Condition

Chronic Low Back Pain

Chronic low back pain is back pain lasting more than 12 weeks, often linked to strained muscles, worn discs or arthritic joints, though sometimes no structural cause turns up. Among supplements, devil's claw has the strongest evidence, with a review of trials finding short-term pain improved versus placebo and less need for rescue pain medication. The studies were small and short, and agmatine eased nerve-related back pain in only one trial of 61 people.

Sources: PMID 15693701; PMID 12509627

Supplements studied: 4
Graded outcomes: 5
Trials: 6
People studied: 1,694

Evidence by supplement

Strong
Moderate
Limited
Very limited

4 supplements

Devil's Claw (Harpagophytum procumbens)

Devil's Claw (Harpagophytum procumbens): outcomes studied for Chronic Low Back Pain
Outcome	Effect	Size	People
Low Back Pain Relief Cochrane review (2 trials, n=315): Strong evidence for short-term pain improvement at 50-100mg harpagoside/day vs placebo. One trial (n=88): 60mg harpagoside equivalent to 12.5mg rofecoxib (Vioxx) for non-specific low back pain. Reduces rescue medication use.	Improves (the measure goes down)	Moderate effect
Chronic Non-Specific Back Pain Multiple trials for chronic non-specific low back pain. Cochrane: Moderate evidence for aqueous extract at 60mg harpagoside being non-inferior to rofecoxib 12.5mg/day. Muscular pain significantly improved at 2x480mg/day.	Improves (the measure goes up)	Moderate effect
Osteoarthritis Symptoms Small Improvement	Improves (the measure goes down)	Small effect	167 people

Devil's Claw

Devil's Claw: outcomes studied for Chronic Low Back Pain
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Osteoarthritis Symptoms Small Improvement	Improves (the measure goes down)	Small effect	3 studies	167 people
Studies that measured osteoarthritis symptoms A 1-year follow-up after a pilot study with Doloteffin for low back painPhytomedicine · PMID 15693701 A randomized double-blind pilot study comparing Doloteffin and Vioxx in the treatment of low back painRheumatology · PMID 12509627 Comparison of outcome measures during treatment with the proprietary Harpagophytum extract doloteffin in patients with pain in the lower back, knee or hipPhytomedicine · PMID 12046857

Agmatine

Pain: improves

Agmatine: outcomes studied for Chronic Low Back Pain
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Pain Moderate improvement in neuropathic pain (lumbar radiculopathy)	Improves (the measure goes down)	Moderate effect	1 study	61 people
Studies that measured pain Safety and Efficacy of Dietary Agmatine Sulfate in Lumbar Disc-associated Radiculopathy. An Open-label, Dose-escalating Study Followed by a Randomized, Double-blind, Placebo-controlled TrialPain Med · PMID 20447305

Alpha-Lipoic Acid

Nerve Repair: improves

Alpha-Lipoic Acid: outcomes studied for Chronic Low Back Pain
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Nerve Repair	Improves (the measure goes up)		1 study	203 people
Studies that measured nerve repair The use of alpha-lipoic acid (ALA), gamma linolenic acid (GLA) and rehabilitation in the treatment of back pain: effect on health-related quality of lifeInt J Immunopathol Pharmacol · PMID 19887043

Key findings

Low Back Pain ReliefDevil's Claw (Harpagophytum procumbens)Improves (the measure goes down)
Osteoarthritis SymptomsDevil's ClawImproves (the measure goes down)
Chronic Non-Specific Back PainDevil's Claw (Harpagophytum procumbens)Improves (the measure goes up)

The Chronic Low Back Pain Support protocol

2 primary supplements · 7 supporting supplements

Devil's Claw (Harpagophytum procumbens)600–1,200 mg standardized extract daily (50–100 mg harpagoside)
Curcumin500–1,000 mg bioavailable curcumin daily

See the full protocol

Shop the evidence-backed picks

Fullscript collectionJoints and bones: evidence-graded picksOpen on Fullscript

The collection holds the supplements we grade A or B for its theme, in third-party tested products where the catalog has them. It opens in our Fullscript store. You can look through it without signing in; Fullscript asks for a free account to order.

Or shop one supplement

The supplements graded A or B for Chronic Low Back Pain. Each opens third-party tested products for that supplement.

Grade A
Grade B

We earn from purchases made in our Fullscript store, and links to Fullscript, iHerb or Thorne carry our referral, so we may earn a commission at no extra cost to you. Grades come from the research and never change based on what we earn. Full disclosure

Studies cited

4 studies from PubMed

The effects of hamstring stretching exercises on pain intensity and function in low back pain patients: A systematic review with meta-analysis of randomized controlled trials.SAGE Open Med · PMID 39086556
Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.JAMA Netw Open · PMID 39485352
Evaluating the effectiveness of six exercise interventions for low back pain: a systematic review and meta-analysis.BMC Musculoskelet Disord · PMID 40312680
Healthy Lifestyle Care vs Guideline-Based Care for Low Back Pain: A Randomized Clinical Trial.JAMA Netw Open · PMID 39792385