Rose & Pain Reduction

This article originally appeared in the NAHA Journal (Winter, 2018) and it is republished here according to the NAHA Writer Guidelines 2019-20 copyright statement.

By: Kathy Sadowski, MS in Aromatherapy, RA (ARC), Professional NAHA & AIA Member, LMT

To smell a rose…

Are you surprised that the aroma of rose has shown in multiple human studies to provide pain relief?  As a Licensed Massage Therapist, my initial thoughts in choosing which essential oils or herbs would be best to reduce physical discomfort would be to focus on those which have demonstrated an analgesic effect on local pain nerve nociceptors topically, such as with peppermint (1), eucalyptus (2), comfrey (3), or arnica (4). 

However, I was surprised to find several human studies demonstrating that Damask rose essential oil, rose water, and rose extracts have effectively reduced pain through non-invasive aromatherapy treatments to fragile populations such as the elderly, pregnant women, children, and people who had been severely burned.  Further, the route of delivery in these studies was not topical, but via inhalation.  How is this physiologically possible?

Ah, the science of smell!  Here is how sniffing the scent of rose may have helped reduce pain for the patients in the studies listed below.  When patients inhaled the rose aroma, it delivered the scent to the olfactory receptors in their nose. Nerves then transmitted a message to their brain’s limbic system, triggering the secretion of certain neurotransmitters like endorphins and encephalin, which then aided in reducing the perception of pain (5).  This is because these types of neurotransmitters could bind to the body’s opioid receptors to inhibit the communication delivery of the pain signals being sent.

Rose & Pain: Reduction via the Aroma

The human body’s ability to reduce the pain perception via the aroma of Damask rose has been demonstrated in the following scientific studies:

• In a randomized clinical trial of 50 patients with severe burns, aromatherapy with diffused Damask rose significantly reduced pain intensity during and after wound dressing changes (6).  
• In a double-blind study with 64 children ages 3-6 years old, inhalation of Rosa damascena reduced post-surgery pain.  Analysis was taken 3,6,9, and 12 hours after surgery (7). 
• Inhalation of Damask rose essential oil significantly reduced pain in a study with 80 elderly patients who had undergone knee arthroplasty surgery.    Dilution rate of the inhalation was 3-4 drops in 5 mL of saline (about a 4% dilution) placed in a plastic zip lock bag and inhaled for 1-2 minutes (8). 
• In a study of 111 women giving birth, rose water was poured over the hands of women in labor.  The women were asked to sniff the scent of the rose water, and it showed to significantly reduced pain compared to the placebo of distilled water (9).

Rose & Pain: Relaxation of the Nervous System

When dealing with those in pain, it is also important to consider the cognitive factors that contribute to the perception of pain, such as anxiety, stress, and depression.  Rose aroma has shown in human studies to reduce anxiety, and depression (10).  Multiple animal studies have further demonstrated a CNS depressing effect with the internal administration of rose extracts, increasing sleep time and reducing pain (11).

While typical hospital protocols for reducing these cognitive components involve writing an oral prescription for sedative or opiate drugs to calm the mind, these medications can come with harsh side effects.  For fragile populations, aromatherapy via inhalation can be a less invasive complimentary or alternative option to reduce the amounts of pharmacological drugs needed to calm the mind and reduce pain.

Rose & Pain: Topical Anti-inflammatory

Further, Damask rose may have a topical anti-inflammatory and analgesic effect.  Multiple human studies have shown topical use resulting in pain reductions.  In a study of 120 pregnant women with lower back pain, rose oil in an almond carrier oil applied topically over 4 weeks significantly reduced pain without side effects (12).  In a double-blind placebo-controlled study of 40 patients with migraine headaches, a topical formulation containing Rosa damascena oil reduced pain, especially in those with “hot” type headaches (13).

Rose & Pain: Menstrual Discomfort 

Rose has been used for centuries as a folk remedy to reduce pain related to the menstrual cycle.  In two human studies, an abdominal massage with essential oil blends that included rose demonstrated reduced dysmenorrhea.  In a 2006 study including 67 female college students, an abdominal massage using Lavandula officinalis, Salvia sclarea, and Rosa centifolia in almond oil reduced the severity of menstrual cramps (14).   In another study of 48 women, an aromatherapy abdominal massage with rose, lavender, clove, and cinnamon in almond oil was effective in alleviating menstrual pain and bleeding heaviness (15).  Circling back to the power of rose’s aroma, in a 2016 study of 100 women with dysmenorrhea, inhaling the rose scent reduced menstrual pain (16).  

Rose & Pain: Digestive Issues

Internal use of herbal extracts of rose have also showed pain reduction.  In a study of 92 women who had just had a c-section, the ingestion of a rosehip extracts reduced pain without side effects compared to the placebo (17).In a double-blind study of 92 young women, pain associated with menstruation was significantly reduced with the intake of a Rosa damascena extract (18).  For the safe internal use of roses at home, try the rose hip tea recipe listed in the recipe section of this article.

In summary, Rosa damascena is an age-old herb used by our ancestors to reduce pain, and multiple modern human studies have demonstrated it to be an effective analgesic via inhalation, topical application, and internal routes.  Inhalation has proven effective, possibly related to the release of pain reducing neurotransmitters.  Further, rose has shown the ability to calm the mind, relaxing the CNS, and lessoning the body’s perception of pain.  Topical use has shown an analgesic effect as demonstrated in a few studies of women with dysmenorrhea, and internal use of the herb has also provided pain reduction in a few human studies. 

There are multiple ways we can enjoy roses with at home recipes.  For aromatherapy, rose hydrosols and infusions can be used as an alternative to the extremely expensive rose essential oil.  Further, rose geranium (Pelargonium graveolens) and palmarosa (Cymbopogon martini) offer a similar aroma profile to rose at less the cost.  Listed below are three easy rose recipes to try at home, one using a rose hydrosol and rose geranium essential oil, another creating a rose oil infusion, and a simple yet elegant recipe for making rose tea.

Rose Recipes

Rose Water Face Spray

Combine the calming aroma of roses and geranium with witch hazel to create a face toner that can help tighten, tone, and improve skin texture. 

• 2 ounces of rose (Rosa damascene) hydrosol, aka rose water
• 2 ounces of witch hazel (Hamamelis virginiana)
• 6 drops of rose geranium (Pelargonium graveolens) essential oil
• 1 four-ounce spray bottle

Combine the ingredients listed above together in a 4-ounce spray bottle.  Shake very well.  Adults, spray one or two pumps on the face as a toner and for calming aromatherapy. 

Avoid during the first trimester of pregnancy.  For those with fragile skin, please skin patch test on the wrist or arm before spraying on the face.  Rose may interact with certain medications such as diabetic drugs; consult a Doctor with questions.

Infused Rose Petal Oil

Enjoy the aroma of roses infused into a carrier oil!  This recipe is great to massage on the skin or pour into the bath!

• 1 clean mason jar with lid – 18 ounces or larger
• 1 cup of fresh clean non-wet organically grown rose petals (preferably from Rosa damascene)
• 1 cup of light carrier oil such as grapeseed, sweet almond, or jojoba
• Optional: 20 drops of rose geranium (Pelargonium graveolens) essential oil

Make sure your roses have been organically grown and not exposed to chemicals or pollutants.  Pick enough rose blossoms to get one cup of rose petals.  Remove the petals off the roses, gently rinse in a colander, shake off as much water as possible, and then place on paper towels to dry, for about 2 hours.  Once dried, put the rose petals in a jar, and pour the light carrier oil over top.  

Seal the jar, shake, and place near a sunny window sill for about two weeks.  Shake the jar about once a day.  Thoroughly remove petals after two weeks, using a cheese cloth or coffee filter to strain out all the plant parts from the oil.  The remaining oil is the rose infused oil.  Optional: add about 20 drops of rose geranium essential oil to the completed infusion to enhance the soft and sweet rose aroma.

Adults: apply about a tablespoon to the skin or pour into a bath.  Avoid during first trimester of pregnancy.  For those with fragile skin, please skin patch test on the wrist or arm before using all over the body.  Rose may interact with certain medications such as diabetic drugs; consult a Doctor with questions.

Rose Hip Tea

Try this calming rose tea that tastes delicate, smooth, mildly sweet, and fruity. 

• 2 Tbsp of fresh rose hips (Rosa ssp.) organically grown, gently rinsed or 1 Tbsp of dried hips – gently crushed if dried
• 2 cups of hot (not boiling) water

Pour the hot water over rose hips.  Steep about 3 minutes.  Strain and drink.

Rose petals can also be used in place of rose hips.

Rose may interact with certain medications such as diabetic drugs; consult a Doctor with questions.

References

1. Wasner, G., Schattschneider, J., Binder, A., & Baron, R. (2004). Topical menthol—a human model for cold pain by activation and sensitization of C nociceptors. Brain, 127(5), 1159-1171.
2. Santos, F. A., & Rao, V. S. N. (2000). Antiinflammatory and antinociceptive effects of 1, 8-cineole a terpenoid oxide present in many plant essential oils. Phytotherapy research, 14(4), 240-244.
3. Grube, B., Grünwald, J., Krug, L., & Staiger, C. (2007). Efficacy of a comfrey root (Symphyti offic. radix) extract ointment in the treatment of patients with painful osteoarthritis of the knee: results of a double-blind, randomised, bicenter, placebo-controlled trial. Phytomedicine, 14(1), 2-10.
4. Iannitti, T., Morales-Medina, J. C., Bellavite, P., Rottigni, V., & Palmieri, B. (2016). Effectiveness and safety of Arnica montana in post-surgical setting, pain and inflammation. American journal of therapeutics, 23(1), e184-e197.
5. Lis-Balchin, M. (2006). Aromatherapy science: a guide for healthcare professionals. Pharmaceutical press.
6. Bikmoradi, A., Harorani, M., Roshanaei, G., Moradkhani, S., & Falahinia, G. H. (2016). The effect of inhalation aromatherapy with damask rose (Rosa damascena) essence on the pain intensity after dressing in patients with burns: A clinical randomized trial. Iranian journal of nursing and midwifery research, 21(3), 247.
7. Marofi, M., Sirousfard, M., Moeini, M., & Ghanadi, A. (2015). Evaluation of the effect of aromatherapy with Rosa damascena Mill. on postoperative pain intensity in hospitalized children in selected hospitals affiliated to Isfahan University of Medical Sciences in 2013: A randomized clinical trial. Iranian journal of nursing and midwifery research, 20(2), 247. 
8. Bastani, F., Samady Kia, P., & Haghani, H. (2017). The Effect of Inhalation Aromatherapy with Damask Rose (Rosa Damascena) on the Pain of Elderly After Knee Arthroplasty. Journal of Client-Centered Nursing Care, 3(2), 153-160.
9. Roozbahani, N., Attarha, M., AkbariTorkestani, N., AmiriFarahani, L., & Heidari, T. (2015). The effect of rose water aromatherapy on reducing labor pain in primiparous women. Complementary Medicine Journal of faculty of Nursing & Midwifery, 5(1), 1042-1053.
10. Hongratanaworakit, T. (2009). Relaxing effect of rose oil on humans. Nat Prod Commun, 4(2), 291-6.
11. Boskabady, M. H., Shafei, M. N., Saberi, Z., & Amini, S. (2011). Pharmacological effects of Rosa damascena. Iranian Journal of Basic Medical Sciences, 14(4), 295.
12. Shirazi, M., Mohebitabar, S., Bioos, S., Yekaninejad, M. S., Rahimi, R., Shahpiri, Z., … & Nejatbakhsh, F. (2017). The effect of topical Rosa damascena (rose) oil on pregnancy-related low back pain: a randomized controlled clinical trial. Journal of evidence-based complementary & alternative medicine, 22(1), 120-126.
13. Niazi, M., Hashempur, M. H., Taghizadeh, M., Heydari, M., & Shariat, A. (2017). Efficacy of topical Rose (Rosa damascena Mill.) oil for migraine headache: A randomized double-blinded placebo-controlled cross-over trial. Complementary therapies in medicine, 34, 35-41.
14. Han, S. H., Hur, M. H., Buckle, J., Choi, J., & Lee, M. S. (2006). Effect of aromatherapy on symptoms of dysmenorrhea in college students: A randomized placebo-controlled clinical trial. Journal of Alternative & Complementary Medicine, 12(6), 535-541. 
15. Marzouk, T. M., El-Nemer, A. M., & Baraka, H. N. (2013). The effect of aromatherapy abdominal massage on alleviating menstrual pain in nursing students: a prospective randomized cross-over study. Evidence-Based Complementary and Alternative Medicine, 2013.
16. Uysal, M., Doğru, H. Y., Sapmaz, E., Tas, U., Çakmak, B., Ozsoy, A. Z., … & Esen, M. (2016). Investigating the effect of rose essential oil in patients with primary dysmenorrhea. Complementary therapies in clinical practice, 24, 45-49.
17. Gharabaghi, P. M., Tabatabei, F., Fard, S. A., Sayyah-Melli, M., Del Azar, E. O. A., Khoei, S. A., … & Mashrabi, O. (2011). Evaluation of the effect of preemptive administration of Rosa damascena extract on post-operative pain in elective cesarean sections. African Journal of Pharmacy and Pharmacology, 5(16), 1950-1955.
18. Bani, S., Hasanpour, S., Mousavi, Z., Garehbaghi, P. M., & Gojazadeh, M. (2014). The effect of rosa damascena extract on primary dysmenorrhea: a double-blind cross-over clinical trial. Iranian Red Crescent Medical Journal, 16(1).