Efficacy of Willow Bark Extract in Temporomandibular Joint Disorders: A Randomized Controlled Trial

Abstract Aim: The aim of the study was to compare the efficacy of different doses of Willow Bark extract versus Diclofenac in reducing pain and improving function in patients with temporomandibular disorders (TMDs). Materials and Methods: A double-blind randomized controlled trial included 70 symptomatic TMD patients allocated to two 15-day treatment groups. Group A ( n = 35) received Diclofenac (50 mg, twice daily). Group B ( n = 35) received Willow Bark extract, subdivided by baseline pain into 250 mg ( n = 11), 450 mg ( n = 12), or 600 mg ( n = 12) doses, twice daily. Pain reduction visual analog scale was measured at baseline and every 3 days. Data were analyzed using non-parametric tests ( P < 0.05). Results: Pain reduction differed significantly among groups (H (3) = 33.519, P < 0.001, η ²=0.42). The 600 mg Willow Bark subgroup showed the greatest mean reduction versus Diclofenac ( P = 0.001) and lower doses ( P < 0.001). Clinically significant pain relief (≥ 50%) occurred in 90% of the 600 mg group, which had higher odds than diclofenac (OR=2.83). Mild gastrointestinal discomfort occurred in a few participants; no severe adverse events were reported. Conclusion: Willow Bark extract demonstrated a dose-dependent analgesic effect in managing TMD pain. The 600 mg dose was superior to both standard non-steroidal anti-inflammatory drugs therapy (Diclofenac) and lower herbal doses. These findings suggest that Willow Bark extract is a promising and effective alternative for TMD pain management. Larger, multi-center trials with longer follow-up periods are warranted to confirm these results and further evaluate long-term safety.