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Devil's Claw (Harpagophytum procumbens)

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.

Best evidence
Grade A
Conditions studied
3
Outcomes
9
Graded outcomes
1610

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

3 conditions

Chronic Low Back Pain

Chronic Low Back Pain: outcomes studied for Devil's Claw (Harpagophytum procumbens)
GradeOutcomeEffectSizeStudiesPeopleStudies 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 effect167 people

Osteoarthritis (OA)

Osteoarthritis (OA): outcomes studied for Devil's Claw (Harpagophytum procumbens)
GradeOutcomeEffectSizeStudiesPeopleStudies 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 SymptomsChanges; see studies227 people

Acute Back Pain

Acute Back Pain: outcomes studied for Devil's Claw (Harpagophytum procumbens)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Pain

Small Improvement

Improves (the measure goes down)Small effect108 people

Key findings

  • Low Back Pain ReliefChronic Low Back PainImproves (the measure goes down)
  • Osteoarthritis Pain (vs NSAID)Osteoarthritis (OA)Improves (the measure goes up)
  • Joint Function (WOMAC)Osteoarthritis (OA)Improves (the measure goes up)

Safety notes in the studies

  • RCT vs diacerhein: Significantly lower adverse event rate.

Studies cited

6 studies from PubMed

  1. Herbal medicine for low-back painCochrane Database Syst Rev, 2014 · PMID 25536022
  2. Devil's Claw (Harpagophytum procumbens) as a treatment for osteoarthritis: a review of efficacy and safetyJ Altern Complement Med, 2006 · PMID 17212570
  3. Devil's Claw (Harpagophytum procumbens DC): an evidence-based systematic review by the Natural Standard Research CollaborationJ Herb Pharmacother, 2004 · PMID 17135164
  4. Treatment of patients with arthrosis of hip or knee with an aqueous extract of devil's claw (Harpagophytum procumbens DC.)Phytother Res, 2003 · PMID 14669250
  5. Effects of Harpagophytum procumbens LI 174 (devil's claw) on sensory, motor and vascular muscle reagibility in the treatment of unspecific back painSchmerz, 2001 · PMID 11810324
  6. Harpagophytum procumbens in the treatment of knee and hip osteoarthritis. Four-month results of a prospective, multicenter, double-blind trial versus diacerheinJoint Bone Spine, 2000 · PMID 11143915

Protocols that include Devil's Claw (Harpagophytum procumbens)