Premna species, particularly Premna serratifolia (known as "Agnimantha" in Ayurveda), have a long history of use in traditional medicine systems such as Ayurveda for treating backache and related musculoskeletal complaints. In classical Ayurvedic texts, Agnimantha is one of the ten roots in the "Dashamoola" formulation, which is commonly prescribed for inflammatory conditions, pain, and specifically, for "Katigraha" (lower back pain). The use of Premna in this context is justified primarily by tradition and its inclusion in polyherbal preparations aimed at alleviating vata disorders, which often manifest as pain or stiffness in the lower back.

As for scientific validation, there is limited direct clinical evidence supporting the efficacy of Premna for backache. Some preclinical studies have indicated that extracts of Premna serratifolia possess anti-inflammatory, analgesic, and antioxidant properties, which could theoretically contribute to pain relief. However, these studies are mostly animal-based or in vitro, and robust human clinical trials focusing specifically on backache are lacking. Therefore, while Premna's use for backache is firmly rooted in tradition and supported by anecdotal evidence and historical usage, its scientific evidence base remains relatively modest.