Although I read about a lot of studies that I would not consider doing myself, the research projects do not often surprise me in their concepts. However, this one is an exception.

The idea of the study was that participating in a flower-arranging course may improve both the pain and psychiatric symptoms for patients with fibromyalgia.

The researchers explored the potential benefits of floristry as occupational therapy to improve the quality of a patient’s life because it is a “multi-stimulation therapy” in that it affects different senses.

Fibromyalgia is characterized by chronic, widespread pain and fatigue and is often accompanied by other problems such as irritable bowel syndrome and migraine headaches. Patients may also complain of mood and anxiety disorders.

Worldwide, fibromyalgia affects up to 4% of the population, especially women. The underlying cause of the problem is uncertain, so treatments primarily focus on improving pain and quality of life. Experts generally recommend a multi-faceted approach that includes aerobic exercise and behavioral therapy in addition to medications.

The recent study included 61 adult female patients with fibromyalgia who completed a 12-week flower design course that included weekly sessions under the supervision of a trained florist. The participants learned to create flower bouquets that they could take home.

Results showed statistically significant improvements in the assessments included the 36-item Short Form Survey (both physical and mental health components), the Visual Analogue Scale and the Fibromyalgia Impact Questionnaire as well as assessment of depression, using the Hamilton Depression Rating Scale, and anxiety, using the Hamilton Anxiety Rating Scale. However, tender-point counts remained unaffected.

There was a slight decline in improvement when the women were tested 12 weeks after their course ended, but the measurements did not return to starting levels. So, it is likely that as with many interventions, especially for patients with fibromyalgia, long term maintenance therapy will be needed to preserve the best effects.

The theory the researchers were testing is that participating in a floristry course combines art therapy with exposure to a natural element, flowers, both of which have been shown to be beneficial.

In the past, studies have shown that self-expression through creative art therapy improves psychiatric symptoms for patients suffering with trauma and depression. Engaging with natural elements, like flowers and houseplants indoors and parks and forests outdoors, is believed to promote relaxation, reduce blood pressure and heart rate, and improve stress levels and mood.

In a world where we are searching for a non-opioid and non-pharmacological approach to the difficult pain management problem of patients with fibromyalgia, this floral intervention shows promise. Anything non-pharmacological that can be shown to work sparks interest because it might also have implications for other pain syndromes.

Unlike other types of occupational therapy, floral design has multiple aspects in that it includes social contact as well as visual stimulation from the flowers and the touch stimulation of arranging them in certain ways. There is also the sense of creation and artfulness. Potentially, there is even an element of aromatherapy, because of the scent of the flowers and greenery involved.

One theory of pain is that pleasant sensory experiences may help to block unpleasant sensory experiences.

So, if you are in pain and/or feeling depressed, you might consider flower arranging as therapy. I doubt that your insurance will pay for it based on this one small study. But I see very little downside, unless you are allergic to flowers, which could cancel out the joy of flower arranging.

Dr. Terry Gaff is a physician in northeast Indiana. Contact him at or on Facebook. To read past columns and to post comments go to

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