Devil's claw (Harpagophytum procumbens)

Tier 2 — promising · Joint pain · Back pain · Inflammation

A South African herb with strong evidence for lower back pain and osteoarthritis. ESCOP and multiple Cochrane-quality reviews confirm significant pain reduction at doses providing 50 to 100 mg harpagoside daily. Works through anti-inflammatory pathways similar to NSAIDs. May cause digestive upset in some people. Avoid with blood thinners and stomach ulcers.

Dose: 600–1,200 mg/day extract providing 50–100 mg harpagoside; avoid with anticoagulants