Willow Bark in the Treatment of Low Back Pain
Reference:Chrubasik S, et al Treatment of low back pain with a herbal or synthetic anti-rheumatic: a randomized controlled study. Willow bark extract for low back pain. Rheumatology .2001 Dec;40(12):1388-93.
NSAIDs are one of the primary interventions prescribed by Physicians for patients with acute, sub acute or recurring low back pain. There have been several studies that have shown the superiority of NSAIDs over placebo with respect to short-term pain relief;
…however, these studies have also demonstrated significantly greater adverse side effects with NSAIDs versus placebo.
In this RCT, a total of 228 patients with at least 6 months history of recurring non-specific low back pain were randomly allocated to one of two groups, for 4 weeks:
Group 1: NSAID -received a single daily 12.5 mg tablet of Rofecoxib
Group 2: Willow Bark- received 4 capsules/day of Assalix (240 mg of salicin) (40% less cost)
Result:With respect to pain relief and recurrences, there were no statistical differences between the two groups. (Only the fact that GI side-effects were more common in the NSAID group)
Clinical Relevance: Considering the equal effectiveness of NSAIDs and Willow bark for individuals with low back pain, Willow bark extract appears to have the upper hand as it is significantly more cost effective and less likely to produce any significant GI adverse effects.
Clinical Relevance #2: It is also hypothesized that unlike NSAIDs, Willow bark extract may actually have a preventive effect on cartilage destruction.
Personal Comment:Considering the limited but convincing evidence, as a physical therapist I will now recommend my patients to speak to their MD, a pharmacist or a Naturopath, and question Willow bark extract as an option. Especially for those either contra-indicated for or who for various reasons do not wish to use NSAIDs.
Posted on: April 26, 2007
Categories: Modalities / Meds / Supplements