Devil's claw
EMA-monograph Southern African root with Cochrane-supported signal for low back pain.
Why
Devil's claw (Harpagophytum procumbens) holds an EMA Well-Established Use monograph for low back pain and an additional Traditional Use registration for joint complaints. The Cochrane review of herbal medicines for low back pain found that Harpagophytum extracts standardised to 50–100 mg/day harpagoside reduced pain versus placebo and were comparable to rofecoxib in one head-to-head trial.
How it works
Iridoid glycosides (harpagoside, harpagide, procumbide) inhibit COX-2 expression and TNF-α release. Bitter principles also stimulate gastric and biliary secretion: the historical European use as a digestive bitter.
Expected onset · Pain reduction often within 2–4 weeks; full effect at 4–8 weeks
How to take
Dosage
Standardised extract delivering 50–100 mg/day harpagoside, typically 600 mg extract three times daily.
Timing
With meals to reduce GI upset
On the label
Look for a Harpagophytum procumbens or H. zeyheri root extract with stated harpagoside content of at least 1.5% (or named as 'Doloteffin', 'WS 1531').
Ideal for
Adults with chronic non-specific low back pain or osteoarthritis pain seeking an NSAID alternative.
Safety
Evidence
Cochrane 2016 SR on herbal medicines for low-back pain: Harpagophytum extracts at 50–100 mg/day harpagoside reduced pain vs placebo (moderate-quality evidence). Chrubasik 2003 Rheumatology head-to-head RCT (n=88) found WS 1531 comparable to rofecoxib 12.5 mg/day for chronic low back pain over 6 weeks. EMA classifies the root as Well-Established Use for low back pain: the highest regulatory tier for a botanical.
Where to get it
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