Willow Bark for All-Natural Pain Relief?

Bark detail of White Willow, Hungary / (Salix alba)
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What is Willow Bark?

Willow bark comes from the willow tree (Salix species). The bark contains salicin, a compound chemically similar to aspirin. Salicin is metabolized in the body to salicylic acid, which is a precursor to aspirin. The herbal extract became popular as a remedy to relieve pain, inflammation, and fever. In the late 1800s, chemists discovered a way to make a synthetic version called acetylsalicylic acid, or aspirin.

Why Do People Use Willow Bark?

Willow bark is said to help manage pain and inflammation for the following health issues:

For cost-savings, a desire to go all-natural, or another reason entirely, willow bark is sometimes used as an alternative non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen.

The herb is available in supplement, tincture, extract, or tea form. It can also be found in skin care products, including ointments and salves. 

The Benefits of Willow Bark: Can It Help?

Here's a look at several findings from the available research:

1) Osteoarthritis

Two studies on willow bark extract for osteoarthritis had disparate findings. In a study published in Phytotherapy Research in 2001, the effectiveness of a willow bark extract providing 240 mg of salicin daily was compared to a placebo in 78 people with osteoarthritis.

After two weeks of treatment, pain scores (on the WOMAC Osteoarthritis Index) in those taking willow bark were reduced by 14 percent compared to those taking the placebo, who had a two percent increase in pain scores.

A six-week study published in the Journal of Rheumatology in 2004 examined the safety and effectiveness of white willow bark in 127 people with hip and/or knee osteoarthritis and 26 people with rheumatoid arthritis.

In the osteoarthritis trial, people received willow bark providing 240 mg salicin, 100 mg of the medication diclogenac, or a placebo daily. People in the rheumatoid arthritis trial received either willow bark or a placebo. The results found that diclofenac, but not white willow bark, was more effective than the placebo in people with osteoarthritis. In rheumatoid arthritis patients, willow bark wasn't more effective than the placebo.

Related: 5 Remedies For Osteoarthritis Pain

2) Low Back Pain

For a report published in the Cochrane Database of Systematic Reviews in 2016, researchers analyzed previously published clinical trials on herbal treatments for low back pain. White willow bark (Salix alba) seemed to reduce pain more than a placebo, however the quality of the reviewed studies was considered moderate at best. No significant adverse events were noted. 

Related: Remedies For Back Pain

Possible Side Effects

Willow bark contains salicylates, so the same precautions as aspirin should be taken until research has shown otherwise.

It shouldn't be taken long-term or in excessive doses.

Children, teenagers, and breastfeeding women shouldn't take willow bark. Like aspirin, there is a risk of a rare, but serious and sometimes fatal condition known as Reye's syndrome.  

The safety of willow bark during pregnancy isn't known, so it would be best to avoid using it.

People with an aspirin or salicylate allergy or sensitivity shouldn't take willow extract.

Some research suggests that people with ulcers, heartburn, liver or kidney disease, anemia, hemophilia, hypoprothrombinemia, gout, hyperuricemia, or asthma may need to avoid willow bark.

Willow bark may prolong bleeding time. It shouldn't be taken with anticoagulant or antiplatelet drugs or supplements, such as warfarin, non-steroidal anti-inflammatory drugs (NSAIDS), ginkgo, vitamin E, or garlic, or by people with bleeding disorders. It should not be taken before having surgery. Willow bark may interact with other medications.

The same side effects as aspirin may theoretically occur. While side effects tend to be mild, stomach upset, ulcers, naus such as ringing in the ears, stomach/intestinal bleeding and ulcers, nausea, liver toxicity, rash, dizziness, and kidney impairment. 

You can get tips on using supplements here, but if you're considering the use of willow bark, talk with your primary care provider first to discuss whether it's appropriate for you. 


Biegert C, Wagner I, Ludtke R, et al. Efficacy and safety of willow bark extract in the treatment of osteoarthritis and rheumatoid arthritis: results of 2 randomized double-blind controlled trials. J Rheumatol. 2004 Nov;31(11):2121-30.

Gagnier JJ, Oltean H, van Tulder MW, Berman BM, Bombardier C, Robbins CB. Herbal Medicine for Low Back Pain: A Cochrane Review. Spine (Phila Pa 1976). 2016 Jan;41(2):116-33. 

Schmid B, Lüdtke R, Selbmann HK, et al. Efficacy and tolerability of a standardized willow bark extract in patients with osteoarthritis: randomized placebo-controlled, double blind clinical trial. Phytother Res. 2001 Jun;15(4):344-50.

Disclaimer: The information contained on this site is intended for educational purposes only and is not a substitute for advice, diagnosis or treatment by a licensed physician. It is not meant to cover all possible precautions, drug interactions, circumstances or adverse effects. You should seek prompt medical care for any health issues and consult your doctor before using alternative medicine or making a change to your regimen.

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