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Awaiting clinical review. This entry is sourced but has not yet been signed off by a pharmacist or clinician.

Harpagophytum procumbens (root)

Devil's claw

Devil's claw may ease low back pain in the short term, but the Cochrane review rated that evidence low quality, and the evidence in osteoarthritis is weaker and mixed. It was well tolerated in trials, with mild stomach upset the most common side effect. The EU regulator lists active gastric or duodenal ulcer as a contraindication, and it is not recommended in pregnancy.

Updated
29 September 2026
Dried devil's claw root pieces in a bowl
At a glance
Last reviewed 29 September 2026
Evidence
Limited
Best for
Short-term low back pain
Typical form & use
Root extract, 50–100 mg harpagoside/day
Onset
4+ weeks
Safety
Not with active stomach or duodenal ulcer. 1 known interaction, most serious with blood thinners.
Check with your medications →

What it's used for

Evidence is rated per use. The same ingredient can be strong for one thing and traditional for another.

UseEvidenceWhat the research shows
Low back painLimitedThe Cochrane review (2014) found that daily doses standardised to 50 mg or 100 mg harpagoside may be better than placebo for short-term pain relief and may reduce rescue medication use, from two trials with 315 participants, graded low quality. A third trial (88 participants) found rough equivalence to rofecoxib 12.5 mg a day but was graded very low quality. An earlier 2007 version of the review called the evidence strong; the 2014 update downgraded it.1,2
Osteoarthritis painLimitedResults are mixed. A meta-analysis of herbal medicines used in Brazil found no difference between devil's claw and control in osteoarthritis (one trial), and rated the overall evidence low. An older best-evidence synthesis called the evidence for devil's claw limited. A small Iranian trial (60 people with knee osteoarthritis) found similar improvement on devil's claw for one month and on meloxicam for ten days, with no placebo arm, so it cannot show the herb beats placebo.3,4,5
Mild digestive complaints and loss of appetiteTraditionalThe EU regulator recognises devil's claw root for mild bloating, flatulence and temporary loss of appetite on the basis of long-standing use alone. We did not find or review clinical trials for this use.6

How much

Ranges below are what studies used and what supplements commonly contain. They are not a recommendation for you. Start at the low end.

Studied range (back pain)
50–100 mg harpagoside daily1
The Cochrane review's trials used extracts standardised to this daily amount of harpagoside, the main active constituent. How much extract that is depends on the product, so check the harpagoside content on the label.
EU monograph range (articular pain)
Varies by preparation6
The EU monograph lists many preparations. Examples include 480 mg dry extract twice daily, 435 mg three times daily, or 4.5 g root as tea divided into 3 doses, with a daily extract dose of up to 2.7 g for some extracts.
Duration
Up to 4 weeks before review6,7
The EU monograph advises seeing a doctor or qualified practitioner if joint pain persists beyond 4 weeks, or digestive symptoms beyond 2 weeks. A 2008 safety review said long-term safety data are lacking.
Timing · The EU monograph gives dose frequencies (2 to 3 times daily for most preparations) but no time-of-day guidance.With food? · No source we read gave food guidance. Mild gastrointestinal effects are the most commonly reported side effect, so if it upsets your stomach, that is a reason to stop rather than to work around it.How long to trial · The EU monograph advises consulting a doctor or qualified practitioner if joint pain persists longer than 4 weeks, or if symptoms worsen at any point. Pain with joint swelling, redness or fever should be examined by a doctor first.

How people take it

Capsule or tablet (dry extract)Standardised to 50–100 mg harpagoside dailyThe form used in the back pain trials reviewed by Cochrane. Extract strengths differ between products, so labels are not interchangeable.
Herbal tea (root)4.5 g in 500 ml, divided into 3 dosesTraditional use in the EU monograph, infused for 8 hours. Not the form tested in the back pain trials.
Liquid extract or tincture0.5–1 ml, up to 3 times dailyOne traditional preparation in the EU monograph (a 1:5 tincture). Other liquid strengths exist, so follow the product label.

Safety

Who should avoid
  • Active stomach or duodenal ulcer — EU regulator contraindication
  • Pregnancy and breastfeeding — safety not established, not recommended
  • Under 18 — not recommended, too little data
  • Gallstones — EU regulator says consult a doctor first
  • Taking warfarin or other blood thinners — ask your prescriber first
  • Known allergy to devil's claw (rash, hives, facial swelling reported)
  • Joint pain with swelling, redness or fever — see a doctor first
Known interactions
MonitorBlood thinners — Reviews of case reports list devil's claw among herbs associated with over-anticoagulation in people on warfarin, though the EU monograph says no interactions have been reported.

Questions people ask

Does devil's claw work for back pain?

Possibly, for short-term pain. The Cochrane review found that extracts standardised to 50 or 100 mg harpagoside a day may beat placebo, but it graded the evidence low quality and the trials were small and short. It is not a proven replacement for standard treatment.

Is devil's claw safe for your stomach?

In 28 clinical trials reviewed for safety, minor side effects occurred in around 3% of patients, mainly gastrointestinal, and none of the double-blind trials reported more side effects than placebo. The EU regulator still lists active gastric or duodenal ulcer as a contraindication and gastrointestinal symptoms as reported effects.

Can I take devil's claw with warfarin?

Ask your prescriber first. Reviews of case reports list devil's claw among herbs linked to over-anticoagulation on warfarin, but the evidence is anecdotal and the EU monograph reports no interactions. We did not find a controlled study either way.

Is devil's claw as good as an anti-inflammatory drug?

Not shown. One small trial found similar pain relief to meloxicam in knee osteoarthritis, and one low-quality back pain trial found rough equivalence to rofecoxib, but neither can establish equivalence.

Sources

  1. Systematic review Oltean H, Robbins C, van Tulder MW, Berman BM, Bombardier C, Gagnier JJ. Herbal medicine for low-back pain. Cochrane Database Syst Rev. 2014.
  2. Systematic review Gagnier JJ, van Tulder MW, Berman B, Bombardier C. Herbal medicine for low back pain: a Cochrane review. Spine. 2007.
  3. Meta-analysis 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. Phytother Res. 2017.
  4. Systematic review Ameye LG, Chee WS. Osteoarthritis and nutrition. From nutraceuticals to functional foods: a systematic review of the scientific evidence. Arthritis Res Ther. 2006.
  5. Randomised trial Farpour HR, Rajabi N, Ebrahimi B. The efficacy of Harpagophytum procumbens (Teltonal) in patients with knee osteoarthritis: a randomized active-controlled clinical trial. Evid Based Complement Alternat Med. 2021.
  6. Regulator monograph European Medicines Agency HMPC. European Union herbal monograph on Harpagophytum procumbens DC. and/or Harpagophytum zeyheri Decne., radix (EMA/HMPC/627057/2015). 2016.
  7. Systematic review Vlachojannis J, Roufogalis BD, Chrubasik S. Systematic review on the safety of Harpagophytum preparations for osteoarthritic and low back pain. Phytother Res. 2008.
  8. Review Izzo AA, Di Carlo G, Borrelli F, Ernst E. Cardiovascular pharmacotherapy and herbal medicines: the risk of drug interaction. Int J Cardiol. 2005.

Last reviewed 29 September 2026 · Next review March 2027 · How we rate evidence