Aromatherapy for pain relief

By Dr Maria Lis-Balchin

Aromatherapy is defined as “treatment using odour”. Aromatherapists massage very diluted essential oils into the body using an ordinary “carrier oil” such as almond or jojoba or olive oil as the base and adding just a 3-5% tot of the essential oil. This mixture hardly smells at all, especially when the back is being massaged! The benefit of this aromatherapeutic application is said to be the “absorption of essential oils into the body, reaching the parts that need curing, getting rid of toxins, etc.” This is in quotes as there is no scientific proof that this actually occurs.

However, there is a benefit in massaging in aromatherapy. Firstly this is through the art of massage itself, which can benefit the patient a great deal, and this has been proven scientifically. One of the main benefits is relaxation. This releases tension, which is usually caused through stress. Stress itself can cause a great number of “illnesses”, such as headaches, backaches, eczema, sleeplessness, tiredness, inability to face the world. We have all experienced stress sometime during life and stress does not decrease with age.

Pain can also benefit from the relief of stress. The use of massage alone can release endorphins, our own body’s chemicals resembling opium, thus giving chemical pain relief. The actual “hands on” experience also helps in relieving pain, as the practitioners are also often healers, and they give the patient the feeling that they care. Part of aromatherapy treatment involves listening to problems, and this can also be beneficial in releasing tension and relieving pain. Many essential oils have been shown to cause relaxation through their odour alone. These include geranium, lavender, roman chamomile, rosewood, sandalwood and valerian. Perhaps the best is valerian as it has a reputation for calming. Used at night, a drop on the pillow suffices for a good night’s sleep. Many essential oils seem to be generally stimulating; examples are basil, jasmine, patchouli, peppermint and ylang ylang. These can be used in the mornings to stimulate the brain and body. There are of course individual preferences, and a stimulating oil to one person may be sedative to the next. Odour can have a profound effect on mood and general sense of well-being. Odour can have an effect on the brain even if the person is anosmic (unable to smell), whether loss of smell is temporary or permanent.

Odour preference can however change due to illness and pain. Only the preferred odours should be used on patients, as a hated odour can have a stressful effect. Many aromatherapists insist on using their own mixtures of essential oils which they say are based on the client’s holistic symptoms. Yin and Yang, etc. This may not be the beneficial mixture for the patient. If you do not like the oils which your practitioner is using, make this clear to your practitioner at once.

Counselling is often included as part of an aromatherapy treatment, unless you go to a beauty aromatherapist who will just give you a massage with essential oils. This counselling is usually given by people who are not qualified in the field. However, they are listening to their clients - this is what clients usually want, having given up with their GPs, their 2.4-minute consultation, and the usual anti-depressant prescription handed over as soon as you sit down to explain your problems. Does it matter if your practitioner does not understand the problem, provided that the practitioner is sympathetic, wants to help and promises to make you better? This is the basis of the placebo effect. This is your will to cure yourself.

This brings us to the second use of essential oils. In this cold climate rheumatism is one of the main problems which gives rise to pain and joint restriction. The other curse is arthritis, which may somehow be connected with our diet. Both of these conditions benefit through massage and therefore aromatherapeutic massage can do nothing but good - in trained hands. Essential oils can also help in this case. Everyone is familiar with some type of embrocation fluid or cream. These products mostly smell of Vicks ointment, which itself can be used as embrocation. The smell is of menthol (from peppermint), camphor and pine, the components in the mixture, which originate from plant essential oils. These components are irritants and, when massaged into the skin, cause a local irritation as well as friction. This results in reddening of the skin, indicative of increased flow of blood near the surface. This in turn can relieve inflammation. Another possibility is the release of endocrine hormones and local hormones, for example prostaglandins which can relieve inflammation biochemically.

Natural or not - does it matter?

Aromatherapy products now appear just about everywhere. There are aromatherapy candles, shampoos, creams, bath salts, essential oils. What does this really mean? Well, the manufacturers have got onto the band wagon and are marketing the same products under a new label!

“Aromatherapy” products sell better. These products should be full of natural ingredients, but are they in reality? The answer is generally no. This again goes with the price of the product. People want cheap products, therefore they cannot have real plant products for the most part. Natural essential oils are highly priced, especially the florals, because it takes about a roomful of rose petals to make a small bottle of pure rose perfume (true essential oil). This costs about £4,000 per kilo, which makes a small 10 ml bottle cost £40 wholesale. The retail price will be higher.

The cost of the essential oils we are offered in different shops partly reflects their authenticity or otherwise. If the prices for all the oils are very similar, it points to massive dilution of the essential oils with carrier oils, whereby the profit on the less expensive diluted oils pays for the loss on the more expensive oils. If there is a vastly different price asked for different essential oils, it suggests that these are pure, unadulterated oils. The floral oils should be extremely expensive, and oils like tea tree, eucalyptus globulus, palmarosa should be very cheap. The floral oils are also usually kept locked up, due to their price. Note this is only indicative of unadulterated oils.

A good guide in assessing whether the essential oils have been diluted with carrier oil (for example, almond or olive oils) is to put a few drops on a white hankie. See if after a day or two there is an oily stain left behind. Pure essential oils do not leave a mark, as they are completely volatile. Adulteration can however be done with volatile solvents, including petroleum spirits. This is the commonest dilutant used for the extremely cheap essential oils which are sold on market stalls. These should only be used for potpourri and never on the skin.

Adulteration also involves mixing different essential oils together to give a single “named essential oil”, for example lemon oil can be orange oil plus lemongrass oil. Cheaper oils are often substituted for expensive oils, for example neroli is often petitgrain. The former should be from the flower of the bitter orange tree, whilst the latter is from the leaves - the price difference is gigantic: neroli costs about £4,000 a kilo whilst the leaf petitgrain costs just a few hundred pounds. It is not surprising that one is substituted for the other!

Many oils are now made entirely of synthetic components, which makes them “nature identicals” and much cheaper. An essential oil can be composed of about 300 different natural chemicals, but the synthetic equivalents usually contain a lot less. In fact the lemon fragrance of our many cleaning products is a single chemical which is not found in lemons.

Does this matter? Yes, if one uses the essential oils as medicines. By law these must be pure, and contain exactly what is given in the formulation. But does it matter if the essential oils are used as odorants? Yes, if they contain chemicals which may prove toxic to the skin or cause asthma or other reactions.

Safety and toxicity of essential oils

All essential oils can be toxic if used in large amounts. In fact in Australia, a few essential oils, for example tea tree oil, are sold with a POISON label. This labelling will probably come to this country soon through EC regulation.

It is disconcerting that many aromatherapists who are not medically qualified, are starting to practise internal medicine using essential oils by mouth, rectum and the vagina. Beware of these people. Essential oils should be used internally only if prescribed by a medically qualified practitioner (aromatherapy practitioners in Europe, but not the UK, have to be medically qualified).

The oils used internally must be pure, uncontaminated by any adulterants which could make them more toxic and their action unpredictable. Some essential oils and their components are already used as propriety medicines, examples are Colpermin, a peppermint oil capsule used for irritable bowel syndrome; also Rowachol and Uroterp, used for breaking down gallstones and ureteric stones. They are sold under licence after clinical trials have shown that these products actually work for a large number of people. Aromatherapists using essential oils internally are doing so without clinical trials and under no licence.

Skin toxicity

Many citrus essential oils in particular contain certain chemicals which if put on the skin prior to exposing it to sunlight or “sun-bed” equivalent, can cause the skin to redden and exhibit signs of severe sunburn. These citrus oils, including orange, lemon, grapefruit and bergamot, are obtained by squeezing the skin of the fruit. The furanocoumarins, the chemicals responsible for the sunburn, can be removed, and oils obtained by steam distillation are free of this component.

Allergy

There have been increasing problems with allergic asthma and allergic dermatitis over the years, caused by chemicals. There is strong evidence that allergic dermatitis can be caused by essential oils, even after they have been removed from the house, if the oils have penetrated into the flooring and furnishings. Most people will be able to enjoy essential oils without experiencing any allergic reaction, but if you do experience a reaction to any oil, stop using it immediately and dispose of it carefully.

Adulteration — does it really matter?

If aromatherapy is strictly a science based on smell, adulteration of oils may not be very important provided the odour remains the same. The way odours work is said to be through their imprint on the special nerve endings of the mucosa in the nose, the response then travels into the ancient part of the brain, the limbic system, which represents our feelings rather than our logic (which is represented by our large cerebral hemispheres). We are therefore unknowingly influenced by certain odours, which may have very distant associations with past experiences which we have forgotten.

Use in psychotherapy and psychiatry

Using essential oils in psychotherapy may therefore seem very plausible, but again care must be taken. For example, in older people, especially those with Alzheimer’s disease, these therapies must be in the right hands, and there must be counselling throughout by specialists. People may be subjected to odours which bring back terrible memories which have luckily been forgotten with time. The effect on the patient could be devastating.

Clinical tests carried out with epileptic patients by a neuropsychiatrist, using essential oils as a new accessory, proved very valuable in reducing the incidence of fits for many epileptic patients. Again this type of therapy must be supervised by medically qualified specialists.

Essential oils as antimicrobial agents

The only scientific studies on the activity of essential oils seem to be those on their anti-bug properties. I have contributed to those myself. Many, but not all, essential oils have a very strong action against bacteria and fungi. They have in fact been used for centuries to kill nasty bugs. During the Plague, doctors and helpers wore a “beak” stuffed with cotton wool which was impregnated with essential oils. In the Second World War, Australian forces were issued with tea tree oil as their basic first aid. Today this essential oil has regained popularity as an antimicrobial agent. It is especially effective against athlete’s foot and this might relieve some pain. Just try a few drops and the fungus disappears by next day.

Using aromatherapy for well-being

By all means have an aromatherapy massage, provided you can afford it. Use essential oils in the bath - a few drops of your favourite gives you a great feeling of well-being. Use other essential oils as perfume, or if cheap enough, as disinfectants (for example, geranium oil).

Above all, enjoy the scent of the oils you like — this is true aromatherapy. This is perhaps the basis of pain relief. The real feel-good factor. Try out some odours, for example geranium oil, which is called the poor man’s rose. This is my personal favourite. I never go without it, although I sometimes add some pure rose attar on special occasions.

In conclusion, get some nice essential oils, put a few drops in the bath, some drops on your pillow, some drops on your clothes — and heal yourself.

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• Dr Maria Lis-Balchin is a senior lecturer at South Bank University where she has pioneered a unit at B.Sc. degree and Master’s Level in the science of Essential Oils and Aromatherapy. This unit is incorporated In the B.Sc. in Complementary Therapies for nurses. She is author of Aroma Science: The Chemistry & Bioactivity of Essential Oils, published by Amberwood.
  
• Essential oils can be purchased by post from Butterbur & Sage,
  7 Tessa Road, Reading RG1 8HH, tel. 01189 505100. Price list available.

© Maria Lis-Balchin. All rights reserved.