Applications of Leech Therapy in Medicine

A recent systematic review published in Frontiers in Medicine explores the growing interest in leech therapy (LT), a practice with ancient roots in traditional medicine that is now gaining renewed attention in modern healthcare. Leech therapy, or hirudotherapy, uses medicinal leeches to treat a variety of health conditions by harnessing the bioactive compounds present in leech saliva. These compounds, which have anticoagulant, anti-inflammatory, analgesic, and antimicrobial properties, make LT particularly useful for conditions involving circulation and inflammation, such as knee osteoarthritis, varicose veins, and chronic back pain.

Historically, leeches were widely used in ancient civilizations, including Egypt, Greece, and Persia, and continued to be a staple in European medicine up until the 19th century. Over time, LT fell out of favor as modern medical treatments emerged, but it has experienced a resurgence due to its ability to address venous congestion and assist in reconstructive surgeries by improving blood flow and promoting healing. This systematic review aimed to assess the clinical applications of LT in the treatment of a wide range of conditions and evaluate its effectiveness based on the existing body of clinical trials.

The review analyzed 12 clinical trials conducted between 2003 and 2022, involving a total of 723 participants. The studies examined the effects of LT on conditions such as knee osteoarthritis, varicose veins, chronic back pain, diabetic neuropathy, and epicondylitis. Each trial varied in its approach, using between 2 to 8 leeches per session, with treatment durations ranging from 30 to 70 minutes. Leech therapy was found to have significant benefits for patients with knee osteoarthritis and chronic back pain, leading to pain relief, improved joint function, and better mobility. Patients with diabetic neuropathy also experienced reduced symptoms and improved nerve function after undergoing LT. While the therapy was well-tolerated by most patients, mild side effects such as itching, localized bleeding, and skin irritation were occasionally reported. However, no severe complications were documented, confirming that LT is generally safe when administered by trained professionals.

The authors of the review concluded that leech therapy offers promising therapeutic benefits, particularly for inflammatory and circulatory disorders. They emphasized that LT can serve as a cost-effective, complementary treatment, especially in cases where conventional therapies have limited efficacy. The bioactive components in leech saliva—such as hirudin, which prevents blood clotting, and various anti-inflammatory enzymes—play a critical role in alleviating pain, reducing swelling, and promoting overall healing. However, the authors stressed the importance of further research to develop standardized treatment protocols. Variables such as the optimal number of leeches to use, the duration of treatment, and the best practices for reducing side effects need to be explored in greater depth. While the current evidence is promising, they called for more high-quality randomized controlled trials (RCTs) to confirm these findings and expand the potential applications of LT to other medical conditions.

In light of these findings, healthcare providers might consider incorporating leech therapy into their treatment plans for managing chronic conditions like osteoarthritis, varicose veins, and diabetic neuropathy, particularly when patients are seeking alternative or non-invasive treatments. LT’s low cost, minimal side effects, and demonstrated effectiveness make it a valuable addition to multidisciplinary care.

From a policy perspective, there is a clear need for the development of guidelines to standardize the use of leech therapy in clinical settings. Training programs for practitioners and regulatory oversight will ensure the safe application of LT and help protect patients from potential risks. Ensuring quality control in the sourcing and handling of medicinal leeches will also be vital as LT becomes more widely adopted in healthcare systems.

The review underscores the importance of conducting research to further understand the long-term effects of LT and optimize its application. Expanding research efforts to investigate its potential in treating other conditions beyond pain management and vascular effects could unlock new therapeutic possibilities. In summary, this systematic review highlights the resurgence of leech therapy as a potentially relevant therapeutic resource.

References

Hosseini M, Jadidi A, Derakhshan Barjoei MM, Salehi M. Applications of leech therapy in medicine: a systematic review. Front Med (Lausanne). 2024 Sep 16;11:1417041. doi: 10.3389/fmed.2024.1417041. PMID: 39351007; PMCID: PMC11439709.

Acknowledgements

This content was developed by the TMGL Editorial Team (JPS) with the assistance of the GPT Integrative Public Health Modeler, a generative artificial intelligence tool trained by BIREME/PAHO for the integration of traditional and scientific public health knowledge.