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The aim of this open, multicentre study was to evaluate the clinical effectiveness and tolerance of the Devil's Claw extract LI 174 in patients suffering from non‐radicular back pain over a period of at least 6 months. A total of 130 patients were treated twice a day with tablets containing 480 mg LI 174. The treatment lasted for 8 weeks. The effectiveness was judged according to the Multidimensional Pain Scale (MPS), Arhus back pain index and to parameters evaluating the mobility of the lumbar spine (finger–floor distance, Schober's sign). Data from 117 patients were evaluated for efficacy. The results showed a significant improvement of pain symptoms and mobility of the affected sections of the patient's spine in the course of treatment. No serious side effects were observed. In view of the excellent compliance and tolerability the investigated extract appears to be an effective plant alternative for the treatment of chronic back pain. However, further studies will be needed to clarify the therapeutic value of this plant remedy. Copyright © 2001 John Wiley & Sons, Ltd.