Willow Bark

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From: Willow bark | University of Maryland Medical Center

Willow bark

Overview

Willow Tree Bark

White Willow Tree Bark

The use of willow bark dates back thousands of years, to the time of Hippocrates (400 BC) when patients were advised to chew on the bark to reduce fever and inflammation. Willow bark has been used throughout the centuries in China and Europe, and continues to be used today for the treatment of pain (particularly low back pain and osteoarthritis), headache, and inflammatory conditions, such as bursitis and tendinitis. The bark of white willow contains salicin, which is a chemical similar to aspirin (acetylsalicylic acid). In combination with the herb’s powerful anti-inflammatory plant compounds (called flavonoids), salicin is thought to be responsible for the pain-relieving and anti-inflammatory effects of the herb. In fact, in the 1800s, salicin was used to develop aspirin. White willow appears to bring pain relief more slowly than aspirin, but its effects may last longer.

Plant Description

The willow family includes a number of different species of trees and shrubs native to Europe, Asia, and some parts of North America. Some of the more commonly known species are white willow/European willow (Salix alba), black willow/pussy willow (Salix nigra), crack willow (Salix fragilis), purple willow (Salix purpurea), and weeping willow (Salix babylonica). Not all willow species accumulate a therapeutically sufficient amount of salicin. In one study, the amount of salicin after 1 and 2 year growth in autumn and spring ranged from 0.08 – 12.6%. The willow bark sold in Europe and the United States usually includes a combination of the bark from white, purple, and crack willows.

Medicinal Uses and Indications

Willow bark is used to ease pain and reduce inflammation. Researchers believe that the chemical salicin, found in willow bark, is responsible for these effects. However, studies show several other components of willow bark, including plant chemicals called polyphenols and flavonoids, have antioxidant, fever reducing, antiseptic, and immune boosting properties. Some studies show willow is as effective as aspirin for reducing pain and inflammation (but not fever), and at a much lower dose. Scientists think that may be due to other compounds in the herb. More research is needed.

Treatment

Studies suggest that willow bark may be useful for the following conditions:

Headache

Willow bark has been shown to relieve headaches. There is some evidence that it is less likely to cause gastrointestinal side effects than other pain relievers, such as ibuprofen (Advil) and other nonsteroidal anti-inflammatory drugs, do. However, studies have not shown this beyond all doubt, and people who are prone to stomach upset may want to avoid willow bark. Large-scale studies are needed to fully determine how safe and effective willow bark is for chronic or recurring headaches.

Low back pain

Willow bark appears to be effective for back pain. In a well-designed study of nearly 200 people with low back pain, those who received willow bark experienced a significant improvement in pain compared to those who received placebo. People who received higher doses of willow bark (240 mg salicin) had more significant pain relief than those who received low doses (120 mg salicin).

Osteoarthritis

Several studies show that willow is more effective at reducing pain from osteoarthritis than placebo. In a small study of people with osteoarthritis of the neck or lower back, those who received willow bark experienced significant improvement in symptoms compared to those who received placebo. A similar study of 78 patients hospitalized with osteoarthritis of the knee or hip joint found that patients who received willow bark had significant pain relief compared to those who received placebo.

Other uses

Professional herbalists may recommend willow bark for the following conditions, however, no scientific studies have shown that it works:

  • Menstrual cramps
  • Fever
  • Flu
  • Tendonitis
  • Bursitis

Dosage and Administration

Pediatric

Because of the danger of developing Reye syndrome (a rare but serious illness associated with the use of aspirin in children), children under the age of 16 should not take willow bark.

Adult

General dosing guidelines for willow bark are as follows:

  • Dried herb (used to make tea): boil 1 – 2 tsp of dried bark in 8 oz of water and simmer for 10 – 15 minutes; let steep for ½ hour; drink 3 – 4 cups daily.
  • Powdered herb (available in capsules) or liquid: 60 – 240 mg of standardized salicin per day; talk to your doctor before taking a higher dose.
  • Tincture (1:5, 30% alcohol): 4 – 6 mL 3 times per day.

Precautions

Because willow bark contains salicin, people who are allergic or sensitive to salicylates (such as aspirin) should not use willow bark. Some researchers suggest that people with asthma, diabetes, gout, gastritis, hemophilia, and stomach ulcers should also avoid willow bark. If you have any of these conditions, take nonsteroidal anti-inflammatory drugs (NSAIDs) regularly, or blood-thinning medication, ask your health care provider before taking willow bark. Children under the age of 16 should not take willow bark.

Side Effects

Side effects tend to be mild. However, stomach upset, ulcers, nausea, vomiting, and stomach bleeding are potential side effects of all compounds containing salicylates. Overdoses of willow bark may cause skin rash, stomach inflammation/irritation, nausea, vomiting, kidney inflammation, and tinnitus (ringing in the ears).

Pregnancy and Breastfeeding

Salicylates are not recommended during pregnancy, so pregnant and breastfeeding women should not take willow bark.

Interactions and Depletions

Because willow bark contains salicylates, it might interact with a number of drugs and herbs. Talk to your doctor before taking willow bark if you take any other medications, herbs, or supplements.

Willow bark may interact with any of the following:

Anticoagulants (blood-thinning medications) — Willow bark may strengthen the effects of drugs and herbs with blood-thinning properties, and increase the risk of bleeding.

Beta blockers — including Atenolol (Tenormin), Metoprolol (Lopressor, Toprol-XL), Propranolol (Inderal, Inderal LA). Willow bark may make these drugs less effective.

Diuretics (water pills) — Willow bark may make these drugs less effective.

Nonsteroidal anti-inflammatory drugs — including ibuprofen (Advil, Motrin) and naproxen (Aleve). Taking willow bark with these drugs may increase risk of stomach bleeding.

Methotrexate and phenytoin (Dilantin) — Willow bark may increase levels of these drugs in the body, resulting in toxic levels.

Supporting Research

Bisset NG. Herbal Drugs and Phytopharmaceuticals. Stuttgart, Germany: Medpharm Scientific Publishers; 2004:534-536.

Blumenthal M. The Complete German Commission E Monographs. Austin, Tex: American Botanical Council. Boston: Integrative Medicine Communications; 1998.

Chrubasik JE, Roufogalis BD, Chrubasik S. Evidence of effectiveness of herbal anti-inflammatory drugs in the treatment of painful osteoarthritis and chronic low back pain. Phytother Res. 2007 Jul;21(7):675-83. Review.

Chrubasik S. Pain therapy using herbal medicines [abstract]. Gynakologe. 2000;33(1):59-64.

Chrubasik S, Eisenburg E, Balan E, et al. Treatment of low back pain exacerbations with willow bark extract: a randomized double blind study. Am J Med. 2000;109:9-14.

Ernst E, Chrubasik S. Phyto-anti-inflammatories. A systematic review of randomized, placebo-controlled, double-blind trials. Rheum Dis Clin North Am. 2000;26(1):13-27.

Foster S, Duke JA. A Field Guide toMedicinal Plants and Herbs of the Eastern and Central US. Boston, Mass: Houghton Mifflin; 2000:321-323.

Freischmidt A, Jurgenliemk G, Kraus B, et al. Contribution of flavonoids and catechol to the reduction of ICAM-1 expression in endothelial cells by a standardised Willow bark extract. Phytomedicine. 2012;19(3-4):245-52.

Gagnier JJ, van Tulder M, Berman B, Bombardier C. Herbal medicine for low back pain. Cochrane Database Syst Rev. 2006;(2):CD004504.

Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm. 2000;57(13):1221-1227.

Hoffmann D. Therapeutic Herbalism. Santa Cruz, Calif: Therapeutic Herbalism Press; 2000.

Kenstaviciene P, Nenortiene P, Kiliuviene G, Zevzikovas A, Lukosius A, Kazlauskiene D. Application of high-performance liquid chromatography for research of salicin in bark of different varieties of Salix. Medicina. 2009;45(8):644-51.

Kuhn MA, Winston D. Herbal Therapy and Supplements. Philadelphia, Pa: Lippincott; 2001.

Little CV, Parsons T, Logan S. Herbal therapy for treating osteoarthritis. The Cochrane Library. 2002:1.

McGuffin M, Hobbs C, Upton R, et al, eds. American Herbal Products Association’s Botanical Safety Handbook. Boca Raton, Fla: CRC Press; 1997:101.

Rakel: Integrative Medicine, 3rd. ed. Philadelphia, PA: Saunders Elsevier. 2012.

Schmid B, Ludtke 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.

Setty AR, Sigal LH. Herbal medications commonly used in the practice of rheumatology: mechanisms of action, efficacy, and side effects. Semin Arthritis Rheum. 2005 Jun;34(6):773-84.

Vlachojannis J, Magora F, Chrubasik S. Willow species and aspirin: different mechanism of actions. Phytother Res. 2011;25(7):1102-4.

Alternative Names

Crack willow; European willow; Liu-zhi; Purple willow; Pussy willow; Salix alba; Salix nigra; Wheeping willow; White willow

Source: Willow bark | University of Maryland Medical Center http://umm.edu/health/medical/altmed/herb/willow-bark#ixzz2YEUdd4X6
University of Maryland Medical Center
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A long time ago,an “Old Man” appeared at the edge of the Rotinonshonni Village.

He was limping and had to use a stick to help him walk. His Buckskin clothes were dirty and ragged with many holes. and he looked very tired and sick. He came to a Bark covered Long House that had a Turtle Skull over the hide covered doorway. He knew he had reached the Dwelling of the Turtle Clan. An Old Woman was scraping a Deer skin nearby, so he asked her if she would give him something to eat and a place to rest for awhile. She looked up at this ragged and dirty Old Man and scowled. She told him to go away and that she had no food. So, the “Old Man”staggered away.

Soon he came to another Lodge that had the Skull of a Wolf over the doorway. As he approached a young Woman pulled back the skin covering the entrance and began yelling at him to go away. She began throwing sticks and stones at him so he ran away as fast as his old legs could carry him.

After awhile he came to a third Bark covered Lodge that had a Bear’s Skull over the Doorway and he knew that it was the Home of the Bear Clan. As he approached, a Young Woman, who had been kneeling in front of the Fire Pit, came foreward to greet him. “Kwe! Kwe! Doda.” (Greetings Grandfather) “You don’t look well.” “Come inside and rest while I get you something to eat.” She got him a bowl of Corn Soup from the Clay Pot that had been sitting on three stones near the Fire. When she took it to him, she saw that he was in pain and had a Fever.. In a weak voice, he asked her to go to the Brook nearby and and gather some Willow Bark. When she returned he told her to scrape off the inner layer from the Bark and steep it in hot water. After he had drunk the Tea, he began to feel better and the Fever broke.

But, almost immediately he began to have Stomach Pains. He sent the Young Woman to gather a certain Root from a small shrub that only grows on the Northern side of the Mountains. When she returned, he had her cut the Root into small pieces and Boil it to make a Tea which took away his Stomach Cramps.

Each time she cured him of one Sickness, He immediately contracted another and so on until she had learned all the Cures for the common ailments of the Onkwehonwe. (Real People)

As she opened the Doorway Flap the last time, there was a Bright Light illuminating a Handsome Young Man standing there. He said to her,” Please don’t be afraid. I am Shonkwaiiatison ( The Maker of Our Bodies). Since you have been so kind and helpful to me, from this day forward, all the Medicine Men and Women, of the Onkwehonwe, shall be members of the Bear Clan.

…And so it is to this Day…

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