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One of the most specific western herbal remedies for back and joint pain

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Devil’s Claw

Harpagophytum procumbens Pedaliaceae

Devil's claw is a safe option for the relief of long-term back pain and osteoarthritis.

  • How does it feel?

    The first impression in tasting devil’s claw is a dry bitter taste (due mainly to its most active constituent harpagoside), with a very slight sweetness. The bitterness is not excessive but lingering and persists in the mouth for many minutes.

    It is notable that indigenous Kalahari tribespeople used laolao (devil’s claw) not only for joints and muscle pains, that the other use of devil’s claw was as a digestive remedy and to reduce fever.

  • What can I use it for?

    Devil’s claw is specifically used in modern times as a natural and safe treatment for back pain, particularly lower back pain, and osteoarthritis. It should be taken in relatively high doses for at least a month to see real benefits.

  • Into the heart of Devil’s Claw

    Although modern laboratory research has not fully explained its effects it is clear that they are different from the usual aspirin-based or steroidal medicines most often used in conventional treatments for arthritis, and there are no reports of stomach or other digestive upsets. It is best to see this remedy as a gentle but potentially effective contribution to managing persistent aches and pains.

  • Traditional uses

    The use of devil’s claw was prominent amongst the indigenous San and Khoi people of southern Africa, and was further adopted by Bantu-speakers. These peoples used the root tuber for a range of conditions including joint and muscle pains, digestive problems, headaches and fever management, and externally for skin inflammations, wounds, ulcers, boils and the relief of pain.

  • Traditional actions

    Analgesics

    Analgesics are medications that are applied internally or externally to reduce pain. Many of them work by depressing the functions of the central nervous system, Examples of effective analgesics include Jamaican Dogwood (Piscidia erythrina), Pasqueflower (Anenome pulsatilla), California Poppy (Eschscholzia californica), Corydalis (Corydalis yanghusuo) and Wild Lettuce (Lactuca virosa). Topically, Aconite (Aconitum napellus) and Cayenne (Capsicum minimum) are powerful anodynes.

    Anti-inflammatory

    Anti-inflammatory herbs reduce inflammation in the body. There are different systems in the body that anti-inflammatory plants target. For example for the gastrointestinal tract chamomile, fenugreek and meadowsweet are useful. For the musculoskeletal system rosehips, turmeric and celery seed are useful. For inflammation against immune mediated inflammation gotu kola (centella asiatica), rehmannia (rehmannia glutinosa) and feverfew (tanacetum parthenium) can be useful.

    Bitters

    Bitters stimulate digestion by enhancing digestive secretion and peristaltic movements of the gut. They act via a reflex from the taste buds to the brain then through the vagus nerve to whole digestive system. Often these herbs are combined with warming digestives to balance the cold nature of bitters. Examples include Artichoke leaf (Cynara scolymus), Gentian root (Gentiana lutea), Wormwood leaf (Artemisia absinthium), Oregon Grape root (Mahonia aquifolium), Goldenseal root (Hydrastis canadensis).

  • What practitioners say

    In modern herbal clinical practice devil’s claw is used almost entirely as a herbal substitute for anti-inflammatory medicines. Its indigenous use however reflects its bitter digestive prospects and this may merit further exploration in modern practice.

    Evidence and experience suggests that devil’s claw needs to be provided in relatively large doses for real benefit, with over 3 grams per day over at least a month or two for back pain and arthritis. It is also likely to be more effective for moderate rather than severe problems.

  • Research

    There is little consistent indication of the way in which devil’s claw could reduce inflammation but some COX2-mediated reduction in NF-kappaB activity has been reported for harpagoside (2).

    The 2016 Cochrane review on herbal treatment for low back pain (the leading source of evidence-based systematic reviews) has concluded that with caveats for methodological quality devil’s claw has an impact on arthritic pain greater than placebo (3). An earlier review had concluded that there was moderate evidence of benefit in osteoarthritic conditions as well as low back pain for devil’s claw preparations delivering between 50-100mg harpagoside (4).

  • Did you know?

    Devil’s claw has a nasty way of propagating itself. The name is supposed to have arisen from the desperate dance that animals use in an attempt to extricate from their feet the grappling claws on the fruit.

Additional information

  • Botany description

    Devil’s claw is the root from a plant native to the Kalahari Desert in southwest Africa. It is a weedy, perennial plant with creeping stems spreading from a tuberous rootstock. The greyish-green leaves are placed either alternately or directly opposite each other. The characteristic fruits have long branching arms with anchor-like hooks (which assist their dissemination by animals) and which give the plant its most common name. The primary root descends up to 2m with secondary roots spreading out for up to 1.5m on all sides, which allows it to conserve water.

    Alternative botanical names:

    Harpagophytum zeyheri is commonly mixed with commercial samples of H. procumbens and is difficult to differentiate from it.

    Two subspecies of H. procumbens are defined: subsp. procumbens and subsp. transvaalensis.

  • Common names

    • Grapple plant (Eng)
    • Teufelskralle
    • Trampelklette (Ger)
    • Griffe du diable (Fr)
    • Duiwelsklou (Afrik)
    • Laolao (Indigenous)

  • Safety

    Devil’s claw has shown itself to have a good safety profile in toxicological studies (5). A systematic review of published clinical trials on devil’s claw concluded adverse effects were comparable with placebo (6).

  • Dosage

    3-6 g/day of the dried root taken between meals.

  • Constituents

    • Iridoid glycosides (0.5 to 3.0%), primarily harpagoside, isoharpagoside, harpagide, procumbide
    • Triterpenes
    • Phytosterols
    • Phenolic acids and glycosides,
    • Flavonoids.
    • Sugars.

    It is possible that the iridoid glycosides are converted into an active monoterpene alkaloid aucubinine B by bacterial species in the gut microbiome (1). This could be a significant factor in modulating inflammation and would add to the variability in effects that have been noted in clinical trials.

  • References

    1. Baghdikian B, Guiraud-Dauriac H, Ollivier E, et al. (1999) Formation of nitrogen-containing metabolites from the main iridoids of Harpagophytum procumbens and H. zeyheri by human intestinal bacteria. Planta Med. 65(2): 164-6. doi: 10.1055/s-2006-960456
    2. Huang TH, Tran VH, Duke RK, et al. (2006) Harpagoside suppresses lipopolysaccharide-induced iNOS and COX-2 expression through inhibition of NF-kappa B activation. J Ethnopharmacol. 104(1-2):149-55. doi: 10.1016/j.jep.2005.08.055
    3. Gagnier JJ, Oltean H, van Tulder MW, et al. (2016) Herbal Medicine for Low Back Pain: A Cochrane Review. Spine (Phila Pa 1976). 41(2): 116-33. doi: 10.1097/BRS.0000000000001310
    4. Gagnier JJ, Chrubasik S, Manheimer E. (2004) Harpgophytum procumbens for osteoarthritis and low back pain: a systematic review. BMC Complement Altern Med. 4: 13. doi: 10.1186/1472-6882-4-13.
    5. EMEA (European Medicines Agency), 2009. Assessment Report on Harpagophytum procumbens DC. and/or Harpagophytum zeyheri Decne, Radix
    6. Vlachojannis J, Roufogalis BD, Chrubasik S. (2008) Systematic review on the safety of Harpagophytum preparations for osteoarthritic and low back pain. Phytother Res. 22(2): 149-52. doi: 10.1002/ptr.2314

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Bitters: Why herbalists love them and how they help digestion

Aromatic
An ‘aromatic’ remedy, high in volatile essential oils, was most often associated with calming and sometimes ‘warming’ the digestion. Most kitchen spices and herbs have this quality: they were used both as flavouring and to ease the digestion of sometimes challenging pre-industrial foods. Many aromatics are classed as ‘carminatives’ and are used to reduce colic, bloating and agitated digestion. They also often feature in respiratory remedies for colds, chest and other airway infections. They are also classic calming inhalants and massage oils, and are the basis of aromatherapy for their mental benefits.
Astringent taste
The puckering taste you get with many plants (the most familiar is black tea after being stewed too long, or some red wines) is produced by complex polyphenols such as tannins. Tannins are used in concentrated form (eg from oak bark) to make leather from animal skins. The process of ‘tanning’ involves the coagulation of relatively fluid proteins in living tissues into tight clotted fibres (similar to the process of boiling an egg). Tannins in effect turn exposed surfaces on the body into leather. In the case of the lining of mouth and upper digestive tract this is only temporary as new mucosa are replenished, but in the meantime can calm inflamed or irritated surfaces. In the case of open wounds tannins can be a life-saver – when strong (as in the bark of broadleaved trees) they can seal a damaged surface. One group of tannins, the reddish-brown ‘condensed tannins’ are procyanidins, which can reduce inflammation and oxidative damage.
Bitter
Bitters are a very complex group of phytochemicals that stimulate the bitter receptors in the mouth. They were some of the most valuable remedies in ancient medicine. They were experienced as stimulating appetite and switching on a wide range of key digestive functions, including increasing bile clearance from the liver (as bile is a key factor in bowel health this can be translated into improving bowel functions and the microbiome). Many of these reputations are being supported by new research on the role of bitter receptors in the mouth and elsewhere round the body. Bitters were also seen as ‘cooling’ reducing the intensity of some fevers and inflammatory diseases.
Blue-purple colouring
Any fruits with a blue-purple colouring contain high levels of the polyphenols known as anthocyanins. These work 1) on the walls of small blood vessels, helping to maintain capillary structure to reduce a key stage in inflammation, and improving the microcirculation to the tissues; 2) to improve retinal function and vision; 3) to support connective tissue repair around the body.
Cooling
Traditional ‘cold’ or cooling’ remedies often contain bitter phytonutrients such a iridoids (gentian), sesiquterpenes (chamomile), anthraquinones (rhubarb root), mucilages (marshmallow), some alkaloids and flavonoids. They tend to influence the digestive system, liver and kidneys. Cooling herbs do just that; they diffuse, drain and clear heat from areas of inflammation, redness and irritation. Sweet, bitter and astringent herbs tend to be cooling.
Hot
Traditional ‘hot’ or ‘heating’ remedies, often containing spice ingredients like capsaicin, the gingerols (ginger), piperine (black or long pepper), curcumin (turmeric) or the sulfurous isothiocyanates from mustard, horseradich or wasabi, generate warmth when taken. In modern times this might translate as thermogenic and circulatory stimulant effects. There is evidence of improved tissue blood flow with such remedies: this would lead to a reduction in build-up of metabolites and tissue damage. Heating remedies were used to counter the impact of cold, reducing any symptoms made worse in the cold. .
Mucilaginous
Mucilages are complex carbohydrate based plant constituents with a slimy or ‘unctuous’ feel especially when chewed or macerated in water. Their effect is due simply to their physical coating exposed surfaces. From prehistory they were most often used as wound remedies for their soothing and healing effects on damaged tissues. Nowadays they are used more for these effects on the digestive lining, from the throat to the stomach, where they can relieve irritation and inflammation such as pharyngitis and gastritis. Some of the prominent mucilaginous remedies like slippery elm, aloe vera and the seaweeds can be used as physical buffers to reduce the harm and pain caused by reflux of excess stomach acid. Mucilages are also widely used to reduce dry coughing. Here the effect seems to be by reflex through embryonic nerve connections: reduced signals from the upper digestive wall appear to translate as reduced activity of airway muscles and increased activity of airway mucus cells. Some seed mucilages, such as in psyllium seed, flaxseed (linseed) or guar bean survive digestion to provide bulking laxative effects in the bowel. These can also reduce rate of absorption of sugar and cholesterol. .
New-mown hay aroma
The familiar country odour of haymaking, of drying grass and other plants, is largely produced by coumarins (originally isolated from tonka beans – in French coumarou) and widely used in perfumery. They are chemically categorised as benzopyrone lactones and are important phytochemicals, with strong antioxidant activity in the laboratory and likely effects in modulating inflammation. They were most often associated with the calming effect linked to their use in stuffing mattresses and pillows and plants, high In coumarins were commonly used for these properties.
Resinous
Resins are most familiar as tacky discharges from pine trees (and as the substance in amber, and rosin for violin bows). They were most valued however as the basis of ancient commodities like frankincense and myrrh (two of the three gifts of the Three Wise Men to the baby Jesus) and getting access to their source was one benefit to Solomon for marrying the Queen of Sheba (now Ethiopia). Resins were the original antiseptic remedies, ground and applied as powders or pastes to wounds or inflamed tissues, and were also used for mummification. With alcohol distillation it was found that they could be dissolved in 90% alcohol and in this form they remain a most powerful mouthwash and gargle, for infected sore throats and gum disease. They never attracted much early research interest because they permanently coat expensive glassware! For use in the mouth, gums and throat hey are best combined with concentrated licorice extracts to keep the resins in suspension and add extra soothing properties. It appears that they work both as local antiseptics and by stimulating white blood cell activity under the mucosal surface. They feel extremely effective!
Salty
The salty flavour is immediately distinctive. A grain dropped onto the tongue is instantly moistening and a sprinkle on food enkindles digestion. This easily recognisable flavour has its receptors right at the front of the tongue. The salty flavor creates moisture and heat, a sinking and heavy effect which is very grounding for the nervous system and encourages stability. People who are solid and reliable become known as ‘the salt of the earth'.
Sharpness
The sharp taste of some fruits, and almost all unripe fruits, as well as vinegar and fermented foods, is produced by weak acids (the taste is generated by H+ ions from acids stimulating the sour taste buds). Sour taste buds are hard-wired to generate immediate reflex responses elsewhere in the body. Anyone who likes the refreshing taste of lemon or other citrus in the morning will know that one reflex effect is increased saliva production. Other effects are subjective rather than confirmed by research but there is a consistent view that they include increased digestive activity and contraction of the gallbladder.
Sweet
In the days when most people never tasted sugar, ‘sweetness’ was associated with the taste of basic foods: that of cooked vegetables, cereals and meat. In other words sweet was the quality of nourishment, and ‘tonic’ remedies. Describing a remedy as sweet generally led to that remedy being used in convalescence or recovery from illness. Interestingly, the plant constituents most often found in classic tonics like licorice, ginseng are plant steroids including saponins, which also have a sweet taste.

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