Overcoming Pain

Why people experience chronic pain, and the power they have to de-intensify it

Chronic Pain and Aromatherapy

Make mine Limburger.

Last week: the psychology of vaginal odor. This week: the biology of the psychology of vaginal odor.

Smell is often our earliest response to stimuli. It warns us of fires before we see flames. It keeps us from putting a spoonful of rotten food into our mouths. However, there are many exotic delicacies that smell terrible, yet taste wonderful.

Smell, like taste, is a chemical sense detected by sensory cells known as chemoreceptors. An odor stimulates chemoreceptors in the nose, and these pass on electrical impulses to the brain. Next, the brain interprets these electrical impulses, translating them into specific odors-and we thus recognize certain smells.

Interestingly, smell, perhaps more than the other senses, is exquisitely linked to the regions of the brain that process emotion and associative learning. The olfactory bulb of the brain, that which sorts sensation into perception, is part of the limbic system. The limbic system includes the amygdala and the hippocampus, both of which play a huge role in behavior related to mood and memory.

It follows that our sense of smell is in many ways more sensitive than any of our other senses. It is more immediate, at least anatomically speaking: Other senses such as touch and taste must traverse the body via nerve networks and the spinal cord before reaching the brain for final processing. But it is almost as if the brain does not want to give us too much, that it wants to keep the amorphousness of smell-as if the sensuality, or the odiousness, of this sense would just be too much for us otherwise.

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And so we must be satisfied to describe to others the smells we experience through comparisons, "like this," or "like that." With smell, never will we be able to use such exactitude as we are able with sight when we recount for others the degrees of the angles of that drawing in the latest edition of an architectural magazine. With smell, we would never be able to similarly describe with such exquisiteness the bold colors of the walls of a building, or the pastels of its window frames.

We are left with describing odors with allusions powered by things as inexact as sentimentality and anger.

How many of us have suddenly experienced the rush of emotion with unexpectedly coming into contact with the scent of the perfume of a former lover? And how many of us have become violently ill when we are confronted with the odor of a food that was around us during a particularly nauseous stage of a pregnancy?

What if we were able to channel those powerful cerebral responses into supporting the body, or at least the spirit-and thus provide healing on at least a metaphysical level? This is the goal of aromatherapy.

Aromatherapy in the modern era began in the early 20th century, when the effects of a variety of so-called essential oils (distilled from a variety of plants) began to be studied in the setting of a variety of clinical conditions. There are a variety of theories as to the mechanism of action of aromatherapy; one theory is that the limbic system of the brain is positively stimulated by these soothing smells, easing anxiety and chronic pain.

Examples of how aromatherapy is administered:
• Indirect inhalation via a room diffuser, or the placement of drops of oil nearby.
• Direct inhalation via an inhaler.
• Massaging of essential oils into the skin.
• Simple application of essential oils to the skin.

A large body of literature has been published on the effects of aromatherapy on mood, alertness, and stress, while other studies have focused on the effects of various odors on task performance, reaction time, heart rate, and blood pressure. Indeed, odors can influence mood, perceived health, and arousal, implicating therapeutic benefit of aromatherapy in the context of stressful and adverse psychological conditions.

Archaeologists tell us aromatherapy was used for pain management by the ancient Egyptians. Some of the oils considered beneficial in the treatment of chronic pain:
• Lavender oil.
• Chamomile oil.
• African marigold oil.
• Peppermint oil.
Unfortunately, robust clinical trials are lacking. Still, some studies have been undertaken in an attempt to build the foundation for further evidence-based investigation of aromatherapy in pain management.

Studies on aromatherapy have examined pain in patients in labor, chronic pain, and pain in combination with other symptoms. An article published over a decade ago theorized that aromatherapy enhanced the parasympathetic response through the effects of touch and smell, encouraging relaxation. Of course, relaxation can alter the perception of pain. The evidence suggests that aromatherapy might be at least beneficial as complementary therapy in the quest to lessen chronic pain.

More research is needed. However, as is often the case with complementary and alternative treatment modalities, financing for research is lacking. Still, this is a relatively harmless treatment; and that it might work gives added incentive to at least try it.

 

Mark Borigini, M.D., is a board-certified rheumatologist who has devoted his career to treating illnesses that cause chronic pain and disability.

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