Devil's Claw (Harpagophytum procumbens)

Devil's Claw is an African plant traditionally used for pain and inflammation. Active compound: harpagoside. Cochrane review for low back pain: Strong evidence for short-term pain improvement at 50-100mg harpagoside/day vs placebo. One trial showed equivalence to 12.5mg rofecoxib (Vioxx). RCT for hip/knee OA (n=122, 4 months): Equivalent to diacerhein with significantly fewer adverse events and reduced NSAID use. WOMAC study: 23.8% pain improvement, 22.2% stiffness improvement. European guideline recommendation for osteoarthritis. Generally well-tolerated with GI effects most common.

Quick Answer

What it is

Devil's Claw is an African plant traditionally used for pain and inflammation. Active compound: harpagoside.

Key findings

  • Grade A: Low Back Pain Relief (Chronic Low Back Pain)
  • Grade B: Osteoarthritis Symptoms (Chronic Low Back Pain)
  • Grade B: Osteoarthritis Pain (vs NSAID) (Osteoarthritis (OA))

Safety

  • RCT for hip/knee OA (n=122, 4 months): Equivalent to diacerhein with significantly fewer adverse events and reduced NSAID use.
  • RCT vs diacerhein: Significantly lower adverse event rate.
ℹ️ Quick Facts: Devil's Claw (Harpagophytum procumbens)

Quick Facts: Devil's Claw (Harpagophytum procumbens)

  • Best Evidence:Grade A
  • Conditions Studied:3
  • Research Outcomes:9
  • Grade A Findings:1
  • Grade B Findings:6
  • Key Effect:Chronic Low Back Pain
Outcomes by grade:
A1
B6
C1
D0
3 conditions · 9 outcomes

Detailed Outcomes

|
A
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.
moderateImproves
B
Osteoarthritis Symptoms
Small Improvement
2 studies
smallImproves
B
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.
moderateImproves
B
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.
moderateImproves
B
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.
moderateImproves
B
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.
moderateImproves
B
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.
moderateImproves
?
Osteoarthritis Symptoms
1 study
Worsens
C
Pain
Small Improvement
1 study
smallImproves

Research Citations (10)

The Efficacy of Harpagophytum procumbens (Teltonal) in Patients with Knee Osteoarthritis: A Randomized Active-Controlled Clinical Trial
(2021)
PMID: 34630571
Herbal medicine for low-back pain
(2014)
PMID: 25536022
Devil's Claw (Harpagophytum procumbens) as a treatment for osteoarthritis: a review of efficacy and safety
(2006)
PMID: 17212570
Devil's Claw (Harpagophytum procumbens DC): an evidence-based systematic review by the Natural Standard Research Collaboration
(2004)
PMID: 17135164
Harpgophytum procumbens for osteoarthritis and low back pain: a systematic review
(2004)
PMID: 15303636
Treatment of patients with arthrosis of hip or knee with an aqueous extract of devil's claw (Harpagophytum procumbens DC.)
(2003)
PMID: 14669250
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
(2003)
PMID: 12622467
Effects of Harpagophytum procumbens LI 174 (devil's claw) on sensory, motor and vascular muscle reagibility in the treatment of unspecific back pain
(2001)
PMID: 11810324
Harpagophytum procumbens in the treatment of knee and hip osteoarthritis. Four-month results of a prospective, multicenter, double-blind trial versus diacerhein
(2000)
PMID: 11143915
Effectiveness of Harpagophytum extract WS 1531 in the treatment of exacerbation of low back pain: a randomized, placebo-controlled, double-blind study
(1999)
PMID: 11518071

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