A "poor man's poultice" made of cabbage leaves was put to the test against a popular pharmaceutical gel for pain. You may be surprised which option worked better to provide knee osteoarthritis patients some relief

Cabbage leaves are sometimes referred to as the "poor man's poultice" due to their pain-relieving effects. Long considered as nothing more than a folk remedy, a randomized open-labeled controlled clinical trial demonstrates that not only are cabbage leaves' pain-relieving properties real -- they work better than diclofenac gel, a widely used topical non-steroidal anti-inflammatory drug (NSAID).^[i]

Cabbage Leaf Works Better Than Topical Drug for Osteoarthritis

Anecdotal reports of using cabbage leaves for pain abound, including one in the BMJ, which reported a 72-year-old woman with knee osteoarthritis who was in the hospital for a total knee replacement. Health care officials reported:^[ii]

"Postoperatively we saw her on the ward with the outer leaf of a cabbage taped to her non-operated knee. She said that this was the only measure that provided relief from the symptoms of her osteoarthritis and that the outer cabbage leaves fitted well with the shape of her knee."

In 2022, researchers with Thailand's Princess Srisavangavadhana College of Medicine put cabbage leaves' effectiveness for osteoarthritis (OA) to the test against a cooling gel pad or diclofenac gel.^[iii] One group used a cooling gel pad for 20 minutes once a day, while another group used diclofenac gel four times a day. The third group applied a cabbage leaf for one hour daily.

After four weeks, both the cabbage leaf group and the cooling gel pad group had significant improvements in pain as well as Oxford Knee Score, which measures pain and function in the knee. Outcomes were similar for the cooling pad and cabbage leaf groups, and outperformed diclofenac gel. According to the team:^[iv]

"Their therapeutic effectiveness was better than that of diclofenac gel … our cabbage leaf therapy demonstrated substantial pain reduction in patients with knee OA with no side effects. Furthermore, our cabbage leaf therapy is an easily accessible and safe option with a low economic burden in terms of hospital expenses for patients with OA undergoing costly treatments with substantial clinically associated side effects and adverse events."

Previous research has also found cabbage leaf wraps to be more effective for knee osteoarthritis than usual care. In one study, women who applied cabbage leaf wraps for four weeks reported significantly less pain than those who received usual care.^[v]

The researchers noted, "Although it is more convenient to use a cooling gel pad to treat OA knee, it is more beneficial to use cabbage leaf in some areas, especially rural areas where it is an inexpensive home remedy to relieve knee pain."^[vi] Further, the cabbage leaf resulted in no side effects, while diclofenac gel can cause burning, itching and redness, along with headaches, eye pain, skin ulcers, chest pain and other adverse effects.^[vii]

Cabbage Leaves May Relieve Breast Pain Better Than Gel Packs

Cabbages leaves are also useful for relieving pain, engorgement and hardness that can occur during breastfeeding. One systematic review found cold cabbage leaves may work better than routine care for breast pain and breast hardness, while room temperature cabbage leaves may relieve breast engorgement better than a hot water bag.

Women were also more satisfied using cold cabbage leaves than routine care or cold gel packs.^[viii] As further noted in Pain: Research and Management, "Cabbage leaf application has been found to be clinically effective in alleviating the pain of breast congestion in women."^[ix]

How Do Cabbage Leaves Relieve Pain?

It's possible that sulfur compounds in cabbage leaves may increase skin penetration of beneficial compounds in the leaves, such as flavonoids, leading to anti-inflammatory effects and reduced swelling. If the leaves are applied chilled, they may also lead to vasoconstriction, which also helps decrease swelling.^[x]

Another potential explanation involves the potential for "cross-kingdom gene expression regulation by microRNAs (miRNAs) from other species," including plants.^[xi] In particular, researchers tested whether miR172a from cabbage affects the FAN (Factor Associated with Neutral Sphingomyelinase Activation) protein, which regulates inflammatory responses. In vitro experiments showed a decrease in FAN protein levels in both human and mouse cells transfected with miR172a from cabbage.

Mice with rheumatoid arthritis also had a reduction in swelling in their paws after treatment with miR172a. The researchers, from the Medical University of Warsaw, Poland, explained:^[xii]

"Crushed cabbage leaves are one of the most widely used anti-inflammatory remedies in Polish folk medicine. Cabbage, due to its specific properties, has been used in natural medicine mainly for rheumatic pain, vein and lymphatic vessel inflammation, bruises, sprains, mastitis or gastrointestinal problems. Its "spectrum" of use is, however, much wider and encompasses the treatment of both internal and external diseases.

… In this paper, we have shown that … miRNA172a from cabbage leaf juice (known in folk medicine as an anti-inflammatory agent) reduces the expression of the FAN protein in human cells, thus lowering the proinflammatory activity of TNF-α … plant miRNAs may interfere with human mRNA, thus regulating gene transcription at the posttranscriptional level and serving as therapeutic agents. This supports the hypothesis of the possible use of plant miRNAs as therapeutic agents in human diseases."

More Health Benefits of Cabbage

Cabbage has potential to help at least 23 diseases, including cancer, Type 2 diabetes and candidiasis. You can read about them in detail at our cabbage research database. For cases of knee or breast pain, using cabbage leaves for natural relief may prove to be extremely effective, and there's little to no risk in giving them a try. If you need additional pain relief, however, we've compiled 21 additional pain-relieving substances from nature in our chronic pain research database.

References

[i] Pain Res Manag. 2022; 2022: 3122153. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9200597/

[ii] BMJ 2003;326:1406 https://www.bmj.com/content/326/7403/1406

[iii] Pain Res Manag. 2022; 2022: 3122153. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9200597/

[iv] Pain Res Manag. 2022; 2022: 3122153. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9200597/

[v] Clin J Pain. 2016 Nov;32(11):961-971. doi: 10.1097/AJP.0000000000000352. https://pubmed.ncbi.nlm.nih.gov/26889617/

[vi] Pain Res Manag. 2022; 2022: 3122153. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9200597/

[vii] Mayo Clinic, Diclofenac https://www.mayoclinic.org/drugs-supplements/diclofenac-topical-application-route/side-effects/drg-20063434

[viii] Cochrane Database Syst Rev. 2020; 2020(9): CD006946. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8094412/

[ix] Pain Res Manag. 2022; 2022: 3122153. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9200597/

[x] Cochrane Database Syst Rev. 2020; 2020(9): CD006946. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8094412/

[xi] Front Pharmacol. 2022; 13: 846830. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8987499/

[xii] Front Pharmacol. 2022; 13: 846830. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8987499/