Willow Bark (Salix Alba) for Musculoskeletal Pain and Inflammation
Willow bark has been used for centuries as a treatment for pain, headache, and inflammatory conditions such as bursitis and tendinitis. The bark of white willow contains salicin, the chemical that was used to develop aspirin. Despite its long history of use, only a few small clinical trials have been conducted that support the use of willow bark extracts in chronic low-back pain and osteoarthritis.
What Does the Research Show?
- A 2019 review evaluated current research on dietary ingredients for chronic musculoskeletal pain to inform decisions for practice and self-care, specifically for Special Operations Forces personnel in the U.S. military. Nineteen eligible dietary ingredients were assessed for quality, efficacy, and safety. Recommendations were made against the use of willow bark extract and several other supplements to mitigate chronic musculoskeletal pain.
- A 2015 review of willow bark extract concluded that based on available evidence in conjunction with its anecdotal use for hundreds of years, the findings suggest that willow bark extract is effective as an analgesic and anti-inflammatory.
- A 2014 Cochrane review of 2 clinical trials involving 261 participants found moderate quality evidence that daily doses of white willow bark are probably better than placebo for short-term improvements in low-back pain and may reduce the use of rescue medication.
Safety
- A 2019 U.S. Pharmacopeia safety review of willow bark found that no serious adverse events were reported from trials of willow bark extracts delivering 120 to 240 mg salicin (the purported active constituent) daily for up to 8 weeks. It is important to note that the trials were conducted in adults only, and none involved children, or pregnant or breastfeeding women. The most common adverse effects associated with willow bark are gastrointestinal, and a few allergic reactions were also reported. The review also concluded that there is a risk of increased bleeding in vulnerable individuals, salicylates cross the placenta and are eliminated slowly in newborns, some persons are sensitive or allergic to aspirin, and children are at risk of Reye's syndrome. Concurrent use with other salicylate-containing medicines increases these risks.
- Children, people who are pregnant or nursing, or people with known sensitivity to aspirin should not use willow bark.
Source: National Center for Complementary and Integrative Health (NCCIH)