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Devil's claw

Two systematic reviews report short-term back pain relief over placebo with extracts giving 50 to 100 mg harpagoside a day, from low-quality trials. In osteoarthritis, it matched diacerhein and meloxicam in comparator trials, but a meta-analysis found no difference from control. Minor side effects, mainly stomach upset, occurred in about 3% of trial patients.

Add to Bio HackChecked 2026-11-09
Status
Dietary supplement in the US. Not FDA-approved as a drug for any condition.
Also called
Harpagophytum procumbens, Harpagophytum zeyheri, harpagoside, grapple plant, wood spider, Harpadol, Doloteffin, Teltonal, WS 1531
Taken for
back pain, low back pain, osteoarthritis, arthritis, joint pain

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Shown to help1

Reported risks0

No risks sourced yet.

What people take it for, and what was found

Shown to help1

Moderate

Low back pain

Shown to lower short-term pain more than placebo in flare-ups of chronic low back pain at 50 or 100 mg harpagoside a day, on low-quality evidence.

The numbers and sources
Effect
A Cochrane review found that daily extracts standardized to 50 or 100 mg harpagoside may lower short-term pain and rescue medication use more than placebo (2 trials, 315 participants). One trial of 88 participants found pain relief similar to 12.5 mg a day of rofecoxib [1]. An earlier systematic review of 12 trials rated the evidence as strong for an aqueous extract giving 50 mg harpagoside a day and moderate for 100 mg, in acute flare-ups of chronic low back pain [2]. In one of those trials, 197 people with a flare-up took 600 or 1,200 mg of extract or placebo for 4 weeks. Pain-free patients without rescue medication numbered 3 on placebo, 6 on 600 mg and 10 on 1,200 mg (p 0.027) [3].
Population
Adults with acute flare-ups of chronic non-specific low back pain [1][2][3].
Sources
[1], [2], [3]
Caveats
The Cochrane review rated the placebo evidence as low quality and the rofecoxib comparison as very low quality, and noted poor reporting [1]. The two reviews share an author [1][2].

Mixed results1

Moderate

Osteoarthritis

Mixed results: trials without placebo found pain relief similar to diacerhein or meloxicam, while one herbal review found no difference from control.

The numbers and sources
Effect
In 122 patients with knee or hip osteoarthritis, 2.6 g a day of powdered root for 4 months lowered pain and Lequesne index scores as much as diacerhein, and patients used less NSAID and pain medicine [4]. In 60 adults with mild knee osteoarthritis, 960 mg a day for one month improved pain and WOMAC scores as much as meloxicam at 8 weeks [5]. A review of 14 studies, 4 of them placebo-controlled, found the higher quality trials pointed to less pain, while the trials were generally of poor quality [6]. A meta-analysis of herbal medicines for osteoarthritis found no difference between devil's claw and control in its one included trial [7].
Population
Adults with knee, hip or spine osteoarthritis [2][4][5][6][7].
Sources
[2], [4], [5], [6], [7]
Caveats
Neither comparator trial had a placebo arm [4][5]. The meloxicam group took its drug for 10 days and the devil's claw group for a month [5]. The reviews rated most trials as low quality [6][7].

Doses studied

Back pain trials used extracts standardized to 50 or 100 mg harpagoside a day, given as 600 or 1,200 mg of extract, for 4 weeks [1][3]. Osteoarthritis trials used 2.6 g of powdered root a day (6 capsules of 435 mg) for 4 months [4] and 960 mg of extract a day for one month [5]. A systematic review noted that a powder giving 60 mg harpagoside a day was used in spine, hip and knee osteoarthritis [2].

Risks

Checked, no increase found1

Moderate

Adverse events in trials

Minor side effects, mainly stomach and bowel symptoms, occurred in about 3% and were no more frequent than on placebo in double-blind trials.

The numbers and sources
Effect
A safety review of 28 clinical trials found no double-blind study in which adverse events were more frequent than on placebo. Minor adverse events occurred in about 3% of patients, mainly stomach and bowel symptoms. It found a few reports of acute toxicity and none of chronic toxicity [8]. In the diacerhein comparison, diarrhea occurred in 8.1% on devil's claw against 26.7% on diacerhein [4]. The Cochrane back pain review noted no significant adverse events in its trials [1].
Population
Patients with osteoarthritis and low back pain in clinical trials [1][4][8].
Sources
[1], [4], [8]
Caveats
The safety review notes most trials used doses at the lower end of the range and called for more long-term safety data [8].

Claims tested and not found

  1. That devil's claw lowers osteoarthritis symptoms more than control. A meta-analysis of herbal medicines found no difference against control [7].

Sources

  1. Oltean H, Robbins C, van Tulder MW, et al. Herbal medicine for low-back pain. Cochrane Database of Systematic Reviews. 2014. https://doi.org/10.1002/14651858.CD004504.pub4
  2. Gagnier JJ, Chrubasik S, Manheimer E. Harpgophytum procumbens for osteoarthritis and low back pain: a systematic review. BMC Complementary and Alternative Medicine. 2004. https://doi.org/10.1186/1472-6882-4-13
  3. Chrubasik S, Junck H, Breitschwerdt H, et al. Effectiveness of Harpagophytum extract WS 1531 in the treatment of exacerbation of low back pain: a randomized, placebo-controlled, double-blind study. European Journal of Anaesthesiology. 1999. https://doi.org/10.1046/j.1365-2346.1999.00435.x
  4. Chantre P, Cappelaere A, Leblan D, et al. Efficacy and tolerance of Harpagophytum procumbens versus diacerhein in treatment of osteoarthritis. Phytomedicine. 2000. https://doi.org/10.1016/S0944-7113(00)80001-X
  5. Farpour HR, Rajabi N, Ebrahimi B. The Efficacy of Harpagophytum procumbens (Teltonal) in Patients with Knee Osteoarthritis: A Randomized Active-Controlled Clinical Trial. Evidence-Based Complementary and Alternative Medicine. 2021. https://doi.org/10.1155/2021/5596892
  6. Brien S, Lewith GT, McGregor G. Devil's Claw (Harpagophytum procumbens) as a treatment for osteoarthritis: a review of efficacy and safety. Journal of Alternative and Complementary Medicine. 2006. https://doi.org/10.1089/acm.2006.12.981
  7. Del Grossi Moura M, Lopes LC, Biavatti MW, et al. Oral herbal medicines marketed in Brazil for the treatment of osteoarthritis: A systematic review and meta-analysis. Phytotherapy Research. 2017. https://doi.org/10.1002/ptr.5910
  8. Vlachojannis J, Roufogalis BD, Chrubasik S. Systematic review on the safety of Harpagophytum preparations for osteoarthritic and low back pain. Phytotherapy Research. 2008. https://doi.org/10.1002/ptr.2314

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