In 2003, a study appeared that opened a new possible application of rosehip peels: the treatment of musculoskeletal pain, especially osteoarthritis. Since then, various publications have appeared confirming this perspective.
Rosehip is the false fruit of the dog rose, whose botanical name is Rosa canina, containing many small nuts. It belongs to the Rosa genus of the rose family (Fig. 1) . The rosehip itself is not a separate plant, but an organ of Rosa canina. However, pseudo-fruits of other species of the genus Rosa can also be used as rose hips.
Small cultural history
The German poet Hoffmann von Fallersleben describes the rosehip in his popular children’s riddle song “Ein Männlein steht im Walde”. In two stanzas, the rosehip is sung about without its name being mentioned, and then the question is asked as to which little man it is. Only in a third stanza added later by Fallersleben is the riddle solved and the rosehip named.
Ingredients and use as food
Rosehips are rich in vitamin C and also contain:
- Polyphenols such as flavonoids, anthocyanins and proanthocyanidins
- Carotenoids like lycopene
- Pectin
- Tannins
Rose hips are sometimes eaten raw after the nutlets have been removed. Late harvest increases the sweetness of rose hips. They are also made into mush or jam, used as a spice and eaten as soup in Sweden. Another use is processing into fruit wine and liqueur.
Rosehip is a component of many fruit teas. However, it does not give them the reddish coloration that is often assumed. The rose hips are not strongly colored. The red color of fruit teas usually comes from hibiscus.
Anti-inflammatory properties
The discussion about anti-inflammatory properties of rosehip was initiated by a Danish research team led by Erik Larsen. Larsen published a study in 2003 describing a galactolipid isolated from rosehip and its anti-inflammatory properties [1]. This agent exerts inhibition on chemotaxis of human peripheral neutrophils in vitro.
Following Larsen’s in vitro study, a clinical trial was conducted in 2003 and 2004 by Warholm and Purely published [2,3]. Both double-blind, randomized, placebo-controlled trials investigated the efficacy of a standardized rosehip preparation for the treatment of osteoarthritis. Patients received 5 g (Rein) or 2.5 g (Warholm) of the standardized powder or placebo daily for four (Warholm) or three (Rein) months. Both studies showed significant improvement over placebo in terms of mobility and pain.
In 2008, a team of researchers from the University of Freiburg published the results of a one-year observational study in which rosehip powder was used to treat acute exacerbations of chronic pain conditions [4]. Data from 77 patients suffering from acute exacerbations of chronic pain of various etiologies and taking the standardized rose hip powder Litozin® daily for one year were evaluated. Most patients showed significant improvement, regardless of the type of chronic pain. Multiple regression analysis showed that the percent improvement from baseline to end of study tended to be greater in patients with more severe pain and limitation of movement.
The most recent publication under the direction of Prof. Dr. med. Sigrun Chrubasik-Hausmann appeared in 2014 [5]. In this three-month study of the efficacy of powder from rosehip peels against acute exacerbations of chronic low back or knee pain, 52 patients with corresponding complaints were treated. 29 had participated in a previous study in which the commercial preparation Litozin® had been used. Patients were asked to take up to 20 g of rosehip peel powder daily for three months, adjusting the daily dose according to symptoms. No difference was found between the two different rosehip preparations. In vitro studies showed that both rosehip powder and rosehip peel powder inhibited cytokine formation.
Robin Christensen et al. published a meta-analysis in 2008 [6]. Three studies published since 2007 met the methodological requirement criteria for randomized, placebo-controlled trials and were included in the meta-study. The primary endpoint was defined as the reduction in pain, and the secondary endpoint was the treatment responder rate. Of the total 287 patients, 145 were treated with rose hip powder and 142 with placebo. The verum group showed significantly increased efficacy in pain reduction compared to placebo (p=0.002). A homogeneity test showed that this improvement was consistent across all three studies. Patients randomized to the rosehip group were twice as likely to respond to therapy (p=0.0009). The authors of the meta-analysis concluded that despite the small amount of data and rather short duration of the three studies evaluated, the results support efficacy of rosehip powder for pain reduction in osteoarthritis.
Summary
Since 2003, several clinical studies have appeared investigating the efficacy of rosehip powder for the treatment of chronic pain, especially osteoarthritis. The results of these studies have been consistently positive, showing a decrease in the intensity of pain and an improvement in the mobility of the affected joints. The majority of the studies covered a period of only a few months. However, even in the one-year observational study of Chrubasik et al. from 2008, positive results were determined.
Thus, the rosehip powder proves to be a valid therapy for the treatment of pain of the musculoskeletal system, especially in arthrosis. An overview of the preparations available in Switzerland is provided in Table 1.
Literature:
- Larsen E, et al: An anti-inflammatory galactolipid from rose hip (Rosa canina) that inhibits chemotaxis if human peripheral blood neutrophils in vitro. J Nat Prod 2003; 66(7): 994-995.
- Warholm O, et al: The effects of a standardized herbal remedy made from a subtype of Rosa canina in patients with osteoarthritis: a double-blind, randomized, placebo-controlled clinical trial. Curr Ther Res Clin Exp 2003; 64(1): 21-31.
- Rein E, Kharazmi A, Winther K: A Herbal remedy, Hyben Vital (stand. powder of a suspecies of Rosa canina fruits), reduces pain and improves general wellbeing in patients with osteoarthritis – a double-blind, placebo-controlled, randomised trial. Phytomedicine 2004; 11(5): 383-391.
- Chrubasik C, et al: A one-year survey on the use of a powder from Rosa canina lito in acute exacerbations of chronic pain. Phytother Res 2008; 22(9): 1141-1148.
- Chrubasik-Hausmann S, et al: A pilot study on the effectiveness of a rose hip shell powder in patients suffering from chronic musculoskeletal pain. Phytother Res 2014; 28(11): 1720-1726.
- Christensen R, et al.: Does the hip powder of Rosa canina (rosehip) reduces pain in osteoarthritispatients? – a meta-analysis of randomized controlled trials. Osteoarthritis Cartilage 2008; 16(9): 965-972.
HAUSARZT PRAXIS 2018; 13(8): 6-8
