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Herbals Effective for Low-Back Pain
By Sunil Shetty
The herbal preparations devil's claw, white willow bark and cayenne
plasters may be as effective as pain medication for short-term low back pain and are better
than placebo, a new systematic review of studies has found.
The review comprised 10 randomized controlled trials involving nearly
1,600 adults who had acute, sub-acute or chronic low back pain.
The authors looked at randomized controlled trials of the three herbals that involved
nearly 1,600 adults with acute, sub-acute or chronic low back pain.
The studies pitted devil's claw (Harpago procumbens), white willow
bark (Salix alba) and cayenne (Capsicum frutescens) against sham
pills and against Vioxx, the painkiller since removed from the market
amid concerns over its long-term safety.
"The results of these 10 trials suggest that specific herbal medicines
may be effective for short-term (four to six weeks) improvement in pain
and functional status for individuals with acute episodes of chronic
non-specific low-back pain," the authors concluded. "These herbal
medicines could be considered as treatment options for acute
episodes of chronic low back pain," they said.
But the authors cautioned that the long-term efficacy and safety of the
herbal treatments remain uncertain because "there is insufficient
evidence to make definitive conclusions regarding those trials
comparing herbal medicine interventions with standard drugs."
The trials of devil's claw were the strongest in terms of methodology,
followed by white willow bark and cayenne, the trials of which were
rated "generally of low quality."
Low back pain afflicts eight out of 10 people at some point in their
lives, according to the National Institute of Arthritis and
Musculoskeletal and Skin Diseases, and it is the second most
frequent cause of work absence in industrialized nations. In the
United States alone, back pain is the most common cause of
disability in people under 45 years of age and is responsible for direct
costs of $20 billion, the authors report.
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Current standard treatments include tissue stimulation, pain medication, exercise
and back braces. Drugs and physical activity show the best results,
the authors said.
The study found strong evidence that a 50 mg dose of devil's claw
was better than placebo in the short term but only moderate evidence
for a 100 mg dose. In a much smaller trial, there did not appear to be
any difference between devil's claw and Vioxx.
In a trial of white willow bark versus placebo, the stronger the dose,
the more pain relief was found. The stronger dose of white willow bark
produced similar pain relief to Vioxx in the short term.
A trial of cayenne plasters produced improvement in pain versus
placebo but no difference versus a homeopathic preparation.
"Given that Vioxx was taken off the market due to safety concerns, at
this point it would be desirable to recommend all three of the above
alternatives for short-term relief, but medication-herbal medicine
interactions must always be considered," Gagnier said, cautioning,
"These treatments should not be tried without the supervision of a
qualified medical professional," he said.
About the Author
Sunil is a very good article writer.
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