Moderate evidenceJoints & skin

White Willow Bark

Willow bark standardised to 240 mg salicin per day probably beats placebo for short-term low back pain, but the best-conducted osteoarthritis and rheumatoid arthritis trials were negative. It is a weak, slow salicylate — not a natural aspirin equivalent.

What the science says

Short-term low back pain Moderate evidence
Cochrane rated the evidence moderate quality: two trials (261 participants) found 240 mg salicin/day better than placebo for pain and rescue medication use over 4 weeks, with 120 mg/day giving a weaker, less consistent response.
Osteoarthritis and rheumatoid arthritis Limited evidence
Two randomised double-blind trials published together in 2004 (127 patients with OA, 26 with RA) gave 240 mg salicin/day for 6 weeks and found no significant benefit over placebo, while the diclofenac control arm did separate from placebo. An earlier smaller positive OA trial has not been reproduced.
Not an aspirin substitute for cardiovascular protection Limited evidence
Salicin doses used in trials deliver far less salicylate than low-dose aspirin, and a 51-participant comparison found willow bark had only minimal effect on platelet aggregation versus a cardioprotective aspirin dose. Do not use it in place of prescribed antiplatelet therapy.

Dosage & safety

Studied doseExtracts standardised to salicin content: 240 mg salicin/day is the dose with the best support (commonly 1-2 capsules of a 15-25% salicin extract); 120 mg/day is weaker. Trials lasted 4-6 weeks.

SafetyWillow bark is a salicylate source and carries salicylate risks: avoid in aspirin allergy or salicylate-sensitive asthma, and do not give to children or teenagers with viral illness because of Reye's syndrome risk. Additive bleeding risk with anticoagulants, antiplatelets and NSAIDs; stop before surgery. Gastrointestinal irritation and rare hypersensitivity reactions including anaphylaxis have been reported. Avoid in pregnancy, breastfeeding, and significant kidney disease. Salicin can produce a positive result on salicylate assays.

Scientific references

Herbal medicine for low-back pain
Oltean H, Robbins C, van Tulder MW, Berman BM, Bombardier C, Gagnier JJ — Cochrane Database of Systematic Reviews, 2014
Efficacy and safety of willow bark extract in the treatment of osteoarthritis and rheumatoid arthritis: results of 2 randomized double-blind controlled trials
Biegert C, Wagner I, Lüdtke R, Kötter I, Lohmüller C, Günaydin I, Taxis K, Heide L — The Journal of Rheumatology, 2004

Where to buy

Nutricost, White Willow Bark, 600 mg, 240 Capsules

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