| Summary: | <p>Abstract</p> <p>Background</p> <p>The objective of this review is to determine the effectiveness of <it>Harpagophytum procumbens </it>preparations in the treatment of various forms of musculoskeletal pain.</p> <p>Methods</p> <p>Several databases and other sources were searched to identify randomized controlled trials, quasi-randomized controlled trials, and controlled clinical trials testing <it>Harpagophytum </it>preparations in adults suffering from pain due to osteoarthritis or low back pain.</p> <p>Results</p> <p>Given the clinical heterogeneity and insufficient data for statistical pooling, trials were described in a narrative way, taking into consideration methodological quality scores. Twelve trials were included with six investigating osteoarthritis (two were identical trials), four low back pain, and three mixed-pain conditions.</p> <p>Conclusions</p> <p>There is limited evidence for an ethanolic <it>Harpagophytum </it>extract containing less than <30 mg harpagoside per day in the treatment of knee and hip osteoarthritis. There is moderate evidence of effectiveness for (1) the use of a <it>Harpagophytum </it>powder at 60 mg harpagoside in the treatment of osteoarthritis of the spine, hip and knee; (2) the use of an aqueous <it>Harpagophytum </it>extract at a daily dose of 100 mg harpagoside in the treatment of acute exacerbations of chronic non-specific low back pain; and (3) the use of an aqueous extract of <it>Harpagophytum procumbens </it>at 60 mg harpagoside being non-inferior to 12.5 mg rofecoxib per day for chronic non-specific low-back pain (NSLBP) in the short term. Strong evidence exists for the use of an aqueous <it>Harpagophytum </it>extract at a daily dose equivalent of 50 mg harpagoside in the treatment of acute exacerbations of chronic NSLBP.</p>
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