Cramp Bark, Guelder Rose, Cranberry Tree, Pembina, Snowball Tree (2).
Dried Bark (1)
Viburnum opulus is native to Northern America and Europe, where it grows in woodlands and thickets (3). It is related to Viburnum prunifolium (Black Haw) and they are often used interchangeably (3).
Viburnum opulus is an upright shrub 1- 3.5m tall, with small white flowers that grow in clusters (4). The leaves are dark green, have 3-5 lobes, and are approximately 6cm wide at the broadest part (5). The fruit are small berries that are red to black in colour. The bark of Viburnum opulus is green-brown on the outer surface, and green-yellow to red-brown on the inner surface (5). The bark has a strong characteristic odour and tastes somewhat bitter (6).
The bark is harvested in spring and summer when the plant is flowering. It is removed in strips from the young shoots, ensuring enough remains for the plant’s continued growth (3, 5).
Traditional use is predominately in Northern America and Canada, where it was used by native Americans as an anti-abortive (5), to remedy uterine prolapse (7), and as a spasmolytic for cramping pains in all parts of the body (3). A decoction of the bark was also used as a social beverage, diuretic, eye-wash, and for conditions involving swollen glands (7).
Cramp Bark was used by Eclectic practitioners of the 19th century for all types of cramping. Indications included dysmenorrhoea, threatened miscarriage, skeletal muscle cramping, ovarian pain, angina, palpitations, spasm of the bladder and infantile enuresis (4, 6, 8, 9,). It was used interchangeably with Viburnum prunifolium, but was considered more specific to the uterus in its action (3) and a more potent antispasmodic (6).
Widespread adulteration of Viburnum spp preparations with Acer spicatum (mountain maple) yielded varying results in research trials conducted in the early 20th century regarding the efficacy of Viburnum opulus (7, 10).
Major Active Constituents
There is little information regarding the constituents of Cramp Bark (10).
- Scopoletin -A coumarin, the major constituent responsible for antispasmodic action (7, 8, 11);
- Viopudial - Contributes to antispasmodic action (2, 7);
- Viburnin - Antispasmodic bitter specific to the uterus and peripheral vasculature (5);
- Catechin, Epicatechin - Presence required for differentiation from Viburnum prunifolium (12), they largely contribute to the astringent activity of cramp bark (1).
- Powerful smooth and skeletal muscle antispasmodic (2, 3, 6, 8, 9, 13, 14);
- Anti-abortive (4, 6, 8, 9, 15);
- Partus preparatory (6, 12, 14);
- Astringent (1, 3, 8, 12);
- Sedative (3, 8, 12);
- Hypotensive due to peripheral vasodilation caused by arterial smooth muscle relaxation (1, 3,5, 12, 15);
- Anti-inflammatory (5, 11);
- Uterine tonic (6).
An in vitro study found that water extracts taken from Viburnum opulus berries and branches inhibited superoxide anion formation, and had strong free radical scavenging action. Increased concentration of the extract resulted in increased antioxidant activity (16).
A study conducted in rats found that proanthocyanidins extracted from Viburnum opulus protected gastric mucosa on exposure to ingested ulcerating substances. The study suggested that Viburnum opulus proanthocyanidins decreased lipid peroxidation, while increasing nitric oxide and antioxidant activity. This resulted in an overall protective effect (17).
One in vitro study extracted water-soluble polysaccharides from the berries of Viburnum opulus. These were found to possess immunostimulating action, as they improved phagocytic activity and lysosomal enzyme secretion of macrophages (18).
A study conducted on rats with induced hepatic damage assessed the hepatorestorative and protective effects of oligomeric anthocyanidins from Viburnum opulus. The study found that the complex of oligomeric anthocyanidins saved glutathione, improved antioxidant action and inhibited lipid peroxidation (19).
Clinical Outcome Studies
No clinical trials concerning the use of Viburnum opulus in humans have been conducted to this date (2, 3).
- Dysmenorrhoea (4, 5, 6, 7, 8, 9, 12, 13)
- Skeletal muscle cramping, particularly of the legs and back (4, 6, 13, 14)
- Threatened miscarriage (4, 6, 8, 9, 14)
- Hypertension (5, 8, 12)
- Asthma (4, 5)
- Tension headache and migraine (5, 12)
- Irritable Bowel Syndrome (3, 5, 12)
- Arthritis where muscle contraction is present (3)
Contra-indications and Cautions
Caution is advised where there is known allergy to other members of the Caprifoliaceae family, or where there have been previous hypersensitivity reactions to cramp bark (2).
Information regarding cramp bark safety in pregnancy and lactation is currently unavailable, therefore avoid use in pregnant or lactating women (13).
- 2 - 4.5 mL per day (1:2 extract) or 15 – 30 mL per week (1:2 extract) (8);
- For acute dysmenorrhoea – 4 – 8 mL tds (1:5 extract) (1, 13);
- Decoction made with 2 teaspoons herb to one cup of water, tds (1).
1. Hoffmann, D. 2003. Medical Herbalism - The science and practice of herbal medicine. Rochester: Healing Arts Press.
2. Viburnum opulus. Natural Standard Database. Accessed 18 September 2008. <http://www.naturalstandard.com>
3. Chevallier, A. 2001. Encyclopaedia of Medicinal Plants. Sydney: Penguin.
4. Felter HW, Lloyd JU. 1898. King’s American Dispensatory, Vol II. Sandy, Oregon: Eclectic Medical Publications, 1983.
5. Mills, S. 1993. The Essential Book of Herbal Medicine. Ringwood: Penguin Arkana.
6. Felter, HW. 1922. The Eclectic Materia Medica, Pharmacology and Therapeutics. Accessed 18/9/2008. <http://www.swsbm.com/FelterMM/Felters.html>
7. Trickey, R. 2003. Women, Hormones and the Menstrual Cycle. 2nd edition. Crows Nest: Allen and Unwin.
8. Bone, K. 2003. A Clinical Guide to Blending Liquid Herbs – Herbal Formulations for the Individual Patient. Missouri: Churchill Livingstone.
9. Lyle, TJ. 1897. Physico-Medical Therapeutics, Materia Medica and Pharmacy.
10. Bone, K. Mills S. 2005. The Essential Guide to Herbal Safety. St. Louis: Churchill Livingstone.
11. Bone K. Mills S. 2005. Principles and Practice of Phytotherapy. St Louis: Churchill Livingstone.
12. Bone, K. 2007. The Ultimate Herbal Compendium – A Desktop Guide for Herbal Practitioners. Warwick: Phytotherapy Press.
13. Hutchings U. Viburnum opulus. Canadian Journal of Herbalism [serial online]. September 2003;24(4):20-21.
14. Vogel, VJ. 1970. American Indian Medicine. Oklahoma: University of Oklahoma Press.
15. Costello, CH. Lynn, EV. 1943. Journal of the American Pharmaceutical Association. 32:20-22.
16. Altun M, Citoglu G, Yilmaz B, Coban T. Antioxidant properties of Viburnum opulus and Viburnum lantana growing in Turkey. International Journal Of Food Sciences And Nutrition 2008;59(3):175-180.
17. Zayachkivska O, Gzhegotsky M, Terletska O, Lutsyk D, Yaschenko A, Dzhura O. Influence of Viburnum opulus proanthocyanidins on stress-induced gastrointestinal mucosal damage. Journal of Physiology and Pharmacology: an Official Journal of the Polish Physiological Society 2006;57 Suppl 5:155-167.
18. Ovodova R, Golovchenko V, Popov S, Shashkov A, Ovodov I. [The isolation, preliminary study of structure and physiological activity of water-soluble polysaccharides from squeezed berries of Snowball tree Viburnum opulus]. Bioorganicheskaia Khimiia 2000;26(1):61-67.
19. Sprygin V, Kushnerova NF, Rakhmanin Yu A. Antioxidant action of oligomeric anthocyanidins isolated from Viburnum opuli on liver lesions caused by carbon tetrachloride and prevention of its toxic effects. Gigiena i Sanitariya 2003, No. 3:57-60
This monograph was authored in 2008 by Ellen Garrett, a student in Southern Cross University’s Bachelor of Naturopathy programme, and edited by Nena Aleschewski BNat. While the author and editor have strived to cite published information accurately, Southern Cross University will not be responsible for any inaccuracies that may have occurred.
This information is provided for educational purposes only and does not constitute medical advice. If you wish to use herbal medicine as part of your health care, seek the advice of an appropriately qualified practitioner.