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Aromatherapy in the Treatment of Arthritis

by Dr Vivian Lunny(more info)

listed in arthritis, originally published in issue 17 - January 1997

AROMATHERAPY is a whole system of healing, a holistic approach to health and well-being by means of aromas, scents derived from the plant kingdom. It can be described as an art and a science, which as well as having a scientific body of knowledge encompasses the intuitive, and creative aspects to preparing special individual blends.Aromatherapy utilises aromatic substances, mainly essential oils, hydrosols and most recently phytols in the various treatment formulations in a base or carrier lotion, fixed vegetable oil or cream.


A client receiving treatment

A client receiving treatment

ESSENTIAL OILS also known in the literature as etheric oils are fragrant, highly volatile (quickly evaporating in contact with air) liquids that are produced naturally in specialised glands of aromatic plants, each essential oil is a unique energetic being.

ARTHRITIS is a general term utilised to describe any inflammatory condition which affects one or more joints of the body.

There are, however, very different conditions grouped under this area, one of them, should be correctly labelled as osteo-arthritis and is due to the wear and tear suffered by joints during life, generally this type of arthritis presents itself in the elderly, and is the cause of aches, pains and stiffness mainly in the lower back, hip and knee joints. Generally the main cause of the need for hip and knee joint replacements if very severe. This type can have acute and chronic forms.

The other type is an autoimmune disease, and should be called Rheumatoid arthritis, which has a characteristic immunological profile and leads to bone destruction and to severe deformities of the hands and feet and is a disabling chronic condition

In looking at both the Holistic and the Clinical aspects of the aromatherapy management of arthritis, we will take a separate look at the two wider aspects: the first one being the assessment and aromatherapy approach to articular pains and rheumatic diseases in childhood, and second the extensive area of Rheumatoid arthritis in adults and its sequels.

Articular pains and rheumatic diseases in childhood

Rheumatic disease and arthritis in childhood are important causes of both short and long term disability. Early medical diagnosis and treatment can minimise the short and long term evolution of this condition.

When treating a child with articular pains the following points should be considered in the clinical assessment:

A joint where inflammation is present can be seen as red, swollen and is warmer than the rest of the body to the touch. If NO INFLAMMATION IS PRESENT you must consider the following:

1 GROWING PAINS: the most common and most misused diagnosis for musculoskeletal pain in childhood. True "growing pains" occur in young children peaking at four to five years of age. The pain classically occurs in the popliteal fossa and occurs only at night. Pain during the day is not due to 'growing pains'. The condition is benign and self-limited, it does not require specific medication.
The ideal recommended treatment is reassurance to the parents as well as the child together with "a gentle rubbing massage" or an aromatherapeutic bath at bedtime.

The following formulation always seems to work magically:

Essential oil of Roman Camomile (Anthemis nobilis) 2 drops
Essential oil of True Lavender (Lavandula angustifola) 3 drops
Essential oil of Rosewood (Anba rosaeodora var amazonica) 3 drops
Dissolved in a base or carrier oil of 20 millilitres of Sweet Almond.

Keep the formulation in a dark amber glass bottle, and store in a cool place, use as required, once daily, either gently massaging the affected area or place 3 or 4 drops in the child's warm bedtime bath.

2 PSYCHOGENIC RHEUMATISM: Vague joint pains and fatigue are frequent manifestations of 'psycho-somatic' disorders. The child who is unable to attend school despite a normal medical examination and laboratory tests is often demonstrating psychological distress.

Gentle holistic aromatherapy massage and bath treatments with personal formulations are very helpful to these children.

Choose your oils from the following, all of which would be beneficial:

Bergamot (Citrus bergamia), True Lemon balm (Melissa officinalis), True Lavender (Lavandula angustifola), Neroli (Citrus auranthim ssp amara), Petitgrain mandarin (Citrus reticulata) to name just a few.

From these oils the most appropriate 2 or 3 should be chosen and a 2% formulation should be blended and applied by an aromatherapist or the parents trained to carry out the treatment.

3 REFLEX NEUROVASCULAR DYSTROPHY: This represents a more severe form of psychogenic rheumatism in which the somatization has progressed and includes areas hyperaesthesia, extreme sensitivity to touch and pain, often with mottled skin colouring and vascular instability. The condition often follows a well documented injury which failed to improve. The syndrome typically occurs in 'perfect' children under excessive parental pressure to do well.

In this type of joint pains aromatherapy can provide an ideal solution, as the individually prepared formulation following a consultation, without the child's parents present, will enable the aromatherapist to address the physical and emotional aspects of the complaint.

Case history:

MICHAEL, aged 13, came to see me after an injury to his left knee which he had sustained while playing football, although the incident happened 4 weeks previously, there remained some small brownish mottled areas around the patellar region. He was a very angry young man, who although not in a great deal of pain, made the most of the injury to avoid going back to football training which he mentioned had been his mother's idea.

After a detailed consultation, the following formulation was prepared for him:

Essential oil of Spike Lavender (Lavandula latfolia) 4 drops
Essential oil of Immortelle (Helicrhysium italicum) 2 drops
Essential oil of Petitgrain mandarin (Citrus reticulata) 2 drops
Essential oil of Geranium (Pelargonium odorantisimum) 2 drops

All of the above blended in 30 ml of carrier oil made up of 20 ml of Sweet Almond oil and 10ml of Rosehip seed oil.

The treatment consisted of a full body massage with the above formulation, carried out once a week over a period of four weeks, the knee improved very quickly, and Michael still comes for his regular Aromatherapy Treatment every two months. Needless to say that the treatment has also improved his self esteem and parental relationships.

Periarticular inflammationis present

Periarticular inflammation may be the result of rheumatic disorders, but bone disorders must be excluded.

1 ORTHOPAEDIC DISORDERS: Acute periarticular pain may result from a fracture or osteomyelitis. Small children with fractures may not report trauma. An aromatherapist would only see these children by referral from the doctor and while under his care. Aromatherapy will help to heal the fracture and combat the infection, however this can only be achieved with the mutual co-operation between a clinically trained aromatherapist and the specialist physician.

2 NEOPLASTIC DISORDERS: Neoplastic diseases associated with infiltration of the bone marrow include leukaemia, lymphoma, and neuroblastoma. All may initially present with 'joint pains.' If the aromatherapy practitioner suspects the possibility of a tumor from a case history which reveals a severe weight loss, lack of appetite, enlarged lymph nodes, bone deformities or other alarm bells the child should be referred to the general practitioner, and the aromatherapy treatment carried out in conjunction with any hospital treatment, for example we know that certain blends of essential oils help with radiotherapy.

3 RHEUMATIC DISORDERS: The juvenile spondyloarthropathies often present with both articular and periarticular inflammation. The periarticular manifestations may predominate, but articular inflammation is usually simultaneously present. Lumbar stiffness and heel pain should be specifically investigated. The aromatherapy treatment is the same as the one described further on.

Articular inflammation

True articular inflammation may be acute or chronic (more than three weeks in duration).

Acute Articular Inflammation

a. DUE TO INFECTION: An acutely inflamed joint must be considered of infectious aetiology until proven otherwise. Staphylococci, Streptococci, and Hemophilus influenza are frequent causes of septic arthritis in childhood. LYME DISEASE is another frequent infectious arthritis where Ixodes ticks are endemic. These arthritides typically present with a single inflamed joint accompanied by fever and laboratory investigations which show increased erythrocyte sedimentation rates.

b REACTIVE ARTHRITIS: Reactive arthritis may accompany or follow bacterial, viral, or fungal infection. It is usually polyarticular and may be associated with fever, rash and systemic illness. Some cases of Lyme disease present in this manner.

Chronic Articular Inflammation:

a. INFECTION: Bacterial infections including staphylococcal arthritis may also present with an insidious slow onset. Children with established collagen vascular disease are not immune to developing complicating septic arthritis or osteomyelitis.

b. COLLAGEN VASCULAR DISEASES: The chronic collagen vascular diseases with findings unique to childhood include juvenile rheumatoid arthritis (JRA), Kawasaki disease.

Rheumatoid Arthritis

Rheumatoid Arthritis (RA) is an autoimmune disease that afflicts approximately 3% of the population in the U.S. and U.K., mostly women. It is characterised by inflammation of synovial tissues, with joint pain, swelling and stiffness. Although autoimmune arthritis can afflict children and adolescents, the disease usually strikes adults between the ages of 30 and 40, and the incidence of clinical illness is greatest among those aged 40 to 60 years. RA is an extremely disabling disease that carries a high mortality. Even with appropriate drug therapy, up to 7% of patients are disabled to some extent 5 years after disease onset, and 50% are too disabled to work 10 years after disease onset.

The following CASE HISTORY highlights sufferer's feelings related to their illness:

JULIE has had Rheumatoid Arthritis for 12 years, since she was 28. She finds she is entering a new level of grieving about the losses and changes in her life and finds them really tough.

"It's like it's moving from chest level to gut level, if that makes sense to you" she commented. Just when she thinks she has resolved most of those issues - the "I remember when" kicks in again. For example, yesterday was such a beautiful day and she was feeling pretty "good", so she decided to plant a few flowers in the garden. She thought she was being really careful about her joints and how she did things and it felt so good to bring a touch of spring to the garden. A few hours later, she was in major pain.

On the morning as she drove to her aromatherapy appointment she saw people walking, jogging, biking etc. and she began to remember when it was so easy for her to do those simple things most people take for granted.

She cried the first half of the session because she felt so sad. She was grieving on a much deeper level than at any time before, since her diagnosis. For the first time in years she felt safe enough to give herself permission to feel the losses and accept them as valid, not "wrong" after all this time.

The aromatherapeutic approach to Julie's treatment included diet management, with a diet free of stimulants such as tea, coffee and alcohol, extensive vitamin supplementation and specific aromatherapy formulation which was blended to her needs and adjusted as her treatments progressed.

This treatment also included a very, very gentle, almost ethereal touch and mobilisation of the affected joints, with a blend which included essential oils of: Rosemary Chemotype verbenone, (Rosmarinus officinalis verbenoniferum) 3 drops, German chamomile (Matricaria recutita) 5 drops, Geranium (Pelargonium odorantisimum) 4 drops and Yellow birch (Betulla alleganiensis) 4 drops in 30 ml of Rosehip carrier oil to which 5 ml of infused Saint John's Wort (Hypericum perforatum) have been added. This formulation has an analgesic, anti-inflammatory, calming and soothing effect on the aching, swollen joints.

A supply of this blend was also taken home for use when required in between her weekly clinic treatments.

In addition to the localised treatment with the above formulation, a relaxing, soothing, full body massage treatment proved invaluable to improve her self-esteem and keep her spirits up. The formulations were adjusted as necessary. Some of the essential oils included in the full body blends were Lemon Balm (Melisa officinalis), Rose (Rosa damascena), Black spruce (Picea mariana), Tarragon (Artemisia dracunculus) and Jasmin (Jasminum grandiflorum).

Juvenile Rheumatoid Arthritis

Children with arthritis are at risk of developing depression. As children get older or if they have a particularly active form of the disease, the risk of depression increases. "There has been some research on older children (with juvenile arthritis ) that says if they understand the meaning of their pain they are more likely to be depressed."

The symptoms of depression in these children may include excessive crying or anger, pain, isolation from other children and restriction of activities. There may be a sudden change in sleeping patterns, appetite or performance at school.

According to Kris Hagglund, a psychologist at the University of Missouri-Columbia, U.S., depression may be triggered by stressful changes, for example, if a youngster experiences a flare up in the disease, has to change schools, move house, depression may follow.

Due to its holistic approach once again, Aromatherapy provides the ideal treatment for Juvenile Rheumatoid Arthritis, however, the treatment must always be carried out in close association with the child's general practitioner. Here, as in the previous types of arthritis, the Holistic and Clinical Aromatherapy Practitioner will prepare individual formulations for each sufferer. The blend include essential oils which will have a therapeutic effect on the Psyche: to be able to help with the anxiety, depression and tension, the Physical changes, such as the inflammation with anti-inflammatory essential oils with particular affinity to the skeletal system, analgesic essential oils which will have an effect on the pain, tonifying and uplifting essential oils with an effect on the whole being, at a Physical, Mental, Emotional and Spiritual level, immuno-modulant oils, which will balance the levels of circulating immunoglobulins, thus helping the condition.

Case History

Robert, 14, was diagnosed as suffering from Juvenile Rheumatoid Arthritis 3 years ago, he has been treated with conventional medication of steroids, strong analgesics and a variety of other treatments. He was brought to see me because he was going through a particular bad patch, very depressed and with a very low self esteem and self image.

The following essential oils were used in his formulation:

Essential oil of Yellow Birch (Betula alleganiensis) 4 drops
Essential oil of Rock Rose (Cistus ladaniferus) 2 drops
Essential oil of Roman Chamomile (Anthemis nobilis) 3 drops
Essential oil of German Chamomile (Matricaria recutita) 3 drops
Formulated in 30ml of base oil made up with 15ml of jojoba and 15 ml of Rosa rubiginosa.

This formulation was used in weekly aromatherapy massage sessions for a period of 6 weeks, and at the same time a blend of essential oils of Lemon balm (Melissa officinalis), Ylang ylang (Cananga odorata) and Rose (Rosa damascena) in equal parts (2 drops of each) was diffused in his bedroom and carried as a personal blend.

The following two weeks the essential oil of Roman Chamomile was substituted by True Lavender, (Lavandula angustifolia) and the following 6 weeks blend 1 was re-instated. This treatment of 6 by 2 weeks continued for a period of 4 months and a marked improvement was achieved, his maintenance treatment continues once every 8 weeks at present.

Psoriatic Arthritis

Psoriatic Arthritis is a combination of Psoriasis and arthritis which affects mainly young females, and mostly begins in childhood. Emotional factors play an important role in this type of arthritis.

Main symptoms include dry, scaly, inflamed skin in addition to aching arthritic joints. It's a "double disorder" with double the pain and irritation. There is always severe loss of intra-articular cartilage which leads to deformities.

The following extracts from case histories of patients with psoriatic arthritis will highlight the symptoms and feelings experienced by the sufferers:

JANE has severe PA on her hands and has no cartilage left in one of her right knuckles (middle finger), she has a splint made which she wears while she is not active or when her hand is especially painful, she has in the past also tried paraffin baths. She cannot fully open her palm and can no longer play tennis, etc. because of pain/inflammation.

JUDITH, 24 years old, has had PA for 12 years and has had loss of cartilage in one finger joint. Her fingers became very painful around the age of 21. Her middle knuckle is always inflamed because she has lost the cartilage. Her neck is "very painful" but X-rays showed no evidence of damage which seems hard to believe.

JILL is 24 and was diagnosed when she was l8. She has a very positive outlook and says that "she feels that each of us is only given what we can handle, that we are given a certain burden because we are strong enough to bear it" and that somehow her experience, albeit frustrating at times, can help others, be it through understanding, listening or whatever. Pain, she says, makes me grumpy; changes me at times, but it builds character.

Jill has found that the weather, food, vitamins, and most of all her attitude affect her disease. She also acknowledges that meditation and aromatherapy treatments can overcome her pain but she does like to think that she is in charge of her own recovery.

JEAN is 36, she was diagnosed 6 years ago, at the time it caused her more annoyance than severe pain. Until this August then – MAJOR KNEE PAIN. She had psoriasis since she was 15 and knew she could get Psoriatic Arthritis but hoped she wouldn't.

She is taking indocin and prednisone and tylenol 3 when the pain is really severe. Her knees cleared up after prednisone and having lymph drainage, but her hands are the worst now. She has to wear splints on the third and fourth fingers on her left hand.

She feels that the worst is the depression that comes and goes and the not knowing how much worse it will get.

In all three ladies, aromatherapy treatments have proven a great help not only with their condition but also with their self-image and self-worth.

As previously the formulations were tailored to their individual needs, the essential oils were chosen for their healing effects on the skin, their anti-inflammatory, antiseptic and warming therapeutic properties and their analgesic and detoxifying effects.

An example of a formulation which proved particularly beneficial follows:

Essential oil of German chamomile (Matricaria recutita) 5 drops
Essential oil of Roman chamomile (Anthemis nobilis) 5 drops
Essential oil of Sandalwood (Santalum album) 5 drops
Essential oil of True lavender (Lavandula angustifolia) 5 drops
Rose hip seed carrier oil (Rosa rubiginosa) 30 ml
Hazelnut carrier oil (Corylus avellana genuina) 20 ml

This blend was applied very gently to the affected areas daily during flare-ups of the condition.

At the same time individual formulations were utilised in full body treatments which took into consideration the sufferers needs at the psychological, mental, emotional and spiritual levels.

In conclusion, Holistic Clinical Aromatherapy and its various methods of treatment has been proven to alleviate greatly the pain, distress and suffering of clients with the various types of articular disorders.

When dealing with these conditions it is very important that the Aromatherapist is fully aware of the need of working in conjunction with the specialist, and, where possible has a working knowledge of the various manifestations of arthritis.

Bibliography

Real Essences Aromatherapy & Leisure Ltd. Postgraduate training workshop notes. 1996
Lunny Associates Anatomy, Physiology and Physio pathology certificated course notes.
The International Academy of Holistic Studies Aromatherapy Diploma course notes.
L'aromatherapie exactement P.Francjhomme, D. Penouel 1990
Die aetherische ole Gildemeister und Hofmann 1962
Essential Oils Gunther 1974
Dr. Clinical Medicine Cecil B. de Mille 1967
Medicine International : Rheumatoid arthritis/Pediatric Rheumatology Conference notes 1996 Thomas J. A. Lehman MD, Cornell University Medical College
The Roger Wyburn-Mason & Jack M. Blount Foundation for the Eradication of Rheumatoid Disease
Dr. Lunny's Personal Pathology Case reports. Mount Vernon Hospital 1977-1978.

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About Dr Vivian Lunny

Vivian Nadya Lunny qualified as an MD in 1973. She specialised in Cardiology and Pathology and obtained Postgraduate Diplomas in Holistic and Scientific Aromatherapy Colour Therapy. She was awarded a Doctorate in Alternative Medicine in 1991. She is the proprietor of Real Essences Aromatherapy & Leisure Ltd. and a well known international Aromatherapy and Holistic Medicine Educator and Facilitator.
She can be contacted at: R.E.A.L. Ltd. P.O. Box 58, Stevenage, Herts. SG2 8XR, England, Tel/Fax: 44 (0) 1438 357 357. E mail: 100306.406@compuserve.com or VivianLunny@btinternet.com. You may visit her Internet site at: http://real.simplenet.com

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