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....

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