September 7, 2019

Acupuncture and aromatherapy are two individual modalities that have been used for thousands of years to successfully treat a gamut of conditions and diseases. But what happens when they are combined together in one treatment? Is the treatment session more effective? Is there no difference at all? Does it merely increase patient satisfaction and comfort? I set out to answer these questions in 2011 while obtaining a doctoral degree in acupuncture and Oriental medicine. Here I will share with you what I discovered and suggest that yes, combining aromatherapy with acupuncture can make a treatment more effective. Let’s begin this discussion the same way I began my research – by asking the question: “What is something that nearly all patients complain about?” The answer is: Stress. Stress is something that affects every one of us in one way or another, especially our patients. Some may even take it further and suggest that stress is the underlying cause or root of the majority of conditions we treat. Many of us know from personal experience that we can effectively reduce stress with acupuncture treatments. In fact, this notion has been proven through multiple studies and a great deal of clinical research. But what if we add aromatherapy to an acupuncture treatment which is aimed at reducing stress levels? Will the addition of aromatherapy reduce stress even more? To determine this, I ran a clinical trial comparing the efficacy of reducing stress levels from acupuncture treatment alone to a treatment session where acupuncture was combined with aromatherapy. In the early days of gathering research for my clinical trial I was immediately surprised that I could not find a single published study or clinical trial on the combination of aromatherapy with acupuncture. Rather, I found three trials wherein acupressure was combined with aromatherapy but none where acupuncture was combined with aromatherapy. Here was an opportunity to enter uncharted territories. Selecting a study design for my trial was the next step and I chose to perform a randomized, double-blind, placebo-controlled pilot study. At the time I remember several people asking me: “How can you have a placebo when performing a trial on aromatherapy?” “You either smell something or you don’t, right?” Well, it turns out that many of the previously performed trials on aromatherapy which elected placebo controlled trial designs simply utilized spring water or alcohol as a placebo. In many of these studies saturated cotton balls were placed on the chest area near the study participant’s nose. The cotton ball either contained aromatherapy (the intervention) or spring water (the placebo). Therefore, I decided to adopt the same deliver method and water-based placebo for my trial. For the acupuncture portion of the trial, I created a point protocol that was made up of acupuncture points that had all been previously proven to reduce stress. The protocol included: Liver 3 Tai Chong, Large Intestine 4 He Gu, Stomach 36 Zu San Li and Yin Tang M-HN-3. This protocol provides a simple and effective stress reducing treatment. Next, I formulated an aromatherapy blend of essential oils, each of which had also been proven to reduce stress levels. The blend included: Ylang-ylang, rose, grapefruit, and lavender all-natural essential oils. From here I had to select study participants, preferably a demographic with inherently high stress levels. Fortunately, finding study participants was an easy task for me as I was, at the time, the off-site supervisor at an in-house drug and alcohol rehabilitation facility for women. Under my supervision, acupuncture students would provide treatments to the patients that resided at the center, many of which were court-ordered to be there, had their children taken away from them and/or were required to be there for up to 18 months. Believe me when I tell you these women had high stress levels. So, with approval from the center’s corporate headquarters, I recruited thirty (n=30) women to be study participants. I acted as the primary researcher/acupuncturist and a prior student of mine, who was subsequently waiting acupuncture licensing, was my amazing research assistant who administered the aromatherapy, conducted all the paperwork and helped me manage the trial. The thirty participants were randomly assigned to either Group A (n=15) or Group B (n=15). While all thirty participants began the six week trial and completed at least two treatments, by the end, only fourteen had completed the entire 6-week trial with Group A containing six (n=6) participants and Group B eight (n=8). High participant attrition was a reflection of participants having to appear in court or tend to sick children, thereby missing a treatment session. The trial had a strict policy that if a participant missed a single treatment session, they would be removed from the trial. Unfortunately, due to this policy and the demands on this particular participant population, we lost more participants that we had anticipated. In retrospect, perhaps a trial length of only four weeks or a study design that allowed for one missed treatment may have yielded higher outcomes. Nonetheless, we ended up having an adequate number of participants and sufficient data to provide results. Each week, for six consecutive weeks, participants came in for a 30-minute treatment session. All participants received the exact same acupuncture treatment from the same primary researcher/acupuncturist (me). Every acupuncture treatment protocol was exactly the same using these points: Liver 3 Tai Chong, Large Intestine 4 He Gu, Stomach 36 Zu San Li and Yin Tang M-HN-3. After needles were inserted, I left the room and the research assistant would come in and administer the aromatherapy by spraying the contents of either Bottle A for Group A or Bottle B for Group B on a cotton ball and placing the saturated cotton ball onto the participant’s chest near their nose. The cotton ball would remain on the participant’s chest as they rested during treatment. After 30 minutes the research assistant would return and remove the cotton ball from the patient’s chest and room before I would return and remove the needles. The rooms were aired

Like Chinese Medicine, aromatherapy has been around for thousands of years. Ancient cultures from all over the world have used various forms of aromatherapy ranging from the burning of incense to utilizing the extracted oils from various plants, herbs and flowers. These ancestors used aromatherapy because they understood the healing properties of essential oils and the aromas that come from them. This article aims to provide a general understanding of how aromatherapy works and ways in which you can incorporate aromatherapy into your practice. Since many of us are familiar with the term “aromatherapy” it is interesting to first explain where this term originated. Back in the late 1920’s, French chemist Rene-Maurice Gattefosse was severely burned in a laboratory experiment. It is said that he applied lavender oil on his burned flesh and discovered that not only did his pain and swelling reduce significantly, but the wound healed rapidly and almost miraculously. It was around this time that Gattefosse began a life-long exploration into this healing modality and coined the term “aromatherapie” (basically referring to the use of essential oils for treating the body, mind and spirit). Generally, aromatherapy can be applied in three ways: Direct application to the skin, inhalation and internal consumption. In all three scenarios the properties of the essential oils, which constitute “aromatherapy”, travel through the body and eventually go to the brain where they have both physiological and psychological effects. When applied to the skin, the essential oils are absorbed and enter into the lymphatic system, which then circulate into the blood stream, making their way into the brain. Similarly, when essential oils are inhaled or ingested, they are absorbed into the mucous membranes of the respiratory tract, lungs and/or gastrointestinal system, transferred into the blood stream, and make their way to the brain. Inhalation of essential oils also utilizes the body’s olfactory system which processes the smell, sending a signal to the limbic system of the brain. The limbic system is directly connected to the parts of the brain that control heart rate, blood pressure, breathing, memory, stress levels, the balancing of hormones and the processing of emotions and memories. For these reasons, it is evident that aromatherapy can have a very powerful effect, both emotionally and physiologically. We can also look at aromatherapy from a TCM point of view. Lavender (Lavandula Angustifolia) and Grapefruit (Citrus Paradisi), two very common essential oils used in aromatherapy, can serve as good examples. Lavender is spicy and sweet, has a cooling nature and affects the Lung, Liver and Pericardium. Two of the major functions of lavender are to promote the smooth flow of Liver qi and calm the shen. Grapefruit is spicy and bitter, has a slightly warming nature and affects the Lung, Stomach and Gallbladder. Major functions of grapefruit include regulating the flow of Liver qi and breaking up qi, food and phlegm stagnation. With their positive influence on qi, just using these two essential oils would be a good start to incorporating aromatherapy into your practice. So, now that we have a basic understanding of aromatherapy, healing mechanisms of same and two essential oils which we can start to use immediately, how can we specifically incorporate this powerful, ancient healing modality in our practice? Here are a few simple and extremely effective ways: DIFFUSERS Diffuse essential oils in your waiting/reception areas and/or treatment rooms. You can buy special plug-in diffusers designed to slowly release essential oils based on your desired strength (i.e. from light to heavy scent). You can also use a small tea-light oil/scented wax burner that does virtually the same thing without the need of electricity or batteries. ACUPUNCTURE POINTS You can place drops of essential oils onto acupuncture points prior to needling or in lieu of needling. If you chose this technique, it is extremely important that you dilute certain essential oils before doing so as some oils can burn the skin. Lavender is an example of an essential oil that is safe to place on the skin directly. SPACE SPRAY You can make an aromatherapy spray by placing drops of essential oils into a bottle (preferably dark colored glass) filled with spring water. Similar to making an herbal formula, you can chose one essential oil or create a blend based the individual make up of each essential oil and the desired therapeutic outcome. For a one ounce bottle, eight to ten drops of essential oils is sufficient. You can spray over the patient during treatment or between patients in the treatment room. EYE PILLOW Many eye pillows come infused with aromatherapy. However, if you do not possess one of these, you can easily make one by lightly spraying essential oils onto a folded Kleenex tissue and placing the Kleenex tissue onto the eyes of your patient. Instructions on making an aromatherapy spray are given above. COTTON BALL Place a few drops of an essential oil or essential oil blend onto a cotton ball and place it on the patient’s chest, near the face, during a face-up treatment. This way the patient is able to receive the aromatherapy while they are having an acupuncture treatment. If they are face down, place the cotton ball on a chair under their nose so they can receive the aroma. When the treatment is over, you can give them the patient the cotton ball to take with them, directing them to continue smelling it throughout the day. You can also give a cotton ball to patients that become extremely relaxed from a treatment and feel “out of it”. Saturate a cotton ball with a few drops of an uplifting essential oil like grapefruit and have them inhale a few times before leaving your office and have them take the cotton ball home with them so they are alert as they drive away and go about their day. MASSAGE Add drops of essential oils into your massage oil and apply to specific channels of the body or even to the UB channel where we find the