White willow bark
Original 'natural aspirin': Cochrane-supported for low back pain at standardised salicin doses.
Why
Willow bark (Salix alba and related species) is the original source of salicylic acid, the historical lineage that led to aspirin. The Cochrane review of herbal medicines for low back pain found extracts standardised to 120–240 mg/day salicin reduced pain versus placebo, with the larger 240 mg dose producing greater effect. Modern willow extracts contain salicin esters that release salicylate slowly via gut metabolism, distinct from acetylsalicylic acid in onset and side-effect profile.
How it works
Salicin glycosides are hydrolysed and oxidised in the gut and liver to salicylic acid, which inhibits COX-1 and COX-2 and dampens prostaglandin synthesis. Polyphenols (flavonoids, tannins) contribute additional anti-inflammatory effect.
Expected onset · Pain reduction often within 1–2 weeks at the higher 240 mg salicin dose
How to take
Dosage
Standardised extract delivering 120–240 mg/day salicin, typically as one or two daily doses.
Timing
With food
On the label
Look for 'salicin 15%' or a stated mg salicin per dose. The therapeutic dose is the standardised-salicin number, not the raw bark weight.
Ideal for
Adults with chronic low back pain or osteoarthritis pain seeking a botanical anti-inflammatory.
Safety
Evidence
Cochrane 2016 SR on herbal medicines for low back pain: willow bark extracts standardised to 120 and 240 mg/day salicin both reduced pain vs placebo, with the higher dose producing greater effect (moderate-quality evidence). Chrubasik 2000 Am J Med RCT (n=210): 39% of patients on 240 mg/day salicin were pain-free at 4 weeks vs 6% on placebo. EMA classifies Salix cortex as Well-Established Use for short-term back pain.
Where to get it
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