Osteoarthritis is a degenerative joint disease that affects approximately 27 million people in America.
It can affect any joint but mostly affects knees, lower back, hips and joints of fingers.
Cartilage is a soft bone tissue present at the end of every bone and it provides a smooth surface to ensure that joints move with ease.
In osteoarthritis, the cartilage breaks down leading to pain and inflammation. As osteoarthritis worsens, the bone starts degrading and developing growth called spurs.
Bits of cartilage and bone start floating around the joint and triggering inflammation. In the last stages of osteoarthritis, the cartilage wears away causing friction and pain between bones.
Symptoms include joint pain, swelling, reduced joint function and weakness and numbness of arms and legs.
Previous joint injury, age, obesity, and certain inherited factors can predispose you to this condition. Treatment involves exercise, lifestyle changes, and pain medications.
Pain medications involve use of opiods and non-steroidal anti-inflammatory drugs.
A variety of natural alternative treatments are available for osteoarthritis and here we are focusing on willow bark as a therapeutic aid for osteoarthritis.
What is willow bark?
Willow bark extract is obtained from bark of willow tree.
Trees of willow family are found in Europe, Asia, and North America. Some of the common species include white willow, black willow, crack willow, purple willow, and weeping willow.
Hippocrates in 400 BC suggested chewing willow bark to reduce fever and inflammation. The willow bark contains a compound of salicin. This is similar to aspirin or acetylsalicylic acid.
Salicin, when consumed, gets broken down to salicylic acid and this helps in controlling pain and inflammation.
Willow bark has been used in the treatment of osteoarthritis, low back pain, headache, and inflammatory conditions.
Salicin in combination with other anti-inflammatory compounds helps in reducing pain and inflammation.
Willow bark also has antioxidant, fever reducing, antiseptic and immune boosting properties.
People use willow bark as an alternative to aspirin since willow bark does not cause gastric erosions like aspirin.
How does willow bark aid in osteoarthritis?
Willow bark serves as a painkiller and anti-inflammatory agent in osteoarthritis.
1. It reduces inflammation
Tumor necrosis factor-alpha and nuclear factor kappa B are two proteins that play an important role in inflammation.
They activate other enzymes and proteins that aggravate inflammation. Willow bark extract mediates anti-inflammatory property by downregulating the activity of these proteins.
Apart from salicin, other compounds such as salicylates, polyphenols, and flavonoids present in willow bark extract contribute to its anti-inflammatory effect.
This prevents the activation of inflammatory cells, prostaglandins, and leukotrienes which contribute to swelling, redness, pain in inflammation.
Its anti-inflammatory and antioxidant effect are found to be superior than anti-inflammatory agents like aspirin and celecoxib.
Aspirin and diclofenac inhibit both COX-1 and COX-2 whereas willow bark increase COX-1 levels and this difference in action could explain the reduced adverse events.
What does this mean? Willow bark extract mediates anti-inflammatory by inhibiting the activity of inflammatory mediators like COX, TNF-alpha, Nuclear factor kappaB. This can aid in reducing inflammation and bone degradation in osteoarthritis.
2. It reduces pain
Due to its analgesic effect, willow bark extract is included in dietary supplements used to alleviate joint pain.
A 6-month study was conducted where 436 patients suffering from pain due to osteoarthritis and low back pain were treated with aqueous willow bark extract and painkiller medications.
A 45.6% reduction in pain was observed and researchers concluded that willow bark extract can be used in combination with painkillers.
A review study examining the effect of willow bark extract on musculoskeletal pain showed that daily doses of 240mg have a moderate effect on low back pain and higher doses may be required for treatment of osteoarthritis and rheumatoid arthritis.
A study in humans reports that willow extract is as effective as non-steroidal anti-inflammatory drug rofecoxib in reducing pain.
What does this mean? Willow bark mediates analgesic property that aids in various musculoskeletal pain.
3. It improves joint function in osteoarthritis
Animal study suggests that willow extract reduces degradation of collagen tissue, inflammation, swelling, and bone degradation.
Biegert et. al conducted a study where 127 patients with hip or knee osteoarthritis were treated with wither 240mg salicin/day or diclofenac 100mg/day or placebo.
The researchers concluded that willow bark was not effective in treating arthritis but the results demonstrated a 17% reduction in pain compared to 47% in the diclofenac group and 10% in the placebo group.
Schmid et. al reported a 14% decrease in pain in osteoarthritis patients when treated with 240mg salicin per day for 2 weeks.
Willow bark is effective in treating initial stages of osteoarthritis of hip and knee.
A study reports that 1572 mg of willow bark extract containing 240mg of salicin per day was more effective than placebo in treating pain in osteoarthritis of hip and knee.
What does this mean? Studies report that willow bark extract is effective in reducing pain and improving joint function in osteoarthritis.
How to take Willow Bark for Osteoarthritis?
The simplest way of taking willow bark is obtaining the dried bark and chewing it. The powdered form of the bark is also available.
You can boil the powder in water and steep and consume the tea that is formed. You can also add the powder to herbal teas and consume it.
Willow bark extract is also available as fluid extract, tincture or capsules and can be taken as advised by the doctor.
The recommended dose is as follows:
- Powder: ½ to 2 teaspoons boiled in 1 cup water for 5 minutes and taken 3-5 times a day
- Fluid extract: 1-3 ml three times a day
- Capsules: As prescribed by the doctor
- Topical: Infused in vegetable oil and applied locally on inflamed joints
Studies recommend a dose of 240mg of the bark daily. Consult a doctor before taking willow bark supplements.
Willow bark does not cause any side effects but if taken in high doses can cause skin rash or gastric symptoms.
Children below the age of 18 and pregnant or breastfeeding women should not take willow bark.
In case you are allergic to aspirin, you should not take willow bark. Researchers suggest that people with asthma, diabetes, gout, gastritis, hemophilia, stomach ulcers, or with kidney or liver issues should not take willow bark.
Willow bark could have drug interactions with the following medications:
- Blood-thinning medications
- Non-steroidal anti-inflammatory drugs
- Methotrexate and phenytoin
Willow bark can serve as a complementary treatment for osteoarthritis.
Salicin found in willow bark can help in reducing pain and inflammation in osteoarthritis and improve joint function.
Unlike conventional painkillers, it does not cause any erosion of the gastric lining.
Consult a doctor before taking willow bark supplements.