Aromatherapist Ellen Rowland takes a look at treatment strategies of inflammation with essential oils.
The complex world of inflammation
What is inflammation, and should I worry about it?
Inflammation has received a significant amount of negative press in recent years, with numerous scientific studies citing it as the biggest health threat facing humans (1) and as the “most significant cause of death in the world today” (2). But science also teaches us that inflammation is the body’s normal immune response to trauma(3,4)infection or injury, and a helpful ally in the fight against infection and disease. So which is it, friend or foe?
Acute or chronic?
The answer may not be so straightforward as we first hoped, but thankfully research that can clarify the muddied waters of inflammation and health does exist. Key to determining whether inflammation may be harmful or helpful to us is understanding the difference between acute and chronic inflammation. Acute inflammation is a natural bodily immune response to invading pathogens, injury or disease. There are a number of visual clues (known as the five ‘cardinal signs’ in ancient times (5)) which can help us detect whether the inflammatory process is happening in our bodies. These signs, which were coined by the ancient Romans and Greeks, are redness, swelling, heat, pain and loss of function (6). Most of us will be familiar with these signs – on cutting a knee, twisting an ankle or even breaking a bone, within minutes, our body – when functioning correctly – triggers them by sending blood to the injured site along with numerous cells such as macrophages which repair and protect the damaged tissue (7), and others which fight off disease, like neutrophils (8).
When inflammation gets out of hand
But what happens when inflammation becomes chronic? Recent research has shown that there are a number of environmental, social and lifestyle factors that can actually increase the likelihood of developing systemic chronic inflammation (SCI) (9). Whilst inflammation in and of itself does not necessarily pose a problem, when ongoing, it can lead to a number of diseases that “collectively represent the leading causes of disability and mortality worldwide” (10).These diseases include type 2 diabetes, hypertension, cardiovascular disease, different types of cancer, neurodegenerative and autoimmune diseases, osteoporosis and even mental health conditions like depression (11).
The wider factors at play
Chronic inflammation has a number of possible causes, including immune disorders, ongoing infection, auto-inflammatory disorders caused by cell defects and exposure to irritants, to name a few (12). However, our modern, urban environments, sedentary lifestyles, nutrient-poor diets and increasing lack of physical activity can all play a role in contributing to chronic inflammation (13) and sending the body’s immune response into overdrive, which in turn may create a “chicken-and-egg” (13) cycle of inflammation-disease-inflammation.
Prevention, treatment and lifestyle
What can we do about inflammation?
But whilst the long lists of risk factors and diseases can seem extensive and scary, there are a number of lifestyle changes we can make as individuals which can help to reduce the likelihood of developing chronic inflammation and its associated conditions. Where appropriate, making some changes to our diet, such as eating more nutrient-dense foods, increasing physical activity (within our ability), avoiding chemical irritants and environmental pollutants and maintaining good sleep hygiene can all help to prevent inflammation (14,15). However, it bears acknowledging that some communities and individuals are much better equipped to tackle public health issues such as SCI than others. Health (in)equity is an urgent worldwide concern, and social factors such as economic status have proven to have a significant influence on variations in population health and mortality rates (16).
Aromatic approaches to treating inflammation
Whilst it cannot legitimately be suggested that aromatherapy alone can cure diseases associated with chronic inflammation, it’s clear that herbal and holistic health disciplines such as aromatherapy have a key role to play in supporting us on an individual level with both chronic and acute inflammation and ultimately increasing quality of life. Increasing quality of life is something we believe should be at the forefront of healthcare priorities.
Let’s take Osteoarthritis (OA) and Rheumatoid arthritis (RA) as examples. Whilst RA is an auto-immune disease, and OA is a degenerative joint disease (17), it’s thought that it is possible for both to be hereditary, too (18,19) This would suggest that sufferers might be in a position where they are managing the effects of inflammation, rather than eliminating it completely. You can read about arthritis and herbalism here, as well as the Ayurvedic perspective here.
Indeed it may not be possible, or desirable, for everyone suffering from forms of Arthritis to eliminate the symptoms completely; constantly striving to do so may cause emotional distress. It is in the short-term ‘flare-up’ treatment (acute) and the management of ongoing (chronic) conditions that aromatherapy can play a part. There are a number of essential and carrier (base) oils that can be used in topical and inhalation blends to treat both forms of Arthritis as well as numerous other inflammatory conditions.
Treating acute flare-ups vs. chronic inflammation
During Rheumatoid arthritic flare-ups, for example, joints can become tender, swollen, and even deviate, becoming deformed (20). These symptoms can appear suddenly, causing intense pain and heat in the joint. In Osteoarthritis, inflammation tends to appear in the later stages of the disease (21), and as such, the Aromatherapist’s focus will tend to be on pain management and joint mobility.
Choosing essential oils and treatment wisely
Which method should I choose?
Aromatherapists work with many methods of application in their practice. Typically, preparations can range from inhalers to oil blends, creams to balms, aromatic soaks to sprays. It’s important to choose the most appropriate method of application to ensure the treatment is targeted to the condition, pleasant and easy to use since this will ensure effective outcomes for the patient or client. In both cases of Arthritis mentioned above, a Clinical Aromatherapist would likely decide to prepare a product for the client to use topically (on the joint itself) such as a balm, cream or ointment made from a mixture of essential and base oils. This method of application allows the active constituents in the oils to permeate the skin barrier and target the affected site quickly, whilst providing some immediate relief (for more acute conditions) through the gentle application of a soothing ointment. An ointment is an excellent choice in this case for practical reasons, too – it’s easy to apply morning and night, and can be carried in a bag or pocket when the patient is out and about. For other inflammatory conditions such as coughs and colds, another method such as inhalation might be more suitable.
Essential oils for inflammation
There are several oils that can be a useful addition to any budding aromatherapist’s natural first-aid kit. For acute inflammatory blends, specific oils indicated include those which are strongly analgesic (pain-relieving) and anti-inflammatory. German chamomile (Matricaria recutita), Lavender (Lavandula angustifolia) and Turmeric (Curcuma longa) all have strong anti-inflammatory properties (23) and can be useful additions to ointments targeting acute inflammation. For more chronic conditions, either pain-relieving (analgesic) ‘cooling’ oils such as Peppermint (Mentha piperita), or indeed ‘warming’ oils like Ginger (Zingiber officinalis) and Black Pepper (Piper nigrum) can also be combined in a blend to provide relief.
Carrier oils: therapeutic in their own right
Base oils (carrier oils) are also important additions since they both serve to dilute and blend the essential oils safely, whilst having therapeutic properties of their own. They can also aid absorption of the essential oils, which are the primary active ingredient in the product. Carriers such as Almond (Prunus amygdalis), Apricot (Prunus armeniaca) and Jojoba (Simmondsia chinensis) oil are particularly useful here. Almond oil is slow-absorbing, allowing for application of the ointment over a long period of time, which is ideal for chronic conditions. Apricot, on the other hand, is light and easily-absorbed, so ideal for fast-acting ointments. Jojoba, which is actually a wax, mimics the chemical structure of skin’s sebum, so is easily tolerated and helps balance the skin’s moisture levels (23). Carrier oils infused with a herb (macerations) are also extremely useful additions, adding another layer of therapeutic intervention to products. Particularly indicated for topical application for inflammatory conditions is St John’s Wort (Hypericum perforatum) infused oil, which has a beautiful deep-red colour.
Blending for synergy: Working holistically
Aside from targeting solely the physical symptoms which are presenting, the Aromatherapist may also consider including an oil in an anti-inflammatory blend that assists with any emotional aspects of suffering with inflammatory conditions. Both Sweet Orange (Citrus aurantium var. dulcis) and Cardamom (Elettaria cardamomum) are good anti-depressive oils, for example, and can help to uplift the spirits of the patient or client if they are suffering from stress or low mood as a result of their physical condition. This synergistic approach to treatment is one that all good Aromatherapists will take, since aromatherapy, like herbalism, tends to focus on the person and their unique situation first and foremost, and not on the presenting symptoms alone.
Inflammation as a messenger
Ultimately, if we try to look at inflammation not as a villain or harbinger of bad news and disease, but as a messenger with something important to tell us, our fear of inflammation may subside. Usually, inflammation is a sign that our body is doing its job to protect us from disease, and knowing this, we can perhaps begin to tune in to its signals and warning signs. We might decide to make changes to our lifestyle that support us with our long-term health, preventing inflammation from becoming chronic and problematic, whilst enlisting our herbal and aromatic allies to address and calm acute and chronic conditions as and when they arise.
Please note: You should always consult a qualified Aromatherapist before applying any essential oil to the skin and always dilute to the appropriate ratio before application. Never ingest essential oils, unless under the guidance of a qualified, licensed Medical Aromatherapist or Medical Herbalist.
References
- Pahwa R, Goyal A, Bansal P, et al. Chronic Inflammation. [Updated 2021 Sep 28]. In: StatPearls [online]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493173/
- Furman D, Campisi J, Verdin E et al. Chronic inflammation in the etiology of disease across the life span. Nat Med. 2019;25(12):1822-1832. doi:10.1038/s41591-019-0675-0. Available from: https://www.nature.com/articles/s41591-019-0675-0
- Oxford University Hospitals NHS Foundation Trust. Inflammatory diseases. [online]. https://www.ouh.nhs.uk/oxparc/information/diagnoses/inflammatory-diseases.aspx. Published 2021. Accessed October 21, 2021.
- Fighting Inflammation. Harvard Health. [online]. https://www.health.harvard.edu/staying-healthy/understanding-inflammation. Published 2021. Accessed October 21, 2021.
- Punchard N, Whelan C, Adcock I. J Inflamm. 2004;1(1):1. doi:10.1186/1476-9255-1-1 Available from: https://journal-inflammation.biomedcentral.com/articles/10.1186/1476-9255-1-1
- Punchard N, Whelan C, Adcock I. J Inflamm. 2004;1(1):1. doi:10.1186/1476-9255-1-1 Available from: https://journal-inflammation.biomedcentral.com/articles/10.1186/1476-9255-1-1
- Actor J. K, 2 – Cells and Organs of the Immune System, Editor(s): Actor, J.K. Elsevier’s Integrated Review Immunology and Microbiology (Second Edition), W.B. Saunders, 2012, Pages 7-16. ISBN 9780323074476, doi: 10.1016/B978-0-323-07447-6.00002-8 Available from: https://www.sciencedirect.com/science/article/pii/B9780323074476000028
- Ali O. A, Mooney D. J. 31 – Converging Cell Therapy with Biomaterials, Editor(s): Craig Halberstadt, Dwaine Emerich. Cellular Transplantation, Academic Press, 2007. ISBN 9780123694157, doi: 10.1016/B978-012369415-7/50032-6. Available from: https://www.sciencedirect.com/science/article/pii/B9780123694157500326?via%3Dihub
- Furman D, Campisi J, Verdin E et al. Chronic inflammation in the etiology of disease across the life span. Nat Med. 2019;25(12):1822-1832. doi:10.1038/s41591-019-0675-0. Available from: https://www.nature.com/articles/s41591-019-0675-0
- Furman D, Campisi J, Verdin E et al. Chronic inflammation in the etiology of disease across the life span. Nat Med. 2019;25(12):1822-1832. doi:10.1038/s41591-019-0675-0. Available from: https://www.nature.com/articles/s41591-019-0675-0
- Furman D, Campisi J, Verdin E et al. Chronic inflammation in the etiology of disease across the life span. Nat Med. 2019;25(12):1822-1832. doi:10.1038/s41591-019-0675-0. Available from: https://www.nature.com/articles/s41591-019-0675-0
- Pahwa R, Goyal A, Bansal P, et al. Chronic Inflammation. [Updated 2021 Sep 28]. In: StatPearls [online]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493173/
- Unknown. Understanding acute and chronic inflammation. Harvard Health. [online] https://www.health.harvard.edu/staying-healthy/understanding-acute-and-chronic-inflammation. Published 2020. Accessed October 21, 2021.
- Unknown. Understanding acute and chronic inflammation. Harvard Health. [online] https://www.health.harvard.edu/staying-healthy/understanding-acute-and-chronic-inflammation. Published 2020. Accessed October 21, 2021.
- Furman D, Campisi J, Verdin E et al. Chronic inflammation in the etiology of disease across the life span. Nat Med. 2019;25(12):1822-1832. doi:10.1038/s41591-019-0675-0. Available from: https://www.nature.com/articles/s41591-019-0675-0
- Mackenbach J, Kunst A. Measuring the magnitude of socio-economic inequalities in health: An overview of available measures illustrated with two examples from Europe. Soc Sci Med. 1997;44(6):757-771. doi:10.1016/s0277-9536(96)00073-1. Available from: https://pubmed.ncbi.nlm.nih.gov/9080560/
- Martin, I. Aromatherapy For Massage Practitioners. 1st ed. Baltimore: Lippincott Williams & Wilkins; 2007:212-213.
- Chen D, Shen J, Zhao W et al. Osteoarthritis: toward a comprehensive understanding of pathological mechanism. Bone Res. 2017;5(1). doi:10.1038/boneres.2016.44 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5240031/
- Bullock J, Rizvi S, Saleh A et al. Rheumatoid Arthritis: A Brief Overview of the Treatment. Medical Principles and Practice. 2018;27(6):501-507. doi:10.1159/000493390 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422329/
- Martin, I. Aromatherapy For Massage Practitioners. 1st ed. Baltimore: Lippincott Williams & Wilkins; 2007: 211-213.
- Martin, I. Aromatherapy For Massage Practitioners. 1st ed. Baltimore: Lippincott Williams & Wilkins; 2007: 211-213.
- Martin, I. Aromatherapy For Massage Practitioners. 1st ed. Baltimore: Lippincott Williams & Wilkins; 2007: 211-213.
- Martin, I. Aromatherapy For Massage Practitioners. 1st ed. Baltimore: Lippincott Williams & Wilkins; 2007: 150-157
- Wölfle U, Seelinger G, Schempp C. Topical Application of St. Johnʼs Wort (Hypericum perforatum). Planta Med. 2013;80(02/03):109-120. doi:10.1055/s-0033-1351019 Available from: https://pubmed.ncbi.nlm.nih.gov/24214835/
Bibliography
- Actor J. K, 2 – Cells and Organs of the Immune System, Editor(s): Actor, J.K. Elsevier’s Integrated Review Immunology and Microbiology (Second Edition), W.B. Saunders, 2012, ISBN 9780323074476, doi: 10.1016/B978-0-323-07447-6.00002-8 Available from: https://www.sciencedirect.com/science/article/pii/B9780323074476000028
- Ali O. A, Mooney D. J. 31 – Converging Cell Therapy with Biomaterials, Editor(s): Craig Halberstadt, Dwaine Emerich. Cellular Transplantation, Academic Press, 2007, ISBN 9780123694157, doi: 10.1016/B978-012369415-7/50032-6. Available from: https://www.sciencedirect.com/science/article/pii/B9780123694157500326?via%3Dihub
- Bullock J, Rizvi S, Saleh A et al. Rheumatoid Arthritis: A Brief Overview of the Treatment. Medical Principles and Practice. 2018. doi:10.1159/000493390 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422329/
- Chen D, Shen J, Zhao W et al. Osteoarthritis: toward a comprehensive understanding of pathological mechanism. Bone Res. 2017. doi:10.1038/boneres.2016.44 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5240031/
- Furman D, Campisi J, Verdin E et al. Chronic inflammation in the etiology of disease across the life span. Nat Med. 2019 doi:10.1038/s41591-019-0675-0. Available from: https://www.nature.com/articles/s41591-019-0675-0
- Mackenbach J, Kunst A. Measuring the magnitude of socio-economic inequalities in health: An overview of available measures illustrated with two examples from Europe. Soc Sci Med. 1997. doi:10.1016/s0277-9536(96)00073-1. Available from: https://pubmed.ncbi.nlm.nih.gov/9080560/
- Martin, I. Aromatherapy For Massage Practitioners. 1st ed. Baltimore: Lippincott Williams & Wilkins; 2007. ISBN: 0-7817-5345-7
- Oxford University Hospitals NHS Foundation Trust. Inflammatory diseases. OUH, NHS, Oxparc. https://www.ouh.nhs.uk/oxparc/information/diagnoses/inflammatory-diseases.aspx. Published 2021. Accessed October 21, 2021.
- Pahwa R, Goyal A, Bansal P, et al. Chronic Inflammation. [online] [Updated 2021 Sep 28]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493173/
- Punchard N, Whelan C, Adcock I. J Inflamm. 2004;1(1):1. doi:10.1186/1476-9255-1-1 Available from: https://journal-inflammation.biomedcentral.com/articles/10.1186/1476-9255-1-1
- Unknown. Fighting Inflammation. Harvard Health. [online]. https://www.health.harvard.edu/staying-healthy/understanding-inflammation. Published 2021. Accessed October 21, 2021.
- Unknown. Understanding acute and chronic inflammation. Harvard Health. [online]. https://www.health.harvard.edu/staying-healthy/understanding-acute-and-chronic-inflammation. Published 2020. Accessed October 21, 2021.
- Wölfle U, Seelinger G, Schempp C. Topical Application of St. Johnʼs Wort (Hypericum perforatum). Planta Med. 2013. doi:10.1055/s-0033-1351019 Available from: https://pubmed.ncbi.nlm.nih.gov/24214835/
