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White Willow; Salix alba

Proposed Uses: Back Pain; Bursitis; Dysmenorrhea; Migraine Headaches; Musculoskeletal Pain; Osteoarthritis; Rheumatoid Arthritis; Tendonitis; Tension Headaches

Willow bark has been used as a treatment for pain and fever in China since 500 B.C. In Europe, it was used for stopping vomiting, removing warts, and suppressing sexual desire.

In 1828, European chemists extracted the substance salicin from white willow, which was soon purified to salicylic acid. Salicylic acid is an effective treatment for pain and fever, but it is also sufficiently irritating to do a good job of burning off warts. Chemists later modified salicylic acid to create acetylsalicylic acid, or aspirin.

Today, as interest in natural medicine has grown, many people have begun to turn back to white willow as an alternative to aspirin. One trial found it effective for back pain, and another found it helpful for osteoarthritis. It is also used for such conditions as bursitis, dysmenorrhea, tension headaches, migraine headaches, rheumatoid arthritis, and tendonitis. However, two recent studies failed to find it effective for rheumatoid arthritis or osteoarthritis.

Aspirin and related anti-inflammatory drugs are notorious for irritating or damaging the stomach. However, when taken in typical doses, willow does not appear to produce this side effect to the same extent.

Dosage
Standardized willow bark extracts should provide 120 to 240 mg of salicin daily.

Safety Issues
Evidence suggests that willow, taken at standard doses, is the equivalent of 50 mg of aspirin, a very small dose. Willow doesn't impair blood coagulation to the same extent as aspirin, and also doesn't appear to significantly irritate the stomach.

Nonetheless, it seems reasonable to suppose that if it is used over the long term or in high doses willow could still cause the side effects associated with aspirin. All the risks of aspirin therapy potentially apply. For this reason, white willow should not be given to children, due to the risk of Reye's syndrome. It should also not be used by people with aspirin allergies, bleeding disorders, or kidney disease, and it may interact adversely with "blood thinners," or other anti-inflammatory drugs.

Safety in pregnant or nursing women, or those with severe liver or kidney disease, has not been established.

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