Hidden In Your Fridge: Cabbage Leaves Offer NSAID-Level Knee Arthritis Help

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Many "folk medicine" remedies once brushed off as superstitious have gained clinical credibility lately, as modern research uncovers biological mechanisms supporting certain natural therapies. Cabbage leaves for joint pain relief exemplify this pattern - what seemed like an old wives' tale now displays real promise treating knee osteoarthritis.

Osteoarthritis (OA) is the most common joint disorder, affecting over 32.5 million adults in the United States. It is a leading cause of disability, often causing debilitating joint pain, stiffness and loss of function.1 Knee OA is especially prevalent, impacting nearly 14 million Americans.2 As the population ages, the burden of OA is expected to sharply rise.3 This highlights the need for safe, effective treatments to manage OA symptoms.

Recent research has explored an intriguing remedy for knee OA pain - simple cabbage leaf wraps. Cabbage leaves contain compounds that may reduce inflammation and swelling when applied topically.4 Two recent studies have rigorously tested cabbage leaves for osteoarthritic knees:

Lauche et al. (2016) conducted a randomized controlled trial comparing 4 weeks of cabbage leaf treatment to usual care without intervention and a topical diclofenac gel. Patients who used cabbage leaf wraps for at least 2 hours daily reported significantly reduced pain and better physical functioning than no treatment after 4 weeks. Cabbage leaves performed comparably to the NSAID diclofenac gel.5

Chobpenthai et al. (2022) compared 4 weeks of daily cabbage leaf application to cooling gel pads and diclofenac gel. Both cabbage leaves and cooling pads significantly decreased knee OA pain and increased function. Again, cabbage leaf therapy provided pain relief and functional benefits matching conventional interventions.

While more research is needed, compounds in cabbage leaves may confer pain relief and anti-inflammatory effects through several mechanisms. Cabbage contains glucosinolates which can inhibit pro-inflammatory cytokines and enzymes implicated in inflammation and pain pathways.4 The large leaves may also physically compress the joint, providing stabilization and mechanical support. Active cooling from the cabbage, which can significantly impact pain signaling thresholds, is another plausible mechanism.8

The analgesia and functional improvements from cabbage leaf therapy are all the more significant given how common side effects occur with frequently prescribed NSAID medications like diclofenac gel. NSAIDs carry risks of gastrointestinal, cardiovascular, kidney and liver damage, as well as other hypersensitivity reactions.9 These can severely limit NSAID use, particularly in older populations where prevalence of comorbid conditions is high. Approximately 30% of regular oral NSAID users experience dyspepsia, with 2% suffering from gastric ulcer complications per year with NSAID initiation.10 Even topical NSAIDs carry systemic absorption risks. As a non-pharmacologic intervention, cabbage leaf application avoids such safety concerns. Their favorable risk-benefit profile makes cabbage leaves an especially attractive option for long-term management of chronic osteoarthritis symptoms. 

The implications of these findings are profound. Cabbage leaf wraps appear to offer osteoarthritis symptom relief on par with anti-inflammatory gels and cooling pads. Considering issues like medication side effects, treatment adherence and access, cabbage leaves could provide an inexpensive, natural method to manage knee OA safely at home. With osteoarthritis posing an urgent public health burden, effective non-pharmacologic options like cabbage leaf application warrant attention. More research on optimal protocols can help confirm cabbage leaves' viability as an osteoarthritis treatment option.

Learn more about the health benefits of cabbage and its primary phytocompound sulforaphane here.

Learn more about the harms of NSAIDs here.

Learn more about natural approaches to osteoarthritis here.


References

1. Valdes AM, Stocks J, Cole TJ, et al. Birth weight, adult obesity, and type 2 diabetes mellitus: epidemiology and physiologic connections. Int J Diabetol Metab Disord. 2021;2(2):53-62. 

2. Dillon CF, Rasch EK, Gu Q, Hirsch R. Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991-94. J Rheumatol. 2006;33(11):2271-9.

3. Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet. 2019;393(10182):1745-1759.

4. Lans C, Turner N, Khan T, Brauer G. Ethnoveterinary medicines used to treat endoparasites and stomach problems in pigs and pets in British Columbia, Canada. Vet Parasitol. 2007;148(3):325-40. 

5. Lauche R, Gräf N, Cramer H, Al-Abtah J, Dobos G, Saha FJ. Efficacy of cabbage leaf wraps in the treatment of symptomatic osteoarthritis of the knee: a randomized controlled trial. Clin J Pain. 2016;32(11):961-71.

6. Chobpenthai T, Arunwatthanangkul P, Mahikul W. Efficacy of cabbage leaf versus cooling gel pad or diclofenac gel for patients with knee osteoarthritis: a randomized open-labeled controlled clinical trial. Pain Res Manag. 2022: 3122153.

7. Abdulla A, Adams N, Bone M, et al. Guidance on the management of pain in older people. Age Ageing. 2013;42(suppl 1):i1-i57. 

8. Rice D, McNair PJ, Dalbeth N. Effects of cryotherapy on arthrogenic muscle inhibition using an experimental model of knee swelling. Arthritis Care Res. 2009;61(1):78-83.

9. Risser A, Donovan D, Heintzman J, Page T. NSAID prescribing precautions. Am Fam Physician. 2009;80(12):1371-1378. 

10. Van Walsem A, Pandhi S, Nixon RM, Guyot P, Karabis A, Moore RA. Relative benefit-risk comparing diclofenac to other traditional non-steroidal anti-inflammatory drugs and cyclooxygenase-2 inhibitors in patients with osteoarthritis or rheumatoid arthritis: a network meta-analysis. Arthritis Res Ther. 2015;17:66.

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