peppermint, lavender (on the soles of his feet and his back) and a Deep Blue Rub that contains wintergreen, camphor, peppermint, blue tansy, German chamomile, helichrysum and osmanthus.
Initially I’d massage him every few days, now it’s mainly just at the weekends.
At times Dervin will breathe in the smell of lavender oil for about 30 seconds and we rub it on his pillow before he sleeps. He uses the Deep Blue Rub to reduce pain throughout the day, especially on his hands and feet in the morning and his knees after soccer.
Other than massage, I have a blend of wild orange essential oil, clove, cinnamon, eucalyptus and rosemary, which we diffuse into the house as it’s said to support the immune system and purify the atmosphere.
Dervin is 6’5”, has blonde hair and green eyes, is goalkeeper of the soccer team… and some days he can’t open a soda bottle or barely walk. We spent last year exploring a variety of pain management techniques and are hopeful this Winter will be better. Why do I as a mother know the aromatherapy is working? Because a 17 year old boy will choose to pack the oils.

Dervin’s point of view
Most traumatic thing said: When we got the diagnosis, the doctor said, “Whatever you thought you were going to do with your life, you now need to know you won’t be doing anything on those feet. What do you want to do assuming you won’t be able to walk much?” I had just turned 16 years old the week before.
What effect does arthritis have on you? Not being able to move; it makes soccer and playing my instrument difficult. My hands and feet are the worst. Last year was horrible.
Did adding the aromatherapy and oils help? It has changed my life. I feel so much better. I can run faster and when I dive for a save in soccer I can get back up and my body is more responsive. Now when I play my instrument my fingers move faster and I have been able to step up my performance level.
How do you feel when we do the oil treatments? I can move better. I get a tingly feeling within a minute and then my hands move better. When I use lavender and Deep Blue at night, I sleep better and wake up refreshed and ready to go.
When my mother does the whole treatment on me everything feels lose and I can move again. All I want to do is take a nap!
What should someone look for in an aromatherapist? An aromatherapy massage should be gentle, not a hard massage. I like that it is simple enough that a family member was able to learn to do it, so it’s on tap whenever I need it.
Advice for others with arthritis? Stay out of the cold! Cold is awful. Pace yourself. Do the oils, it may sound crazy but do the oils.