White willow is a tree that was used as an early form of aspirin. The bark has been used to ease pain in muscles, bones, and joints. White willow has also been used to reduce fever and ease headache pain. It can be taken as a pill, powder, or extract. White willow can also be made into a tea.
120 milligrams 1 to 2 times daily
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.
It may be safe for most adults to take white willow in small doses for a short time. Not enough studies have been done to say whether it is safe to use for a long period. People who are allergic to aspirin, women who are pregnant or breastfeeding, and children should not use white willow.
Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse. For example:
A. Low Back Pain
A1. Chrubasik S, Eisenberg E, et al. Treatment of low back pain exacerbations with willow bark extract: a randomized double-blind study. Am J Med. 2000;109(1):9-14.
A2. Chrubasik S, Künzel O, et al. Treatment of low back pain with a herbal or synthetic anti-rheumatic: a randomized controlled study. Willow bark extract for low back pain. Rheumatology (Oxford). 2001 Dec;40(12):1388-1393.
A3. Gagnier JJ, Oltean H, et al. Herbal Medicine for Low Back Pain: A Cochrane Review. Spine (Phila Pa 1976). 2016 Jan;41(2):116-133.
B. Musculoskeletal Pain
B1. Vlachojannis JE, Cameron M, et al. A systematic review on the effectiveness of willow bark for musculoskeletal pain. Phytother Res. 2009 Jul;23(7):897-900.
B2. Uehleke B, Müller J, et al. Willow bark extract STW 33-I in the long-term treatment of outpatients with rheumatic pain mainly osteoarthritis or back pain. Phytomedicine. 2013 Aug 15;20(11):980-984.
C1. Schmid B, Lüdtke R, 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):344-350.
C2. Biegert C, Wagner I, 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):2121-2130.
D. Rheumatoid Arthritis
D1. Biegert C, Wagner I, 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):2121-2130.
E1. Heck AM, DeWitt BA, et al. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm. 2000 Jul 1;57(13):1221-7; quiz 1228-1230.
E2. Food and Drug Administration, HHS. Labeling for oral and rectal over-the-counter drug products containing aspirin and nonaspirin salicylates; Reye's Syndrome warning. Final rule. Fed Regist. 2003 Apr 17;68(74):18861-18869.
E3. Shalansky S, Lynd L, et al. Risk of warfarin-related bleeding events and supratherapeutic international normalized ratios associated with complementary and alternative medicine: a longitudinal analysis. Pharmacotherapy. 2007 Sep;27(9):1237-1247.
E4. Shara M, Stohs SJ. Efficacy and Safety of White Willow Bark (Salix alba) Extracts. Phytother Res. 2015 Aug;29(8):1112-1116.
Last reviewed July 2019 by EBSCO NAT Review Board Eric Hurwitz, DC Last Updated: 3/27/2020