By Anita Kalnay, RA®, EOT®

What kind of clients are you attracting as a practitioner? 

Often those are the exact clients that become your teachers and, in fact, I have learned everything from my clients as a practitioner over the years. 

Recently, I had a request to explore how aromatherapy might fit into the management of osteoarthritis and osteoporosis. Which is very interesting because I am dealing with just that myself and at the beginning stage of figuring it all out! 

According to a recent CBC interview, 20% of our population will soon be over the age of 60. Also during the COVID period, almost all of my female clients and many friends were complaining about right-hip issues and pain, including me!

Because I love Ayurveda I decided to take Intermediate/Advanced Ayurveda, Osteoporosis (2) by KP Khalsa (1), a well-known herbalist, Ayurvedic practitioner and teacher as part of additional CEU credits.

It was insightful in understanding the slow progression of the disease itself and the possibilities for alleviating pain and encouraging the natural healing process. 

Some of the basics

Understanding Bones

There are 206 bones in the human body, making up 70% of our body mass! 

Bone is a living tissue, constantly being remodelled. It is the mineral bank for the body, storing minerals as they come and go. Blood mineral content does not change, remaining stable. However, blood draws its minerals from the bone, and that’s what changes! 

Osteoporosis is when the body loses too much bone, makes too little bone, or both. As a result, bones become weak and may break from a fall or even from sneezing or a minor bump. 

My client reported over-exercising as the cause of her thigh and joint pain, which affected her much loved ability to dance! She attributed her issues to osteoporosis. 

The Three Main Elements in Bone Are Earth, Air and Water

Earth is the dominant element, or kapha. Air is the dominant dysregulation or, in Ayurveda, the vata type. Bones are 80% earth and 20% air as they are porous.

Vata

The natural home of vata is the air/space element and includes the large intestine, pelvis, thigh, ear, bone and skin. 

This was a cue to linking the hip conditions I observed with accompanying low back pain to osteoarthritis and osteoporosis. Osteoarthritis being a degeneration of the tissue around the bones. 

Good bones are strong and stable like the kapha earth/water constitutional type, including good teeth and nails. Psychological kaphas are also forgiving and hard working. 

And interestingly the pitta or fire/oil types rarely get osteoporosis as they are more inclined to -itis types of issues, e.g. rheumatoid arthritis and other inflammatory conditions.

In Ayurveda there are always three causes for every type of disease to consider—vata, pitta or kapha. Each requires a different approach to food, lifestyle patterns, and treatment including the use of aromatics and herbs. 

Often osteoporosis that is in the later stages can be complex and tridoshic to treat. The idea is to plan for 20 years ahead, meaning when you are 40, begin preventive maintenance. 

Is osteoporosis curable? 

No, but according to Khalsa, that does not mean it is not treatable. 

Who gets osteoporosis?

Usually someone in their later or vata years. Post-menopausal women also report increases in bone-density loss. Secondary characteristics of bone-density loss can also include loss of hair and public hair. And the most characteristic symptom to look for might be bluish colour of the sclera or white area surrounding the eye. A bluish colour surrounding the iris can be an indicator of osteoporosis.

Characteristically, “Caucasian American women over 50 with blue eyes have more chance of a healthy skeleton slipping away every year.”(3) Black women luck out as they typically have greater bone density. 

In looking at inheritance, Ayurveda suggests that all hard things in the body are inherited from the father, e.g. bones, while all soft tissue is inherited from the mother. 

Treatment Options

Prevent osteoporosis by getting a bone density test. With treatment, it takes about five years to notice improvement and can only be tested with bone-density testing. Osteoporosis itself does not cause pain, but rather it is the falls and injuries that cause the pain.

Excessive Vata Causes of Osteoporosis

Anyone can score as excessive vata. Our lifestyle routines such as diet, sleep, our jobs and family responsibilities, how we spend our leisure time, the hobbies we do and the friends we keep are all part of our cumulated lifestyle patterns. 

Vata’s main pattern is irregularity. Vatas are consistently inconsistent! Some people have a vata dosha or constitutional birth type, while 70% of disease can be attributed to vata imbalances in any type.

Experiencing 30 years of excessive vata lifestyle and diet can cause us to wear down. Also recent disruptions that shift our routines can bring on vata dysregulation. All of us have been challenged with several years of COVID disruption and many are still in active transition between what was and what is now.

Signs of excessive vata include:

• Diet: irregular eating times; food that is dry, rough, cold, light, small quantities, pungent, bitter
• Excessive fasting
• Excessive physical exercise including jumping, jogging, flying
• Not enough sleep and staying up late
• Excessive sexual activity
• Suppression of natural urges, e.g. dry constipation
• Stress, worry, anxiety, trauma
• Fall or cold season, gusty winds, cloudy, dry

In the later stages of vata dysregulation:

• Spasms, tremors or ticks
• Nerve diseases such as fibromyalgia 
• Severe dehydration, emaciation, osteoporosis, tissue degeneration, constrictive asthma, epilepsy, coma

Main areas affected:

• Joints and bony tissue, especially the pelvic area
• Loss of teeth, hair and brittle nails
• Fatigue, joint flaccidity, bone pain (from wear)
• Dry rough skin 
• Cracking of teeth and nails
• Herniated discs
• Tingling and numbness
• Sciatica that radiates down the leg
• Low back ache relieved by pressure or support

Vata excess results in thinner and more fragile membrane health, including the membranes that surround the bones. 

As bone mass decreases:

• Teeth fall out
• Fractures can be caused by movement, falls or even sneezing

Vata, Sub-doshas

Vata is divided into sub-doshas, which indicate the flow of the energy movement itself and where it might be restricted or compromised, much like a river with a dam or obstruction. These are called sub-doshas. Treatments such as acupuncture and TCM also consider these in balancing the flow as part of their treatment modalities. 

Since air is the central force in vata, that air can flow in different directions. These directions create the sub-dosha categories. And air requires unrestricted flow. 

Prana vata, located in the head, air/energy that moves in a downward flow including the breath and food/digestion. Symptoms of dysregulation can include: anxiety, fear, anger, stroke and breathlessness.

Udana vata, located in the chest, air that flows upwards, air that propels out of the body, e.g. exhalation, burping, nausea, vomiting. Symptoms of speech disturbances such as stuttering, muttering, memory loss, directionless, depression, skin discolouration, hoarse voice, asthma.

Vayana vata, located near the heart and moves everywhere in all directions, i.e. moves blood and oxygen to all parts of the body. Symptoms of poor circulation, ischemic heart/brain diseases, stroke, circulation and muscle activities.

Samana vata, located near the digestive fire and moves into the gastro intestinal tract. Symptoms of appetite loss, indigestion, distressed peristalsis, gas, malabsorption.

Apana vata, located in the lower pelvic area, large intestine, bladder, genitals. The movement is downward and out of the body. Symptoms include constipation, diarrhea, dysfunction of menstruation, gas, sex, backache.

The best reference book for aromatherapy in relation to essential oils for each of these sub-doshas is Ayurveda and Aromatherapy: The EARTH Essentials Guide to Ancient Wisdom and Modern Healing (4) by Dr. Light Miller (see illustration).

At this point I would suggest that the course offered by KP Khalsa covers far more information and is very helpful in identifying the causes and also herbal supports as well for osteoporosis. 

How Do We Address and Treat Osteoporosis with Our Clients?

Each of us may be trained in different complementary modalities. 

Here are a few ideas:

• Communicate and educate together with your client

Together you can track patterns and look at the history of how they might have led to osteoporosis. Most of the time and as a result of information available on the internet, many clients have a lot of knowledge that they have collected on their condition. What they likely haven’t collected is recognizing how that all fits together as a pattern. This is where our listening skills come in and also visual diagramming and client intake information including history and family history.

• Use diagnostics

Bone-density testing can be done initially and repeated regularly to track results. Expect the journey to be at least a five-year process! I have used bio-feedback, which also offers a detailed list of vitamins and minerals that may be depleted or even overused and ,depending on your service provider, offers a 44-page printout as a reference. It is also affordable and can be used to understand baseline heath, identify both chronic and acute symptoms, and, over time, provide a record of progressive change.

• Get a game plan

In this case, discuss and create some sources of either referral or information sourcing to help the client identify dietary and lifestyle issues and support. I love the joyfulbelly.com (5) platform as the dosha tests are free and there is an enormous data base of both diet and lifestyle suggestions, including online introductory and affordable courses. Clients need a connection to discussion and accountability. That may or may not be your focus as a practitioner but consider where or who to refer them to for ongoing support based on their game plan.

• As a practitioner, offer the skills the you have related to the issues presented

In my case, as one who offers Ayurvedic oils used in massage, the application of body oiling is the primary treatment in Ayurveda for vata conditions! We know that essential oils, more than anything, can help to restore balance to the autonomic nervous system quickly and effectively. This can include booking regular body oiling treatments and creating products for at-home use including body oil and applications to soothe and balance the nervous system. Also, I can relate my choice of oils to the sub-dosha categories listed above and reference them in the book listed.

• Herbal supplements

Although I am certainly not an herbalist, there are many over-the-counter vitamin supports that can be considered and often the stores themselves are well-informed and clients can be referred to specialists in this area for a consultation. KP Khalsa offers online consultations as well. The main supplements to consider are mineral supplements. In Ayurveda, these are constructed of seashell and calcium compounds. Also “hard” compounds such as Indian frankincense (Boswellia serrata) (9), which is from a hard resin, can be used.

What Is Working for Me

Since I have been troubled by many of these issues myself, I have personally received the most noticeable benefits from:

• Acupuncture, which relieved the pain effectively and also provided balanced energy support and endocrine balance with only a few treatments. The relationship with your practitioner is the main key to healing! It has to be a good match and that can take a bit of exploring. If you don’t notice results within a few treatments or sessions, don’t waste your money, look elsewhere.
• Homeopathy, such as the cartilage remedy (10) I used for hip tissue degeneration. I noticed the difference immediately although the process of healing will be ongoing.
• I am also using an enhanced protein collagen powder daily from a bovine source and have noticed improvements already in my nails especially, as well as a mineral supplement. 
• Getting an electric bike to exercise and be social without causing more harm to the tissues.
• Using custom daily mineral salt baths, Ayurveda body oils and shampoo blends, and observing and addressing underlying patterns through journalling in order to support and balance vata. 

I truly wish there were more practitioners available to offer Abyanga body massage, which requires the generous use of herbal base oils (8). There are too few of us out there and many of my favourite Ayurvedic suppliers do not ship to Canada. 

So, YES, the treatment is worth the effort!

Expect the process to take at least five years to restore bone density and rebuild the tissues.

And balancing vata is the number-one focus along with supporting the earth element of kapha.

Dr. Khalsa also offers simpler online courses to support learning more about osteoporosis (11). 

Repertory (6) Categories to Consider for Essential Oils

Osteoporosis 

Angelica; balsam fir; bergamot; blue chamomile; blue cypress; calendula; cardamom; carrot seed; cassia; cedarwood; champaca; cinnamon; cistus; clary sage; clove; coriander; elemi; Douglas fir; eucalyptus; fenugreek; frankincense; Gandhi root; geranium; ginger; goldenrod; guaiac wood; helichrysum; jasmine; juniper; laurel; lemon; lemongrass; monarda; myrrh; nagarmotha; neroli; nettle; olive leaf; oregano; palo santo; patchouli; pemou; peppermint; pine; plai; prickly ash; rhododendron; Roman chamomile; sage; sandalwood; santolina; silver fir; spikenard; tagetes; tamarack; thuja; tuberose; valerian; vetiver; violet; wintergreen; ylang ylang

Calcium Themes 

Balsam fir; bergamot; black spruce; carrot seed; cedarwood; champaca; juniper; leleshwa; lime; mastic; olive leaf; oregano; rhododendron; santolina; savory; seaweed; silver fir; spikenard; tamarack; thuja

Carbon Themes

Blue chamomile; cedarwood; clary sage; cypress; helichrysum; juniper; neroli; Peru balsam; ravensara; santolina 

Back

Weakness, lumbar and sacral

Ammi visnaga; anise; balsam fir; balsam poplar; benzoin; bitter orange; blue chamomile; buchu; camphor; carrot seed; cassia; catnip; cedarwood; celery seed; clove; copaiba; cypress; dill; Douglas fir; fenugreek; frankincense; garlic; ginger; guaiac wood; helichrysum; hemp; hyssop; jasmine; laurel; lavender; ledum; lemon; litsea; marjoram; monarda; neroli; nutmeg; olive leaf; oregano; orris root; palmarosa; peppermint; Peru balsam; pine; plai; Roman chamomile; rosemary; rosewood; savory; seaweed; spearmint; spikenard; St. John’s wort; tarragon; thuja; thyme; tobacco leaf; turmeric; valerian; vetiver; yarrow 

Bones 

Anise; balsam fir; bergamot; bitter orange peel; black pepper; black spruce; blue chamomile; blue cypress; calendula; caraway; cardamom; carrot seed; cassia; cedarwood; champaca; cinnamon; cistus; clary sage; clove; coriander; elemi; Douglas fir; eucalyptus; fenugreek; frankincense; Gandhi root; geranium; ginger; goldenrod; greenheart wood; guaiac wood; helichrysum; hyssop; jasmine; juniper; ledum; leleshwa; lemon; lemongrass; lime; mastic; monarda; myrrh; nagarmotha; neroli; niaouli; olive leaf; oregano; palo santo; pemou; peppermint; petitgrain bigarade; pine; plai; rhododendron; Roman chamomile; sage; sandalwood; santolina; saro; savory; seaweed; silver fir; spikenard; tagetes; tamarack; thuja; thyme; tuberose; valerian; vetiver; violet; white spruce; wintergreen; ylang ylang 

Here is an interesting although complex research paper that investigates the following essential oils in relation to bone tissue repair and regeneration, including the use of St. John’s wort, rosemary, ylang ylang, white poplar, eucalyptus, lavender and grapeseed. 

Other Factors

Medications can be a contributing and causative factor. source: (7) 

Long-term use of certain medications may make you more likely to develop bone loss and osteoporosis, such as:

• Glucocorticoids and adrenocorticotropic hormone, which treat various conditions, such as asthma and rheumatoid arthritis
• Anti-epileptic medicines, which treat seizures and other neurological disorders
• Cancer medications, which use hormones to treat breast and prostate cancer
• Proton-pump inhibitors, which lower stomach acid
• Selective serotonin re-uptake inhibitors, which treat depression and anxiety
• Thiazolidinediones, which treat type II diabetes

Your comments are welcome! What have you found that worked? Please share your thoughts, observations, insights and suggestions.

References:

1. KP Khalsa, https://internationalintegrative.com/about/kp-khalsa/
2. Intermediate/Advanced Ayurveda, Osteoporosis course, https://internationalintegrative.com/course/intermediate-advanced-ayurveda-osteoporosis/
3. Quote from the course, https://internationalintegrative.com/course/intermediate-advanced-ayurveda-osteoporosis/
4. Book Ayurveda and Aromatherapy by Dr. Light Miller  https://www.amazon.ca/Ayurveda-Aromatherapy-Essentials-Ancient-Healing/dp/0914955209/ref=asc_df_0914955209/?tag=googleshopc0c-20&linkCode=df0&hvadid=292969433943&hvpos=&hvnetw=g&hvrand=9182950733322318451&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=1001890&hvtargid=pla-647468093272&psc=1
5. Joyfulbelly, test your body type https://www.joyfulbelly.com
6. Berkowsky’s Spiritual PhytoEssencing Repertory of Essential Oils https://naturalhealthscience.com/product/2018-spiritual-phytoessencing-repertory-of-essential-oils/
7. Treatment of Osteoporosis https://www.wellinghomeopathy.com/treatment-of-osteoporosis/
8. Sewanti, Ayurveda massage oils Canada https://sewanti.com/pages/shop-by-format/#oils
9. Indian Boswellia, Boswellia Serrata https://en.wikipedia.org/wiki/Boswellia_serrata
10. Cartilage Remedies Homeopathy, https://www.doctorbhatia.com/treatment/cartilage-homeopathy-treatment-and-homeopathic-remedies/
11. More about osteoporosis, KP Khalsa course offerings, https://internationalintegrative.com/?s=osteoporosis