Native to southern Africa, devil's claw (Harpagophytum procumbens) is named for the miniature hooks that cover its fruit. For thousands of years, the Khoisan peoples of the Kalahari Desert have used devil's claw root in remedies to treat pain and complications of pregnancy and in topical ointments to heal sores, boils, and other skin problems. Since its introduction to Europe from Africa in the early 1900s, dried roots have been used to restore appetite, relieve heartburn, and reduce pain and inflammation. Today, devil's claw is used for degenerative joint diseases such as arthritis, for low back pain, and as an appetite stimulant and digestive tonic. Scientific evidence supports the use of devil's claw root to help relieve pain and inflammation in people with arthritis and other painful disorders.

Devil's claw does not have an odor, but it contains substances that make it taste bitter. It is a leafy perennial with branching roots and shoots. It has secondary roots, called tubers, that grow out of the main roots. The roots and tubers are used for medicinal purposes.

Osteoarthritis

Studies have found that taking devil's claw for several months substantially reduces pain and improves physical functioning in people with osteoarthritis. A 4-month study, including 122 people with knee and hip osteoarthritis, examined the effects of devil's claw root powder on pain. The devil's claw supplement reduced pain and improved functional ability as effectively as standard doses of a leading European medication for osteoarthritis. In addition, those who received devil's claw experienced fewer side effects and required fewer pain-reducing medications throughout the study.

Another study found that devil's claw supplementation was effective in patients with rheumatic diseases (arthrosis and low back pain). Seventy-five patients with hip or knee arthritis were given devil's claw, 2,400 mg daily, corresponding to 50 mg of harpagosides, for 12 weeks. The dosage provided a significant reduction of pain and symptoms associated with osteoarthritis. Only two cases of possible adverse drug reactions were reported (complaints of indigestion and a sensation of fullness).

Back and neck pain

Although study results have been somewhat conflicting, evidence suggests that devil's claw may help relieve low back and neck pain. In a small study of 63 people with mild-to-moderate back, neck, or shoulder pain, 4 weeks of treatment with a standardized extract of devil's claw root provided moderate relief from muscle pain. In a larger study of 197 men and women with chronic low back pain, those who received daily doses of a commercialized devil's claw extract every day for a month reported experiencing less pain and needing fewer painkilling medications than those who received placebo.

Another study followed 73 patients. Thirty-eight patients took a standardized devil's claw supplement, while 35 taking the COX-2 inhibitor medicine rofecoxib, also known as Celebrex, for up to 54 weeks. Results inidicated that devil's claw was as effective in relieving pain as the rofecoxib.

Other uses

In addition to the treatment of these and other painful disorders, many professional herbalists consider devil's claw to be useful for upset stomach, loss of appetite, headaches, allergies, and fever. Topical preparations of devil's claw are also applied to the surface of the skin to heal sores, ulcers, boils, and skin lesions.

Devil's claw contains iridoid glycosides, components believed to have strong anti-inflammatory effects. Harpagoside (one type of iridoid) is highly concentrated in devil's claw root and has been reported in some laboratory studies to have significant pain-relieving and anti-inflammatory properties.

Devil's claw is available as dried or fresh root supplements and is found in capsules, tablets, liquid extracts, and topical ointments. Teas (infusions) can also be made from dried devil's claw root.

Pediatric

There are no known scientific reports on the pediatric use of devil's claw. Therefore, it is not currently recommended for children.

Adult

• Standardized dose: 600 - 1,200 mg, standardized to contain 50 - 100 mg of harpagoside, 3 times daily
• Dried tuber or dried root powder: 100 - 250 mg, 3 times daily
• Capsules containing dried root powder: 100 - 250 mg, 3 times daily
• Liquid extract (1:1 in 25 % alcohol): 2 - 7 drops, 3 times daily
• Tincture (1:5 in 25 % alcohol): 10 - 30 drops, 3 times daily
• Tea (Decoction): Boil 1/3 - 1 (1.5 - 4 gm) teaspoonful in water. Strain and drink, 1 - 3 times daily.

The use of herbs is a time-honored approach for strengthening the body and treating disease. Herbs, however, contain components that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care provider qualified in the field of botanical medicine.

Devil's claw is nontoxic and safe, with virtually no side effects if taken at the recommended therapeutic dose for short periods of time. However, high doses can cause mild gastrointestinal problems in some individuals, and it is not clear whether devil's claw becomes toxic if taken for long periods of time.

Individuals with stomach ulcers, duodenal ulcers, or gallstones should not take devil's claw unless recommended by a health care provider.

Safety of devil's claw for pregnant and breas-tfeeding women is not known. Therefore, it should be avoided during those times unless otherwise directed by your health care provider.

Warfarin -- Devil's claw may interact with a blood-thinning medicine called warfarin (Coumadin) and cause bruising or bleeding disorders. For this reason, individuals taking warfarin or other blood thinners should not use devil's claw without first talking to a health care provider.

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