Africa · Zimbabwe / Southern Africa Practitioners 5 September 2026

Devil's claw takes its name from the barbed hooks on its fruit. The part used medicinally is the secondary storage tuber, which is dug, sliced and dried. In Zimbabwe it is harvested mainly in the drier western regions around Hwange and Matabeleland North. Traditional southern African use centres on pain and inflammation: joint disease, back pain, and digestive complaints, with the bitter tuber also used as an appetite stimulant. San and Khoi communities have used it for generations, and that knowledge underpinned its introduction to Europe in the early twentieth century. The principal active constituents are iridoid glycosides, chiefly harpagoside, along with harpagide and procumbide. Proposed mechanisms include suppression of pro-inflammatory cytokines and inhibition of COX-2 and inducible nitric oxide synthase expression. The clinical evidence is more substantial than for most African botanicals. Several randomised trials and systematic reviews have examined devil's claw in osteoarthritis of the hip and knee and in non-specific low back pain, with a number reporting reductions in pain and rescue-analgesic use comparable to standard treatments. Reviews generally judge the evidence moderate rather than definitive, citing heterogeneous preparations and variable harpagoside content between products. Practitioners should note real cautions. Devil's claw stimulates gastric acid secretion and is not appropriate in active peptic ulcer disease. It may potentiate anticoagulants such as warfarin, and interacts with drugs metabolised through cytochrome P450 pathways. It should be avoided in pregnancy, and used carefully alongside antidiabetic and antiarrhythmic medication. Sustainability is a live concern. Wild populations have come under significant pressure from export demand, and destructive harvesting that removes the primary tuber kills the plant. Permit systems and community harvesting associations now regulate offtake in parts of Zimbabwe, and practitioners sourcing devil's claw should ask suppliers about provenance.

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