Devil's claw's therapeutic uses

• DEFINITION: Natural plant product used to treat specific health conditions.
• PRINCIPAL PROPOSED USES: Back pain, gout, loss of appetite, mild stomach upset, muscle pain, osteoarthritis, rheumatoid arthritis

Overview

Devil’s claw is a native herb of South Africa, so named because of its rather peculiar appearance. Its large tuberous roots are used medicinally after being chopped up and dried in the sun for three days. Indigenous South Africans used the herb to reduce pain and fever and to stimulate digestion. Colonists brought devil’s claw home to Europe, where it became a popular treatment for arthritis.

Therapeutic Dosages

A typical dosage of devil’s claw is 750 milligrams three times daily of a preparation standardized to contain 3 percent iridoid glycosides.

Therapeutic Uses

In modern Europe, devil’s claw has been used to treat all types of joint pain, including osteoarthritis, rheumatoid arthritis, and gout. Devil’s claw is also used for soft-tissue (muscle-related or tendon-related) pain. Like other bitter herbs, devil’s claw is said to improve appetite and relieve mild stomach upset.

Scientific Evidence

The evidence for devil’s claw is fairly preliminary, with the largest and most well-designed studies showing marginal benefits at best. Most studies have evaluated the herb for the treatment of arthritis.

A double-blind study compared devil’s claw to the European drug diacerein. Diacerein is a member of a drug category not recognized in the United States: the symptomatic slow-acting drugs for osteoarthritis (SySADOAs). Unlike anti-inflammatory drugs, such as ibuprofen, SySADOAs do not provide immediate relief but rather act over a period of weeks to gradually reduce arthritis pain. The supplements glucosamine and chondroitin have been proposed as natural SySADOAs.

In this trial, 122 persons with osteoarthritis of the hip or knee (or both) were given either devil’s claw or diacerhein for four months. The results showed that devil’s claw was as effective as diacerein, as measured by pain levels, mobility, and need for pain-relief medications (such as acetaminophen or ibuprofen). While this might seem impressive, diacerein itself is only slightly effective, and in such cases, comparative studies must use a placebo group to achieve reliable results.

Another double-blind study followed eighty-nine persons with rheumatoid arthritis for two months. The group given devil’s claw showed a significant decrease in pain intensity and improved mobility. A third double-blind study of fifty people with various types of arthritis found that ten days of treatment with devil’s claw provided significant pain relief. A fourth study compared devil’s claw against Vioxx, an anti-inflammatory drug no longer on the market. While it was widely reported that devil’s claw was as effective as the drug, the study was too small to produce statistically meaningful results.

Evaluating devil’s claw for treatment of muscular tension and discomfort, one four-week, double-blind, placebo-controlled trial that evaluated sixty-three persons with muscular tension or pain in the back, shoulder, and neck. The results showed significant pain reduction in the treatment group compared with the placebo group. However, a double-blind study of 197 persons with back pain found devil’s claw marginally effective at best. Similarly unimpressive results were seen in an earlier double-blind study of 118 people with back pain.

It remains unclear how devil’s claw might work. Some studies have found an anti-inflammatory effect, but others have not. Apparently, the herb does not produce the same changes in prostaglandins as standard anti-inflammatory drugs. Despite this, devil's claw is widely used in Germany and France for anti-inflammatory and pain relief purposes. Emerging studies in the twenty-first century appear to show more promising results for osteoarthritis and back pain as well.

Safety Issues

Devil’s claw appears to be safe, at least for short-term use. In one study, no evidence of toxicity emerged at doses many times higher than recommended. In a review of twenty-eight clinical trials, researchers found no instances where adverse effects were more common than those associated with a placebo. Minor adverse effects, most gastrointestinal in nature, occurred in roughly 3 percent of patients.

Devil’s claw is not recommended for people with ulcers. Also, a six-month open study of 630 people with arthritis showed no side effects other than occasional mild gastrointestinal distress. According to one case report, devil’s claw might increase the potential for bleeding in persons taking warfarin (Coumadin).

Safety in young children, pregnant or nursing women, or those with severe liver or kidney disease has not been established. Persons taking blood-thinning medications, such as warfarin or heparin, should note that devil’s claw might enhance the effect of these drugs, possibly producing a risk of bleeding.

Bibliography

"Devil's Claw." Icahn School of Medicine of Mount Sinai, www.mountsinai.org/health-library/herb/devils-claw. Accessed 21 Nov. 2024.

Geng, Caitlin. “What to Know about Devil's Claw.” Medical News Today, 20 Aug. 2021, www.medicalnewstoday.com/articles/devils-claw. Accessed 21 Nov. 2024.

Gxaba, Nomagugu, and Madira Coutlyne Manganyi. “The Fight against Infection and Pain: Devil's Claw (Harpagophytum Procumbens) a Rich Source of Anti-Inflammatory Activity: 2011-2022.” Molecules, vol. 27, no. 11, June 2022, p. 3637, doi:10.3390/molecules27113637. Accessed 21 Nov. 2024.

Meixner, Makayla. “Devil's Claw: Benefits, Side Effects and Dosage.” Healthline, 27 Aug. 2018, www.healthline.com/nutrition/devils-claw. Accessed 21 Nov. 2024.

Schulz, V., R. Hansel, and V. E. Tyler, editors. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine. 5th ed., Springer, 2004.

Vlachojannis, J., B. D. Roufogalis, and S. Chrubasik. "Systematic Review on the Safety of Harpagophytum Preparations for Osteoarthritic and Low Back Pain." Phytotherapy Research, vol. 22, 2008, pp. 149-152.