Osha was (and still is) a sacred herb to various Native American tribes, including the Zuni, Aztec, Chiricahua, Yaqui, Tarahumara, and Mescalero Apache. While the seed and leaf were once traditional foods, the root was attached to moccasins or tied about the ankle to protect the wearer from rattlesnakes. Flathead tribe members ritually washed freshly harvested roots in streams near plant growth locations to precipitate rainfall in times of drought.
Osha is commonly burned as a purifying incense or smudge to guard against malicious spirits and as well as harmful pathogens. In terms of the latter, the root is traditionally used in ways similar to the Echinacea root.