Summary

Devil's claw was traditionally used by tribes in southern Africa and it has been adopted in modern western herbalism for pain management and digestive disorders to a lesser degree. The Commission E approved the use of devil's claw root for loss of appetite, dyspepsia, and degenerative disorders of the locomotor system. Devil's claw root has been used to treat painful arthroses, tendonitis, indigestion, blood diseases, headache, allergies, rheumatism, arthritis, lumbago, neuralgia, and fever, and externally for sores, ulcer, boils, and skin lesions.

The root contains a variety of phytochemicals and in particular the iridoid glycosides (harpagosides), that possess anti-inflammatory action. They work by inhibiting multiple enzymes involved in inflammation including inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2). Its analgesic properties may improve opioid analgesic efficacy thus reducing dependency for pain management. Devil's claw is primarily used to decrease pain associated with osteoarthritis and low back pain and is supported by research. Also, it appears to inhibit degradation of the cartilage therefore possibly playing a role in slowing the progression in joint degeneration and the development of arthritis.

Published clinical trials support the use of devil's claw for back pain and arthritis.

Indications

Musculoskeletal
• rheumatic conditions
- osteoarthritis (OA)
- rheumatoid arthritis (RA)
• tendonitis
• sprains / strains
• bursitis
• lumbago (chronic back pain)
• plantar fasciitis

Gastrointestinal
• atonic digestive complaints
• dyspepsia
• hypochlorhydria

Dermatologic
• skin infections
• wounds
• bruises

Actions

• Antiinflammatory
• Antirheumatic
• Analgesic
• Bitter
• Stomachic
• Hepatic
• Cholagogue
• Choleretic
• Antithrombotic

Constituents

• Iridoid Glycosides (E.g. Harpagoside)
• Diterpenes
• Flavonoids
• Phenolic Acids

Posology

• Tincture (1:5 in 40% EtOH): 1-2 ml tid
• Decoction (dried root): 1/2-1 tsp tid

Note: must be taken for at least 1 month before efficacy can be evaluated.

Safety

Gastritis, ulcers: Stimulation of gastric secretions can irritate inflamed mucous membranes; concomitant ingestion of demulcent herbs can help prevent.aggravation.

Blood thinners • may potentiate effects.

References

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Bone K. Principles and Practice of Phytotherapy. Edinburgh: Churchill Livingstone, 2000.

Bone K. A Clinical Guide to Blending Liquid Herbs: Herbal Formulations for the Individual Patient. St Louis, MO: Churchill Livingstone, 2003.

Brinker F. The Toxicology of Botanical Medicines, 3rd ed. Sandy, Oregon: Eclectic Medical Publications, 2000.

Felter HW, Lloyd JU. King's American Dispensatory. 1898. http://www.ibiblio.org/herbmed/eclectic/kings/main.html. Accessed: August 19, 2006.

Hoffman D. Medical Herbalism. Rochester, Vermont: Healing Arts Press, 2003.

Weiss RF. Herbal Medicine. Beaconsfield, England: Beaconsfield Publishers Ltd, 1988.

Williamson EM, ed. Major Herbs of Ayurveda. Edinburgh: Churchill Livingstone, 2002