TREATING FIBROMYALGIA WITH AROMATHERAPY
By SHELLIE ENTEEN, BA, LMT

In the early 90´s, I was working as a licensed massage therapist at a five star resort in Florida. People from all over the country and all over the world came in for massage. After a few years, I began to be told with greater and greater frequency, "My neck and shoulders are hurting, but please be gentle with me because I have fibromyalgia." "Fibromyalgia!?" I thought. I had been a massage therapist for over ten years at that point, trained at the clinically focused Swedish Institute in New York. I taught a continuing education class for massage therapists in pathology at the Community College. It was a big surprise for me to begin hearing about a new diagnosis.

The word itself told me “pain involving muscle and connective tissue.” But why was that any different from the kind of muscle pain I saw every day? Naturally, I asked these clients what this condition implied for them and then I began to see articles about fibromyalgia in the trade publications for massage and to hear about it from other therapists. Still, the criteria for diagnosis and the implications for treatment were not very precise at this point. I began to formulate my own theories and offer my own combination of gentle massage with aromatic essential oils. I also referred several clients to an herbalist from New Mexico after I attended his presentation at an American Massage Therapy Association convention because he had a formula specifically for this condition called “FM.”

Most of my clients at the resort were ‘just passing through,’ but the one fibromyalgia sufferer I had at the time who was a regular, local client was able to stop her anti inflammatory and pain relief medications with this regimen.

On the website for the National Fibromyalgia Association, www.FMaware.org, we are told that:

“Fibromyalgia (FM) is an increasingly recognized chronic pain illness which is characterized by widespread musculoskeletal aches, pain and stiffness, soft tissue tenderness, general fatigue and sleep disturbances. The most common sites of pain include the neck, back, shoulders, pelvic girdle and hands, but any body part can be involved. Fibromyalgia patients experience a range of symptoms of varying intensities that wax and wane over time.

FM is characterized by the presence of multiple tender points and a constellation of symptoms.

Pain The pain of FM is profound, widespread and chronic. It knows no boundaries, migrating to all parts of the body and varying in intensity. FM pain has been described as deep muscular aching, throbbing, twitching, stabbing and shooting pain that defines the very existence of the Fibromyalgia patient. Neurological complaints such as numbness, tingling and burning are often present and add to the discomfort of the patient. The severity of the pain and stiffness is often worse in the morning. Aggravating factors which affect pain include cold/humid weather, non-restorative sleep, physical and mental fatigue, excessive physical activity, physical inactivity, anxiety and stress.

Fatigue In today´s world many people complain of fatigue; however, the fatigue of FM is much more than being tired. It is an all-encompassing exhaustion that interferes with even the simplest daily activities. It feels like every drop of energy has been drained from the body, which at times can leave the patient with a limited ability to function both mentally and physically.

Sleep Problems Many Fibromyalgia patients have an associated sleep disorder which prevents them from getting deep, restful, restorative sleep. Medical researchers have documented specific and distinctive abnormalities in the stage 4 deep sleep of FM patients. During sleep, individuals with FM are constantly interrupted by bursts of awake-like brain activity, limiting the amount of time they spend in deep sleep.

Other symptoms Additional symptoms may include: irritable bowel and bladder, headaches and migraines, restless legs syndrome (periodic limb movement disorder), impaired memory and concentration, skin sensitivities and rashes, dry eyes and mouth, anxiety, depression, ringing in the ears, dizziness, vision problems, Raynaud´s syndrome, neurological symptoms and impaired coordination.

How is it diagnosed?
Currently there are no laboratory tests available for diagnosing Fibromyalgia. Doctors must rely on patient histories, self-reported symptoms, a physical examination and an accurate manual tender point examination. This exam is based on the standardized ACR criteria. Proper implementation of the exam determines the presence of multiple tender points at characteristic locations.

It is estimated that it takes an average of five years for a FM patient to get an accurate diagnosis. Many doctors are still not adequately informed or educated about FM. Laboratory tests often prove negative and many FM symptoms overlap with the symptoms of other conditions, thus leading to extensive investigative costs and frustration for both the doctor and patient. Another essential point that must be considered is that the presence of other diseases, such as rheumatoid arthritis or lupus, does not rule out a FM diagnosis. Fibromyalgia is not a diagnosis of exclusion and must be diagnosed by its own characteristic features.

To receive a diagnosis of FM, the patient must meet the following diagnostic criteria:

· Widespread pain in all four quadrants of the body for a minimum duration of three months
· Tenderness or pain in at least 11 of the 18 specified tender points when pressure is applied

What causes FM?

While the underlying cause or causes of FM still remain a mystery, new research findings continue to bring us closer to understanding the basic mechanisms of Fibromyalgia. Most researchers agree that FM is a disorder of central processing with neuroendocrine/neurotransmitter dysregulation. The FM patient experiences pain amplification due to abnormal sensory processing in the central nervous system. An increasing number of scientific studies now show multiple physiological abnormalities in the FM patient, including: increased levels of substance P in the spinal cord, low levels of blood flow to the thalamus region of the brain, HPA axis hypo function, low levels of serotonin and tryptophan and abnormalities in cytokine function.

Recent studies show that genetic factors may predispose individuals to a genetic susceptibility to FM. For some, the onset of FM is slow; however, in a large percentage of patients the onset is triggered by an illness or injury that causes trauma to the body. These events may act to incite an undetected physiological problem already present." (For more information on fibromyalgia, please visit the website.)

Essential oils have a long history of treating pain, insomnia, headache, digestive and urinary tract symptoms, skin rash, anxiety and depression. Proposed causes that include dysfunction involving neuroendocrine/neurotransmitters, blood flow to the thalamus, levels of serotonin and tryptophan, certainly bring fibromyalgia into the territory where essential oils are known to operate.

Lynne K. Matallana, President of the NFA has said, "The National Fibromyalgia Association (NFA) suggests that individuals who suffer with the symptoms of fibromyalgia implement a self-management program which incorporates both western and complementary approaches to health care. Some people with FM are very sensitive to medicines and prefer to use more natural health care options. Dealing with the constant pain and fatigue of fibromyalgia can be quite stressful and finding ways to help relieve stress can also help to reduce the overall symptoms of this chronic illness. Since fibromyalgia involves an increase in neurological sensitivity, both physically and emotionally, practices that are calming can bring a sense of relief. To accomplish these goals, we suggest Aromatherapy alone or in combination with massage and other relaxation techniques. The use of fragrant herbs or oils can help promote sleep, calm the mind, decrease muscle pain, increase circulation, relieve headaches and promote a general sense of well being. To find credible information on Aromatherapy, you can contact NAHA (National Association for Holistic Aromatherapy, www.NAHA.org.)"

When the National Fibromyalgia Association asked NAHA if they would prepare an article on the use of Aromatherapy for the treatment of fibromyalgia for their publication, "Fibromyalgia AWARE," it seemed like a great opportunity to interview some of our NAHA members to get their point of view and methods of treating Fibromyalgia with essential oils.

NAHA Directors who were interviewed for this article are Cheryl Hoard, Joyce I. Benoit, Rhavda Cooper Emison, Kelly Holland Azzaro RA, CCAP, LMBT, OCN, FAAIM and Jillian Alexander-Gregory. In a serendipitous way, these professional Aromatherapists represent different areas of focus in their individual practice that encompass herbology, psychology, oriental medicine, massage, and other healing arts. I asked each of them to comment on four questions. Their answers, edited for length, are conveyed below:

Question one: Do you feel Aromatherapy has a place in the treatment of Fibromyalgia and if so, what do you believe is the benefit of using essential oils on this condition?

Cheryl: "There are many natural remedies for pain and inflammation. I know of one person with Fibromyalgia who experiences great pain relief from body wraps using herbs and essential oils."

Joyce: "Yes, Aromatherapy has a strong place in the treatment of Fibromyalgia. The benefit is not only physical but to assist each individual emotionally."

Rhavda: "I do feel that aromatherapy works well with dealing with fibromyalgia if the person is ready to work with alternative methods and is ready mentally to work with you. I think it is best to use essential oils along with aged herbal infused oils."

Kelly: "Yes. The benefits are numerous. Inhalation can assist emotional imbalance, topical application can help reduce pain, swelling, inflammation and increase circulation and blood flow. Essential oils can be added to bath salts for bath or foot soak to reduce swelling and inflammation as well as create time to clear the mind and rejuvenate the body. The Mind Body Spirit connection that exists with essential oils can help people with fibromyalgia who feel overwhelmed by their many symptoms. Having an Aromatherapy oil to carry and inhale during the day is a gentle but powerful tool."

Jillian: "The benefit is the very essence of Aromatherapy, the way essential oils work on more than the body. Aromatherapy eases the physical discomfort while dealing with the underlying factors that keep the symptoms of FM active. These factors include the shock or initial trauma that brought on the FM. In the case of all persons with FM whom I have observed, an experience of extraordinary trauma, sometimes more than one type in a week, precedes the manifestation of symptoms. Sometimes the person doesn’t attribute the symptoms to the trauma until we look at their complaints from this point of view."

Question 2: Do you have favorite blends for use on fibromyalgia? Would you share those with us?

Cheryl: "Useful essential oils are Thyme Linalool, Peppermint, Spike Lavender and Helichrysm. Blending the Spike Lavender with the Peppermint and Helichrysum would create an anti- inflammatory synergy. Add Thyme Linalool and dilute with St. John´s Wort oil and you have an anti-inflammatory muscle pain reliever. Recent studies have proven that herbal preparations of Ginger are effective for pain and inflammation. I know people who take the herb Clove internally for pain relief. Other recommended herbs are Feverfew, Turmeric, Black Cohosh, Cayenne and external applications of Comfrey Root and Leaf."

Joyce: "I use Rose Otto a lot, depending on how long the client has buried this trauma. It works wonders on the heart while we are working together. I send the client home with a synergy of Elemi, Lavender and Frankincense. I also like these blends: I drop Rose Otto, 3 drops Frankincense, 3 drops Sweet Marjoram, and 6 drops of Petitgrain in Jojoba Oil.
10 drops Mandarin, 7 drops Lavender, 4 drops Juniper Berry in Grapeseed Oil. And this one was used on the feet of a client with no motivation, low concentration, anxiety and depression: 4 drops Ylang Ylang, 3 drops Tangerine, 3 drops Rose Geranium, 6 drops Sandalwood, 1 drop Neroli in Grapeseed Oil."

Rhavda: "When blending I look at the client´s lifestyle, psychological needs, age, diet and exercise levels. Infused oils of Melissa, Oatstraw and Chaste Berry are my best helpmates in winning battles with fibromyalgia. Melissa will put a virus into remission and Oatstraw and Chaste Berry sooth nerve endings. To this I will add essential oils of Lavender, Geranium and three to five others depending on the client’s needs."

Kelly:"Yes I have lots of blends but one of my favorites is a formula for pain and arthritis. It also works well for people who have cold hands and feet and poor circulation: 7 ounces Grapeseed Oil, 1 ounce Tamanu Oil, 25 drops Vitamin E, 10 drops Lavender Spike, 10 drops Ginger, 6 drops Black Pepper. I also make specific formulas for each individual and a basic blend to use at home and while traveling. The oils I find most helpful are: Lavender, Lavender Spike, Ginger, Black Pepper, Lemongrass, Roman Chamomile, Sweet Marjoram, Juniper, Helichrysum, Ylang Ylang, Sweet Orange, Grapefruit, Bergamot, Patchouli and for Mind and Spirit, Frankincense and Lemon."

Jillian: "I have two blends for FM, one for the shock and one for the heat, pain and nerve sensations. The shock blend is a pure synergy for topical application to the heart chakra and navel area and I include Helichrysum, Rose and or Jasmine, Roman Chamomile, Neroli and Tangerine. Helichrysum unlocks cellular memory, Rose/Jasmine eases the heart, Neroli nurtures and protects the shocked being, and Tangerine (or other citrus) is for joy. If the person is really angry, I add Ylang Ylang, but it is the Helichrysum and Neroli who are the major players in the healing. To cool and calm hot hands and feet and deal with the short circuited nervous system, I blend High Alpine Lavender, a gentle European Peppermint and Roman Chamomile in an Aloe Vera gel base."

Question 3: Can you give a brief description of a case study using essential oils for fibromyalgia?

Joyce: "The Client that comes to mind is Jane, a petite, 42 year old woman, married with two daughters in college. She was raped at home while her daughters were away at college and her husband was on a business trip. She said this was a painful time for everyone. She relied mostly on the eldest daughter for support when her husband was away. When I met Jane, her physician had recommended a counseling group but she never attended. We had several sessions at which time I was able to make a few blends for her. Her response was good, but not consistent. She stopped therapy after several sessions. Her containment of emotions overcame her attempts to heal and she has continued to be seriously ill, with many ailments along with the fibromyalgia."

Rhavda: “I had a client back in the mid 1990’s when we still did not have much information on FM and I learned right along with her. I learned that most conventional treatment doesn’t work that well and that the information we had as aromatherapists was exceedingly limited. She developed fibro after going through a divorce. She had been married over 40 years and her husband had walked out. She was in so much pain that she literally had to quit her job as a teacher and go on welfare. I do believe that stress had set off her fibromyalgia. I started working with her at this point. I tried the traditional pain relievers with little success. So I turned to a combination of the Oatstraw and Chaste Berry. To this I added Helichrysum, Melissa, and Rose infused oils along with essential oils of Juniper, Rosemary, Lavender and Peppermint. We played with this combination and many others until we achieved relief for her pain. After achieving pain relief she was able to return to work and heal. Then she moved to Georgia and I have lost contact with her. She worked with me for about three years before moving to Georgia.”

Kelly: “My client was a 42 year old female, married with no children. Her symptoms were headache, menstrual pain, sleep disturbance, pain, mainly in the low back area and stress. She had been experiencing her symptoms for approximately three years. She said she had a very stressful job as well as painful menstrual periods all her life. She spoke very fast, exuded a hyper energy, never waiting to hear the answers to her questions.
A blend of essential oils was applied during full body massage which focused on neck, shoulders, back and feet. She was given a Lavender inhalation during her acupuncture treatment. Her blend was 2 drops Lavender, 4 drops Sweet Orange, 4 drops Clary Sage in Coconut and Tamanu Oil. She was given the same blend for home use.
The client reported that she felt no anxiety or stress after these treatments and on the night of her treatments she slept better than ever. Her pain level had dropped from a reported 8 out of 10 to a 3.
She continued with the blend at home, applying it to her neck, shoulders and feet and using it in a warm bath before bed. Her quality of sleep improved and continued to do so even without any treatments. Her periods are not as painful and her headaches are not as frequent or painful as before using the aromatherapy blend.”

Jillian: The client was a female psychologist in her early 50’s who complained of debilitating pain, hot and tingling hands and pain at the site of the FM tender points. During the consultation, she revealed she had lost her mother and had a serious car accident in the same week. The FM symptoms began to appear several weeks after the accident and had continued through the year with varying intensity.
I used the following blends: to 1 ounce of Aloe and 1 ounce of neutral cream, I added 18 drops Helichrysum, 10 drops Lavender, 5 drops Tangerine, 3 drops Rose, 3 drops Neroli and 2 drops of Frankincense. To 10 ml of Aloe Vera gel I added equal parts of Lavender, Chamomile and Peppermint, which she was to apply to her hands and other hot spots.
She used the first batch and said there was little change and she was rather frantic as she had hoped aromatherapy would be a magic bullet to cure her. I assured her that time and patience would be her best healers. She did report that the peppermint blend helped with the heat and tingling in her hands.
I doubled my efforts with blend number one, putting 30 drops of Helichrysum, 15 drops of Lavender, 8 drops of Neroli 5 drops of Tangerine, 3 drops of Rose, 3 drops of Jasmine in one ounce of Aloe Vera gel and one ounce of neutral cream. The Peppermint synergy stayed the same. After this second batch, her symptoms abated to a point where she couldn’t decide if she actually had FM anymore. She said she would call if the symptoms returned, but she never called.
This gradual healing has happened repeatedly in my experience with FM clients.”

Question 4: Do you have any personal ideas about the condition itself…its genesis and nature or anything else you would like to add?

Joyce: “My personal and professional opinion about Fibromyalgia is not restricted to this condition but pertains to most disease, I believe. We do get ill, and it is very difficult to manage because we are a society of instant gratification and we seldom make the time to reflect on how we “feel” about the present circumstance, which may serve to exacerbate illness of all types. I believe that when those of us that have an illness can ‘honor’ the feelings that accompany the disease, we will find that we are better equipped to manage the disease overall.”

Rhavda: “I think that fibromyalgia, along with chronic fatigue syndrome, mononucleosis, multiple sclerosis, are immune system disorders that are in the genetic code, passed through the mother if she marries a man with this in his genetic code, and appear in families. Factors that encourage the symptoms to manifest are a stressful lifestyle and psychological needs.”

Kelly: “At our holistic healing center we look at each person as an individual. The client’s list of symptoms and complaints are evaluated as a whole picture, along with their professional and personal life, diet, activities and lifestyles. We do not feel that they can be separated into syndromes.
I personally feel that if you palpate the “FM points” on a large group of people you may be surprised to find that each one would most likely have these “sore points.” Does this mean that the entire group has fibromyalgia? I doubt it. In individual consultation, you would probably find other causes and reasons for the soreness. Almost everyone that I know has some type of stress factor going on in their life and experiences some kind of trickle down effect from that stress. These symptoms could be easily addressed with many natural alternatives before they escalate to dis-ease and dis-harmony.
I also feel that disease and disorder can come from an emotional blockage. For over three thousand years, Traditional Chinese Medicine has addressed individuals based on a pain concept that says where there is a blockage in the chi or body’s energy areas (meridians) there can be pain. Remove the blockage and allow the chi to flow and the body can heal itself. These blockages can be caused from physical, emotional or spiritual traumas. When we address the cause of the blockage, healing can begin on each level, balancing body, mind and spirit. Many alternative therapies can be used alone or in combination with the client’s allopathic care as long as it is not contraindicated.”

Jillian: “I believe that this kind of condition is an accumulation of stress, a life crisis and a cry from the spirit of the person to deal with deep grief and loss. It is created out of all of the deep issues of loss: grief, anger, denial, bargaining. However, the onset of symptoms is, from my point of view, created by a current trauma: car accident, death, sudden break up of a relationship or loss of a job. It seems that FM stands as a deep nerve response to the shock or trauma of the incident happening in the life of the person. It is like the trauma comes to live and remains in the body, in a set pattern, until the pattern is broken up and released. I only look for the spiritual and emotional issues because, for me, the physical manifestation is the fire and smoke. I look for the burning logs. Aromatherapy is a physical vehicle to speak to the emotions and spirit within the person. When the person looks at what their body is telling them and listens, the healing has begun. I honor anyone who decided to learn more about themselves through the experience of a dis-ease. Pain is an extraordinary teacher.”

Reading the responses of my fellow Aromatherapists, I realized that I could relate my own practice experience to most of what they said. The client of mine who had the success with herbs and gentle aromatherapy massage was a single woman in her early 40’s whose job was intensely stressful and whose life was full of financial issues. She was a high strung personality, fast talker, very fastidious about her appearance. She told me her symptoms began after a car accident where she was rear-ended. She also told me that there had been emotional and physical abuse in her early childhood, a disappointing early marriage and many subsequent years with no romantic life. For these reasons, I gravitate to the use of Frankincense, Mandarin, Helichrysum, Lavender, and Rose. Marjoram and Chamomile might also be included for relaxation and pain relief and especially if there is insomnia or inflammation.
Like Kelly, I have studied an oriental healing modality, Jin Shin Jyutsu, and was fascinated to discover the FM tender points are almost all directly on the Jin Shin Jyutsu ‘Safety Energy Locks’ which are like the meridian points in acupuncture. In this philosophy, the energy locks are also located on the flows of the twelve organ energies and imbalances on these flows all are associated with a disharmious emotion or attitude: worry, fear, anger, grief and over effort or pretending.
I agree that the pain and suffering of the person who is experiencing fibromyalgia is very real and can be severely debilitating. I have read recently of studies that are attempting to find a medicine that will block certain enzymes or chemicals that are associated with the pain in the FM list of symptoms. But I wonder if blocking the body’s ability to express is the way to go or if, despite any symptom relief it might provide, that will just create the need for other pathways for the disharmony to manifest. I would, and I believe my fellow Aromatherapists would agree with me, strongly suggest that anyone who has the variety of symptoms associated with fibromyalgia seek the assistance of a well trained holistic practitioner who is well versed in the use of aromatic essential oils and herbal formulas. To add this dimension to a team effort that includes medical consultation, holistic practitioners such as Chiropractors and Acupuncturists and psychological and spiritual counseling might be the key to unlock fibromyalgia and the way for FM sufferers to lead to a fuller, happier life.


Author: Shellie Enteen, BA, LMT, is a southeast Florida Regional Director and has served as Secretary on NAHA’s Board of Directors. She can be reached through her website, www.astralessence.com

Cheryl Hoard, Past President of NAHA and owner of Cheryl’s Herbs, can be reached at can be reached at 314-963-4449 or through her website www.cherylsherbs.com

Joyce Maclaughlin can be located at heartsropen@yahoo.com

Rhavda Cooper Emison, Texas Regional Director for NAHA can be reached at sos79@earthlink.net

Kelly Holland Azzaro, RA, CCAP, LMBT Vice President on the NAHA Board of Directors, is the District Director for the Southeast States. She can be reached through her website www.ashitherapy.com or 828-898-5555, Ashitherapy, PO Box 1858, Banner Elk, NC 28604. Ashi Therapy ™ and Ashi Aromatics Inc.™

Jillian Alexander-Gregory, NAHA Regional Director, California, Holistic Beauty, Healer, Teacher, Author, can be reached at 877-386-1688 or through her website www.jagbeautyistruth.com