Supplement
Devil's claw is a southern African herb whose root holds harpagoside, a compound thought to calm inflammation in joints and muscles. People mostly look at it for chronic low back pain, and a Cochrane review found strong evidence of short-term pain relief compared with placebo, with hints that people needed less rescue pain medication. The trials were few and small, though, and the evidence for sudden-onset back pain is limited.
- Updated
- How we grade
- 10 studies cited
- Best evidence
- Grade A
- Conditions studied
- 3
- Outcomes
- 9
- Graded outcomes
- 1610
Evidence by condition
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| 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 |
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Osteoarthritis Pain (vs NSAID) RCT (n=122, 4 months): Harpagophytum 2610mg/day equivalent to diacerhein 100mg/day for hip/knee OA. No significant difference in pain, disability, or Lequesne score. Significantly reduced need for analgesic and NSAID co-medication. | Improves (the measure goes up) | Moderate effect | ||||
| Joint Function (WOMAC) Observational study (n=75, 12 weeks, 50mg harpagoside/day): WOMAC subscale improvements - pain 23.8%, stiffness 22.2%, physical function 23.1%. Consistent improvement across all domains. | Improves (the measure goes up) | Moderate effect | ||||
| Safety vs NSAIDs/DMOADs RCT vs diacerhein: Significantly lower adverse event rate. Diarrhea in 8.1% (Devil's Claw) vs 26.7% (diacerhein). Cochrane: Low to moderate quality evidence shows few side effects. Better GI safety profile than NSAIDs. | Improves (the measure goes up) | Moderate effect | ||||
| Rescue Medication Reduction Cochrane review: Devil's Claw may reduce use of rescue medication compared to placebo. RCT vs diacerhein: Significantly reduced need for analgesic (acetaminophen-caffeine) and NSAID (diclofenac) co-medication. | Improves (the measure goes up) | Moderate effect | ||||
| Osteoarthritis Symptoms | Changes; see studies | 227 people |
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Pain Small Improvement | Improves (the measure goes down) | Small effect | 108 people |
Key findings
- Low Back Pain ReliefImproves (the measure goes down)
- Osteoarthritis Pain (vs NSAID)Improves (the measure goes up)
- Joint Function (WOMAC)Improves (the measure goes up)
Safety notes in the studies
- RCT vs diacerhein: Significantly lower adverse event rate.
Shop the evidence-backed picks
Third-party tested Devil's Claw (Harpagophytum procumbens) products, in the forms the graded studies used where we can match them.
- Grade A
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Studies cited
10 studies from PubMed
- The Efficacy of Harpagophytum procumbens (Teltonal) in Patients with Knee Osteoarthritis: A Randomized Active-Controlled Clinical Trial
- Herbal medicine for low-back pain
- Devil's Claw (Harpagophytum procumbens) as a treatment for osteoarthritis: a review of efficacy and safety
- Devil's Claw (Harpagophytum procumbens DC): an evidence-based systematic review by the Natural Standard Research Collaboration
- Harpgophytum procumbens for osteoarthritis and low back pain: a systematic review
- Treatment of patients with arthrosis of hip or knee with an aqueous extract of devil's claw (Harpagophytum procumbens DC.)
- A randomized trial comparing a proprietary extract of Harpagophytum procumbens (devil's claw) with the COX-2 inhibitor rofecoxib in the treatment of low back pain
- Effects of Harpagophytum procumbens LI 174 (devil's claw) on sensory, motor and vascular muscle reagibility in the treatment of unspecific back pain
- Harpagophytum procumbens in the treatment of knee and hip osteoarthritis. Four-month results of a prospective, multicenter, double-blind trial versus diacerhein
- Effectiveness of Harpagophytum extract WS 1531 in the treatment of exacerbation of low back pain: a randomized, placebo-controlled, double-blind study