Leeches give bite to arthritis care

The once-reviled leech, recently lauded for its potential in preventing repeat heart attacks, could also have a role to play in the treatment of pain and inflammation. In the October Annals of the Rheumatic Diseases Gustav Dobos and colleagues at the Essen-Mitte Clinic, Germany, used leech therapy to treat a number of patients with chronic arthritis (Ann Rheum Dis 2001, 60:986).They studied 16 patients with an average age of 68 years who had suffered persistent knee pain for more than six months

By | September 18, 2001

The once-reviled leech, recently lauded for its potential in preventing repeat heart attacks, could also have a role to play in the treatment of pain and inflammation. In the October Annals of the Rheumatic Diseases Gustav Dobos and colleagues at the Essen-Mitte Clinic, Germany, used leech therapy to treat a number of patients with chronic arthritis (Ann Rheum Dis 2001, 60:986).

They studied 16 patients with an average age of 68 years who had suffered persistent knee pain for more than six months. None had sustained an injury to the knee and all had X-ray evidence of osteoarthritis. They were already being treated with exercises, physiotherapy and relaxation techniques, along with dietary changes.

In all, 10 of the patients received leech therapy, while the remainder were given conventional pain treatment. Four leeches were applied to the painful knee and left in place for an hour and 20 minutes. Pain measurements were taken for 10 days from three days before the start of treatment and then 28 days after.

Treatment with leeches brought rapid pain relief, compared with conventional treatment. The greatest effect was seen within 24 hours of application, levels that were sustained four weeks later. It is thought that a cocktail of compounds found in the saliva could be responsible for the observed analgesic effects.

Michalsen et al. note that leech therapy was a mainstay in the conventional treatment of pain and inflammation up until the 20th century. They add that leech saliva contains various analgesic, anaesthetic and histamine-like compounds.

"We recognise the limitations of the present study. However, we regard the observed treatment effect as remarkable. The efficacy and safety of this traditional treatment in knee osteoarthritis should therefore be tested in larger randomised clinical trials," wrote the authors.

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