Garra del diablo

Related Terms

Acteoside, Afrikanische Teufelskralle (German), Algophytum?, ao ao, aromatic acids, arpagofito (Italian), Arthrosetten H?, Arthrotabsm?, Artigel?, artiglio del diavolo, arpagofito (Italian), Artosan?, beta-sitosterol, burdock, caffeic acid, cinnamic acid, Defencid?, Devil's Claw Capsule?, Devil's Claw Secondary Root?, Devil's Claw Vegicaps?, Doloteffin?, duiwelsklou (Afrikaans), ekatata (Ndonga, Kwangali), elyata (Kwanyama), Fitokey Harpagophytum?, grapple plant, griffe du diable (French), gum resins, Hariosen?, Harpadol?, HarpagoMega?, Harpagon?, Harpagophyti radix (Latin), Harpagophytum procumbens, Harpagophytum zeyheri, harpagoquinone, harpagoside, iridoid glycosides, isoacteoside, Jucurba N?, khams, khuripe, kloudoring (Afrikaans), likakata (Gciriku, Shambyu), otjihangatene (Herero), Pedaliaceae (family), procumbide, procumboside, Rheuma-Sern?, Rheuma-Tee?, Salus?, sengaparile (Senegalese), stigmasterol, S?dafrikanische Teufelskralle, Trampelklette (German), triterpenes, Venustorn (Danish), Windhoek's root, wood spider, xemta'eisa (Kung bushman), xsamsa-oro6-acetylacteoside.

Background

Devil's claw (Harpagophytum procumbens) originates from the Kalahari and Savannah desert regions of South and Southeast Africa. In these parts of the world, devil's claw has historically been used to treat a wide range of conditions including fever, malaria, and indigestion. The medicinal ingredient of the devil's claw plant is extracted from the dried out roots.
Currently, the major uses of devil's claw are as an anti-inflammatory and pain reliever for joint diseases, back pain, and headache. There is currently widespread use of standardized devil's claw for mild joint pain in Europe.
Potential side effects include gastrointestinal upset, low blood pressure, or abnormal heart rhythms (increased heart rate or increased heart squeezing effects).
Traditionally, it has been recommended to avoid using devil's claw in patients with stomach ulcers or in people using blood thinners (anticoagulants such as warfarin/Coumadin?).

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


There is increasing scientific evidence suggesting that devil's claw is safe and beneficial for the short-term treatment of pain related to degenerative joint disease or osteoarthritis (8-12 weeks), it may be equally effective as drug therapies such as non-steroidal anti-inflammatory drugs like ibuprofen (Advil?, Motrin?), and it may allow for dose reductions or stopping of these drugs in some patients. However, most studies have been small with flaws in their designs. Additional well-designed trials are necessary before a firm conclusion can be reached.

 B


There is increasing scientific evidence suggesting that devil's claw is safe and beneficial for the short-term treatment of pain related to degenerative joint disease or osteoarthritis (8-12 weeks), it may be equally effective as drug therapies such as non-steroidal anti-inflammatory drugs like ibuprofen (Advil?, Motrin?), and it may allow for dose reductions or stopping of these drugs in some patients. However, most studies have been small with flaws in their designs. Additional well-designed trials are necessary before a firm conclusion can be reached.

 B


There are several human studies that support the use of devil's claw for the treatment of low back pain. However, most studies have been small with flaws in their designs, and many have been done by the same authors. Therefore, although these results can be considered promising early evidence, additional well-designed trials are necessary before a firm conclusion can be reached. It is not clear how devil's claw compares to other therapies for back pain.

 B


There are several human studies that support the use of devil's claw for the treatment of low back pain. However, most studies have been small with flaws in their designs, and many have been done by the same authors. Therefore, although these results can be considered promising early evidence, additional well-designed trials are necessary before a firm conclusion can be reached. It is not clear how devil's claw compares to other therapies for back pain.

 B


Traditionally, devil's claw was commonly used as an appetite stimulant, and this remains a popular use. However, there is no reliable scientific evidence in this area, and it remains unclear if devil's claw is beneficial as an appetite stimulant.

 C


Traditionally, devil's claw was commonly used as an appetite stimulant, and this remains a popular use. However, there is no reliable scientific evidence in this area, and it remains unclear if devil's claw is beneficial as an appetite stimulant.

 C


Devil's claw is used to treat several types of pain, including osteoarthritis and low back pain. One case report indicates it may also be helpful for pain due to bone metastases. More research is needed in this area before a conclusion can be drawn.

 C


Devil's claw is used to treat several types of pain, including osteoarthritis and low back pain. One case report indicates it may also be helpful for pain due to bone metastases. More research is needed in this area before a conclusion can be drawn.

 C


Devil's claw is popular as a digestive tonic for the relief of constipation, diarrhea, and flatulence. However, there is no reliable scientific evidence in this area, and it remains unclear if devil's claw is beneficial for these uses.

 C


Devil's claw is popular as a digestive tonic for the relief of constipation, diarrhea, and flatulence. However, there is no reliable scientific evidence in this area, and it remains unclear if devil's claw is beneficial for these uses.

 C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

Adults(18 years and older)
In general, a liquid extract (1:1 in 25% ethanol) of 0.10-0.25 milliliter three times daily has been used. For appetite loss or stomach discomfort, 1.5 grams daily in decoction or preparations with adequate bitterness has been used. For low back pain or osteoarthritis, 2-9 grams daily of crude extract or equivalent amounts of extract has been used. As tablets, 600 to 1,200 milligrams (standardized to contain 50 to 100 milligrams of harpagoside) by mouth three times per day has been used. For treatment of painful osteoarthritis, treatment for 2-3 months is often recommended. A doctor should be consulted if symptoms continue for longer.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Interactions

Interactions with Drugs
Devil's claw may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. A qualified healthcare provider should monitor patients taking drugs for diabetes by mouth or insulin closely. Medication adjustments may be necessary.
In theory, devil's claw may have an additive effect if taken with drugs used for pain, inflammation, high cholesterol, and gout. Drugs used for malaria may also interact.
Devil's claw may increase stomach acidity and therefore may affect drugs used to decrease the amount of acid in the stomach, such as antacids, sucralfate, ranitidine (Zantac?), and esomeprazole (Nexium?). Individuals taking any of these drugs should consult a qualified healthcare professional, including a pharmacist, before taking devil's claw.
Because devil's claw may affect heart rhythm, heart rate, and the force of heartbeats, individuals taking prescription drugs such as antiarrhythmics or digoxin (Lanoxin?) should consult their healthcare providers before taking devil's claw.
In theory, devil's claw may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin?) or heparin, anti-platelet drugs such as clopidogrel (Plavix?), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin?, Advil?) or naproxen (Naprosyn?, Aleve?).

Attribution

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

Chantre P, Cappelaere A, Leblan D, et al. Efficacy and tolerance of Harpagophytum procumbens versus diacerhein in treatment of osteoarthritis. Phytomedicine 2000;7(3):177-183.
Chrubasik S, Model A, Black A, et al. A randomized double-blind pilot study comparing Doloteffin? and Vioxx? in the treatment of low back pain. Rheumatology 2003;42:141-148.
Chrubasik S, Sporer F, Wink M. [Harpagoside content of different powdered dry extracts from Harpagophytum procumbens]. Forsch Komplmentarmed 1996;3:6-11.
Chrubasik S, Sporer F, Wink M, et al. Zum wirkstoffgehalt in arzneimitteln aus harpagophytum procumbens. Forsch Komplement?rmed 1996;3:57-63.
Chrubasik S, Conradt C, Black A. The quality of clinical trials with Harpagophytum procumbens. Phytomedicine 2003;10(6-7):613-623.
Chrubasik S, Conradt C, Roufogalis BD. Effectiveness of Harpagophytum extracts and clinical efficacy. Phytother Res 2004;18(2):187-189.
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. Eur J Anaesthesiol 1999;16(2):118-129.
Circosta C, Occhiuto F, Ragusa S, et al. A drug used in traditional medicine: Harpagophytum procumbens DC. II. Cardiovascular activity. J Ethnopharmacol 1984;11(3):259-274.
Ernst E, Chrubasik S. Phyto-anti-inflammatories. A systematic review of randomized, placebo-controlled, double-blind trials. Rheum Dis Clin North Am 2000;26(1):13-27.
Grant L, McBean DE, Fyfe L, et al. A review of the biological and potential therapeutic actions of Harpagophytum procumbens. Phytother Res 2007;21(3):199-209.
Gagnier JJ, van Tulder MW, Berman B, et al. Herbal medicine for low back pain: a Cochrane review. Spine 1-1-2007;32(1):82-92.
Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm 2000;57(13):1221-1227.
Lanhers MC, Fleurentin J, Mortier F, et al. Anti-inflammatory and analgesic effects of an aqueous extract of Harpagophytum procumbens. Planta Med 1992;58(2):117-123.
Laudahn D, Walper A. Efficacy and tolerance of Harpagophytum extract LI 174 in patients with chronic non-radicular back pain. Phytother Res 2001;15(7):621-624.
Wegener T, Lupke NP. Treatment of patients with arthrosis of hip or knee with an aqueous extract of devil's claw (Harpagophytum procumbens DC.). Phytother Res 2003;17(10):1165-1172.