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Medical Leeches for Arthritis Pain

medical leech back pain treatmentThe use of leeches in medicine might seem medieval but research into medical leeches for arthritis pain might have some spinal stenosis sufferers scooping up these bloodsucking worms in place of current pain medication. Osteoarthritis pain relief is just the latest in recent treatments involving leeches, which the US Food and Drug Administration have approved as a medical device.

Leech Research

Leeches release a chemical in their saliva that keeps blood flowing while they feed and it is this substance, along with others in leech saliva that provide a numbing effect and pain relief when applied to the skin. Leeches have also been used in microsurgery to numb the skin and prevent the blood from clotting. In one trial, Michalsen, et al (2002) looked at fifty-one patients with osteoarthritis of the knee and compared one application of four to six leeches to a standard treatment for osteoarthritis, a four week-long course of diclofenac (a non-steroidal anti-inflammatory drug).

Patients in the leech treatment group had reduced pain on the seventh day and also experienced increased function, lower degrees of stiffness and lesser arthritis symptoms overall when assessed at a three-month follow-up. Pain from osteoarthritis decreased by two-thirds by using medical leeches on the knee, with just a one-fifth reduction in pain in the standard treatment group.

Thumbs Up for Leech Therapy Pain Relief

Another German trial (Michalsen, et al, 2008) looked at the use of leeches to help with degeneration of the thumb joints, this time with thirty-two participants, half of whom used a diclofenac ointment and the other half having leech treatment using up to three leeches attached to the base of the thumb. Pain was reduced more significantly again in the leech group with the improvements still significant two months after therapy. Hand and arm disability had also decreased by 47% compared to just 2% in the diclofenac group, with the effects seen between three to seven days of treatment commencing.

Leeches for Osteoarthritis Pain

leech therapy osteoarthritis painLeech therapy for spinal stenosis might be more difficult to access as no trials have been carried out looking specifically at this issue. The therapy usually involves the leeches being put in place for an hour or so and in New York, The Continuum Center for Health and Healing is already using leeches to treat people with osteoarthritis of the knee. Along with leech treatment the center conducts two follow-up examinations and the therapy costs around $600. Patients are unlikely to be reimbursed by their insurance company as yet, although they may be able to receive financial help from charitable organizations to cover the costs. Should further clinical trials be carried out, looking this time at spinal stenosis or degenerative joint disease in the spine, leech treatment could be approved and may then be covered by insurance.

Grow Your Own… Leeches for Back Pain?

Patients may think they can head to their local fishing and tackle store or even just scoop out some leeches from the mud of their back yard pond but the leeches used in medical treatment are significantly different. These carnivorous, hermaphroditic, segmented worms have suckers on each end of their body and five pairs of eyes but Hirudo medicinalis are bred in strictly controlled laboratory environments to ensure they carry no infections. The use of leeches in bloodletting dates back before Hippocrates, who introduced the infamous idea of the four humors, blood phlegm, yellow bile, and black bile of which an imbalance was the cause of all disease. Draining the blood, through ancient leech therapy, was purported to restore balance but the therapy is now used to help in cases of necrotic tissue removal, reconnecting severed limbs, digits, and even ears, and the scalp. The success of leeches in such therapy is due to their ability to prevent blood clots forming which keeps the blood flowing to the reattached tissue long enough for the blood vessels to reconnect.

Leech Farms are Big Business

The FDA approved medical leeches for marketing and use as a medical device in 2004 although some companies already bred the leeches for such purposes prior to that on the basis of a 1976 law which allowed anyone breeding such leeches at that time to continue to do so. Giant leech-farms now exist to supply the growing demand for medical leeches which looks set to continue as celebrities such as Demi Moore report using them for cosmetic purposes, in her case it was to ‘detox.’ Leeches produce a wide variety of chemicals secreted in their saliva, including those which numb, prevent blood clotting, and also enzymes involved with inflammation, connective tissue, and even digestion.

Leech Therapy Side-Effects

Leech therapy appears to be free of side-effects in the clinical trials conducted so far, although many physicians using medical leeches warn that they are usually a last resort and only appropriate for some patients at certain times in treatment. Side-effects may also be minimized simply by dent of the leeches themselves and the placebo effect attributed to their use. Attaching leeches to the body elicits a certain psychological response, most likely triggered by cultural conditioning, and the more impressive a treatment appears the bigger the effects in most cases. In other words, rubbing some NSAID ointment onto your knee-joint is far less spectacular than having five or six leeches suck your blood for an hour. Another trial, single-blinded this time, aimed to overcome this methodological weakness of the other trials when examining the use of leech therapy for osteoarthritis knee pain (Andereya, et al, 2008). The treatment still provided more significant pain relief in comparison to the control group treated with an ‘artificial leech’, but the researchers were still not confident that the placebo-effect had been fully accounted for.

Leech Therapy for Back Pain

leeches for back painPatients with back pain from spinal stenosis caused by inflammation and problems with the connective tissues, fractures, muscle damage, ligament and tendon dysfunction, or even disc bulging or herniation may find relief from the application of leech therapy. The anti-inflammatory and analgesic effects could reduce pain whilst other enzymes in the leeches’ saliva may help connective tissue disorders and increase blood flow to the spine in order to speed recovery from trauma. Bacterial infection of the spine will usually be treated more aggressively but leeches could help reduce bacterial load as an adjunct therapy. The evidence supporting the use of medical leeches for osteoarthritis is mounting and it may not be long before leech therapy for back pain from spinal stenosis is part of standard treatment.


Bäcker Marcus, Lüdtke Rainer, Afra Dani, et al. Effectiveness of Leech Therapy in Chronic Lateral Epicondylitis: A Randomized Controlled Trial. Clinical Journal of Pain 2011; 27: 442-447.

Andereya S, Stanzel S, Maus U, Mueller-Rath R, Mumme T, Siebert CH, Stock F, Schneider U., Assessment of leech therapy for knee osteoarthritis: a randomized study. Acta Orthop. 2008 Apr;79(2):235-43.

Michalsen A, Moebus S, Spahn G, Esch T, Langhorst J, Dobos GJ., Leech therapy for symptomatic treatment of knee osteoarthritis: results and implications of a pilot study. Altern Ther Health Med. 2002 Sep-Oct;8(5):84-8.

Michalsen A, Lüdtke R, Cesur O, Afra D, Musial F, Baecker M, Fink M, Dobos GJ., Effectiveness of leech therapy in women with symptomatic arthrosis of the first carpometacarpal joint: a randomized controlled trial. Pain. 2008 Jul 15;137(2):452-9. Epub 2008 Apr 14.

1 reply
    DR. DIPAK ROY ,MD says:

    Leech has a long history of use inHuman Desease Conditions: Hemorrhiods,Thrombophlrbitis, Phlibothrombosis and also Joint Degenerative diseases.Spinal Canal Stenosis due to I V Disc Degeneration is another illness where Leech Therapy has given encouraging clinical improvement is exciting news for Researchers.


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