Osteoarthritis is the most common joint disorder in the world. It causes destruction of the cartilage and other parts of the joints, mainly in the hands, knees, hips or the spine. The damage leads to the osteoarthritis symptoms of joint pain and stiffness, which impair joint function and inevitably impact on quality of life.
Non-steroidal anti-inflammatory drugs (NSAIDs) are not the best choice of medicine for osteoarthritis for the reasons I discuss here. Yet, the medic’s preferred long term medication paracetamol is not all that effective for relieving the pain of osteoarthritis. One reason for this may be that paracetamol is not a strong anti-inflammatory.
See 8 natural alternatives to NSAIDs in which I discuss the use of natural remedies for osteoarthritis, including the anti-inflammatory herbs frankincense, willow bark and pine bark extract.
With the arrival of autumn, I am reminded of another anti-inflammatory herbal remedy, rosehips. These hips are the bright red fruits of wild roses and especially the dog rose (Rosa canina) often seen in the hedgerows at this time of year.
Rosehip syrup became popular during the second world war as a good source of vitamin C. It’s popularity no doubt due to the delicious flavour. The hips are still collected at this time of year and made into a variety of preparations including purees, jams, syrups, cordials and juices.
The constituents of rosehips
As well as being a good source of vitamin C, rosehips contain numerous other compounds known for their health-promoting effects. These include:
- carotenoids, including lycopene and beta-carotene
- fruit acids, including ascorbic acid (vitamin C)
- fatty oils, including the essential fatty acids linoleic acid and alpha-linoleic acid
The above constituents mean rosehips have potent antioxidant and radical scavenging effects, as well as providing anti-inflammatory activity via several mechanisms.
The inflammatory processes of osteoarthritis
We used to think that osteoarthritis was caused by wear and tear of the joints. But, newer research suggests that the immune system has a key role and drives the inflammation and tissue destruction that we now know causes osteoarthritis.
The inflammatory processes of osteoarthritis include over-production of reactive oxygen and nitrogen species, including superoxide, hydrogen peroxide, nitric oxide and peroxynitrite. These chemicals are a normal and necessary part of the function of the immune system, but overproduction results in oxidative stress. Excess production damages proteins, lipids and nucleic acids, and extracellular matrix components and increases inflammation.
Rosehips and osteoarthritis
Research shows rosehips:
- reduce pro-inflammatory cytokines and chemokines
- reduce NFkB signalling
- inhibit pro-inflammatory enzymes, including COX-1 and COX-2, 5-LOX and iNOS
- reduce C-reactive protein, a marker of inflammation
- reduce chemotaxis and chemoluminescence of PMNs
- inhibit pro-inflammatory matrix metalloproteases
There are several studies on the use of rosehip powder to relieve osteoarthritis symptoms, these include:
A study of a hundred men and women, of an average age of 65, all with osteoarthritis, of either the knee or the hip. Half of the patients took 5g per day of rosehip powder in capsules, and the other half took a placebo. The study lasted for four months, during which time they were asked to continue with their usual NSAIDs medication if any. Patients were asked to rate the effectiveness of their given treatment in terms of relief of their pain. Mobility of the hip or knee was also measured, before and after the trial period.
Despite being asked to maintain their usual medicine, 14.6% of those taking rosehips actually reduced their usual medicine, whilst none increased their medicine. In contrast, 8.3% of people in the placebo group reduced their usual medicine, and 8.3% increased their usual medicine during the trial period.
Notably in this study, hip joint mobility significantly improved in the rosehip group, and the pain was significantly reduced in around two-thirds of people.
And another study involved 287 people and compared the herbal remedy rosehip powder with placebo for the symptomatic treatment of osteoarthritis. The researchers concluded that rosehip preparations provided a small but clinically relevant anti-inflammatory action that resulted in pain reduction.
Several randomised placebo-controlled double-blind studies demonstrate efficacy and excellent tolerability of rosehip preparations. With the sole adverse effect of gastrointestinal discomfort reported in equal numbers between the treatment and placebo groups.
Medical herbalists usually do not provide herbal medicines as single herbs. They know that combinations of herbs are usually superior in terms of medicinal effects. So, it is worth mentioning the trial of a combination herbal product that comprised a liquid combination of rosehip puree/juice concentrate, along with nettle leaf extract and devil’s claw root extract. This herbal combination provided outstanding and superior clinical effects of rosehip combination in comparison to the placebo for the treatment of osteoarthritis symptoms, with the main effects of pain reduction and improved quality of life. Researchers also mentioned the excellent tolerability and safety of the rosehip combination.