 In a section of the British medical journal called Minerva, where they compile interesting little snippets, they published a picture of a woman who they found had taped a cabbage leaf to her knee. She said that this was the only measure that provided relief from the symptoms of her osteoarthritis. Some doctors responded with bemusement. Others were like, duh, amazed to see the photograph, not because the cabbage leaf was used, but that this was considered newsworthy. The doctor disclosed she may be a little biased, though, as she admits of being a cabbage leaf user herself. There's nothing new about this ancient remedy, wrote another reader, used to help reduce all kinds of painful swelling. Freshly-washed cabbage leaves are known in European folk medicine as the poor man's poultice, so there's nothing freakish or stupid about putting cabbage leaves on your knees. But, okay, I didn't realize it was such a touchy topic. Of course, we'll never really know if it actually works. I mean, it's never been a randomized controlled trial of topical cabbage leaves for osteoarthritis, and there never will be, until now. The efficacy of cabbage leaf wraps in the treatment of symptomatic osteoarthritis in the knee, a randomized controlled trial. Wait, how did this study even get funded? A family foundation just stepped forward and paid for it. I love that. In fact, the former president and first lady of Germany's foundation. After all, osteoarthritis in the knees is one of the most common chronic diseases among older adults, so let's test the effects of cabbage leaf wraps. Why not? Patients with confirmed osteoarthritis in the knees were randomly assigned to four weeks of treatment with a cabbage leaf on their knees every day, or a topical pain gel containing an anti-inflammatory drug, or neither. Even better would have been a fourth group applying like iceberg lettuce leaves, but I'll take what I can get. Here's a graph of pain intensity over the 28-day experiment. Here's how the drug worked, not much better than doing nothing. But the cabbage worked better. Overall, the study found that a four-week application of cabbage leaves was more effective than usual care with respect to pain, functional disability, and quality of life. It was, however, not in the final analysis superior to a four-week application of a topical medication. But hey, cabbage leaves are safe, can be used in the longer term, and so why not give them a try? It also wouldn't hurt if you ate some as well as cabbage may have internal anti-inflammatory potential as well. The anti-inflammatory effects may explain the health benefits of the cabbage family vegetables, not just potent anti-inflammatory effects in petri dishes, but in people. Ten days of broccoli consumption in smokers cut CRP levels 40%. OK, but what about for arthritis? In vitro, sulforaphane, the magic cabbage chemical, protects cartilage from destruction, suggesting that a high-cabbage or broccoli family vegetable diet may be a useful measure, either to prevent or to slow the progression of osteoarthritis. But even if sulforaphane can protect cartilage cells in a petri dish, how do we even know that this compound makes it into the joint when we eat it? No one's ever done a study where you'd have people eat broccoli and stick a needle in their knee joint to check. No one that is until now. And sulforaphane was indeed detected in the synovial fluid of 40 patients with osteoarthritis following broccoli consumption, followed by significant epigenetic changes of gene expression within the joint. The next step is to see if it can actually improve the disease.