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Not medical advice. The Atlas is not a substitute for a clinician who can examine you.

Devil's Claw (Sengaparile, Harpagophytum procumbens)

A Kalahari tuber whose thorns name it and whose bitterness treats it

Evidence grade 2 of 5, Thin. Read how the Atlas grades evidence.

Gagnier, Chrubasik and Manheimer's 2004 review in BMC Complementary and Alternative Medicine pooled twelve trials and reported strong evidence for an aqueous extract at 50 mg harpagoside daily in acute exacerbations of chronic non-specific low back pain. That verdict predates GRADE. The 2014 Cochrane review, with Gagnier again among the authors, reassessed the literature and found that 50 mg or 100 mg daily may beat placebo for short-term pain on low quality evidence from two trials and 315 participants, with one 88-participant trial suggesting rough equivalence to rofecoxib on very low quality evidence. The EMA read the same work and registered the root for minor joint pain as a traditional use medicine, not a well-established use one.

Reference only. Not medical advice.

What can go wrong

Generally well tolerated at label doses, with mild gastrointestinal upset the most common complaint. Devil's claw stimulates gastric acid and bile secretion, so it is contraindicated in active peptic ulcer, hyperchlorhydria and acute diarrhoea, and is cautioned in gallstone disease. Animal work shows negative chronotropic and inotropic activity, which argues for caution in arrhythmia and on antiarrhythmics or digoxin. A poorly documented case report describes purpura in a patient taking warfarin, and the theoretical bleeding interaction is enough that anticoagulated patients should tell their prescriber. The material itself is an adulteration problem: since the 1970s commerce has drawn on both H. procumbens and the lower-harpagoside H. zeyheri, often mixed, so a product's stated species is not always what is in the capsule. Avoid in pregnancy given the traditional oxytocic use.

Devil's claw is the dried secondary storage tuber of Harpagophytum procumbens, a trailing plant of the deep Kalahari sands whose woody fruit carries curved, barbed arms that catch in the hooves and hides of passing animals. The San and Tswana peoples of southern Africa used decoctions of the bitter tuber for pain, fever, digestive complaints and in childbirth long before any European recorded it. German settlers carried it north in the twentieth century, and it is now among the most commercially significant medicinal plants of Africa, with Namibia supplying most of a trade that has run at roughly 700 metric tons a year. The clinical question is narrower than the reputation. Extracts standardised to the iridoid glycoside harpagoside have been tested mainly against low back pain and osteoarthritis, and the trials are small, short and mostly old. A signal exists. The evidence supporting it is thin enough that European regulators registered the root on tradition rather than on trial data.

Kalahari pain remedy of the San and Tswana. Trials favour it for short-term low back pain, though Cochrane graded that evidence low quality and the EMA registered it on tradition.

How it is supposed to work

Harpagoside, an iridoid glycoside, is the marker compound and the basis of standardisation, though it is probably not the only active constituent. In laboratory work harpagoside and related iridoids suppress NF-kappaB activation and reduce COX-2 and iNOS expression, which would plausibly dampen inflammatory pain. Whether enough harpagoside survives gastric hydrolysis and reaches joint tissue at ordinary doses is not well established, and the gap between the cell-culture mechanism and the modest clinical results has never been closed.

What people get wrong

  • Often saidA German settler discovered devil's claw and shared it with the world.

    ActuallySan and Tswana communities had used the tuber for generations. Lübbert documented its use in 1901, before the Mehnert story is set, and the discovery narrative is best read as trade folklore.

  • Often saidDevil's claw is proven to work as well as anti-inflammatory drugs for arthritis.

    ActuallyOne 88-participant trial suggested rough equivalence to rofecoxib for back pain, and Cochrane graded it very low quality evidence. No regulator has accepted the arthritis claim as well established.

  • Often saidThe plant is endangered and CITES-listed.

    ActuallyGermany proposed an Appendix II listing at CITES CoP11 in 2000. It was not adopted. Harpagophytum sits in Annex D of the EU wildlife trade regulation, a monitoring category for species not on the CITES appendices.

Who profits, and who pushes back

  • Cochrane (Oltean, Gagnier et al., Herbal medicine for low-back pain, 2014)

    caveatsSystematic review group

    Daily doses standardised to 50 mg or 100 mg harpagoside may be better than placebo for short-term improvements in pain and reduced use of rescue medication, on low quality evidence from two trials.

  • European Medicines Agency, Committee on Herbal Medicinal Products

    caveatsEU herbal medicines regulator

    Registered devil's claw root for relief of minor joint pain as a traditional use medicine, concluding that effectiveness is plausible on the basis of at least 30 years of use rather than on adequate clinical trial evidence.

  • Sigrun Chrubasik

    supportsPhysician and pharmacologist, University of Freiburg; principal investigator on several Harpagophytum trials

    Argues from her comparative trials that standardised aqueous extracts give clinically useful relief in chronic low back pain with a better tolerability profile than conventional anti-inflammatories.

  • Kelly M. Stewart and Dave Cole

    caveatsEthnobotanist and devil's claw trade researchers, J. Ethnopharmacology 2005

    Argue that the sustainability debate has been conducted without the population and resource data needed to settle it, and that harvester livelihoods and benefit sharing deserve as much attention as the conservation question.

Where the research comes from

Most of the published research on this comes from one place. 100% of it is from Kalahari sands of Namibia, Botswana and northern South Africa, exported since the 1950s to Germany, which remains the largest market. Findings that no unrelated group has reproduced are weaker than the study count makes them look.

Share of published research by country of origin.
PlaceShare of published research
Kalahari sands of Namibia, Botswana and northern South Africa, exported since the 1950s to Germany, which remains the largest market100%

How we got here

The plant's names divide along what people noticed about it. Southern African names such as sengaparile and otjihangatene attach to the tuber and its use, while the European names, duiwelsklou, Teufelskralle, grapple plant, all describe the barbed fruit that catches in animals' feet, which is what a traveller sees first. The botanical genus name Harpagophytum makes the same observation in Greek, from harpagos, a grappling hook. A second and more consequential lineage problem sits in the trade rather than the language: since the 1970s commercial devil's claw has been drawn from both H. procumbens and the lower-harpagoside H. zeyheri, frequently mixed, so pharmacopoeial identity, label species and capsule contents have never quite converged.

Indigenous knowledge of the tuber long precedes the written record. Lübbert published on its uses in 1901 and Hellwig followed in 1907, both drawing on southern African informants. The story most often retold, that the farmer and soldier Gottreich Hubertus Mehnert learned of the plant from a local healer during the Nama and Herero wars of 1904 to 1908, has been treated sceptically by later historians, who read it as marketing romance grafted onto a much older San and Tswana pharmacopoeia. Its route into European medicine ran through the botanist O. H. Volk, interned in South West Africa during the Second World War, who met Mehnert in captivity, brought the plant to German attention on his return, and passed it to the researcher Zorn, whose work in the 1950s began the modern investigation. German firms built the export trade from there.

  1. 1901Lübbert publishes on southern African medicinal uses of Harpagophytum, the earliest substantial European record.
  2. 1907Hellwig documents further traditional applications of the tuber.
  3. 1904 to 1908The period in which Gottreich Hubertus Mehnert is said to have learned of the plant from a healer, a story later historians treat as embellished.
  4. 1950sO. H. Volk brings the plant to German scientific attention after wartime internment in South West Africa; Zorn's laboratory work begins the modern research line.
  5. 1975Namibia's Nature Conservation Ordinance makes both Harpagophytum species permit-controlled for collection, transport, possession and sale.
  6. 2000Germany proposes listing H. procumbens on CITES Appendix II at CoP11; range states object on livelihood grounds and no listing is adopted.
  7. 2004Gagnier, Chrubasik and Manheimer publish the first systematic review; the CITES Plants Committee continues reviewing the species without listing it.
  8. 2014The Cochrane review of herbal medicine for low back pain grades the devil's claw evidence as low quality.
  9. 2016The EMA adopts its revised herbal monograph, registering the root for traditional use only.

How it is understood

For San and Tswana communities the tuber is sengaparile, dug in the wet season when the plant's above-ground growth reveals where the roots lie. Traditional applications ran wider than joints: decoctions for fever, malaria, indigestion and blood diseases, ointments for sores and boils, and preparations used by women in childbirth and afterwards. Harvesting is still overwhelmingly done by hand, largely by rural women in their forties to sixties, using a digging stick to follow the lateral roots out from the parent plant.

At a glance

Key compound
Harpagoside (an iridoid glycoside), 0 to 4% in H. procumbens
Part used
Secondary storage tuber, not the parent root
Namibian export scale
Roughly 700 metric tons a year (2015 to 2020 average)
Regulatory status (EU)
EMA traditional-use monograph for minor joint pain, 2016

What this entry does not yet cover

What follows is unfinished work on our side, not a finding about Devil's Claw (Sengaparile, Harpagophytum procumbens). A short entry is not a safe entry.

  • Cost and market. We have not documented what it sells for or who sells it.
  • Supply chain. We have not mapped where it is made.
  • Who uses it. We have not documented the user groups.
  • What could change. No forward-looking summary yet.
  • How it compares. We have not set it against the alternatives.
  • Children and teenagers. We have not checked what is known about younger people.
  • What people take it for. We have not catalogued the claims made for it.

Sources