White willow bark (Salix alba)

Tier 2 — promising · Pain · Inflammation · Back pain

Contains salicin, a natural precursor to aspirin. ESCOP approves it for back pain, osteoarthritis, and headache. A 2024 review found 240 mg salicin per day significantly reduces lower back pain. Gentler on the stomach than aspirin in most studies. Avoid in children under 16 due to theoretical Reye syndrome risk. Do not combine with blood thinners or NSAIDs.

Dose: 240 mg salicin/day from standardised extract; avoid with aspirin, NSAIDs, and anticoagulants