Background & Aims
Hirudotherpy is an adjunct modality employed for managing chronic pain worldwide. Several studies describe the efficacy of leeches in treating various chronic pain conditions. The US FDA has approved the distribution and application of leeches, limited to plastic and microvascular surgery. This study aims to help expand hirudotherapy for use in chronic pain.
Literature describes the following effects of leeching: analgesic, anti-inflammatory, bactericidal, and decongestant: decreased local edema, improved local circulation, increased oxygenation; and regenerative enhancement, including stimulation of vessel and nerve growth.
Few of these medicinal properties can be attributed to leeches as “bloodletting devices” as defined by the FDA. Over 80 biologically active substances are identified in leech saliva and a vast variety of the effects described above rely on the introduction of secretions into circulation during the leech’s feeding process.
Methods
A retrospective cohort study including 147 patients with chronic pain was carried out using 11 years of accumulated patient cases. In each case, the patient received a thorough initial evaluation followed by a course of hirudotherapy (ranging from one to 10 procedures). Data on principle diagnosis, comorbidities, and demographics was obtained. Patient-reported pain scores and patients’ reports on satisfaction with treatment were used as outcome measures.
Results
Analysis of the outcome measures demonstrated that 81% of all patients had at least a 2-point drop in their average pain scores. 98% of the patients had at least “fair” satisfaction with their pain management and 90% rated it as “good” or “excellent”. Only five patients had to terminate the procedure prematurely due to discomfort or side effects. Adverse reactions were rare and generally tolerable.
Conclusions
Hirudotherapy for chronic pain in the treated outpatient group was effective. We propose to expand our investigation and invite pain specialists from around the world to coordinate a database for hirudotherapy outcomes in managing chronic pain. We believe that these magnificent creatures hold great potential for alleviating pain in many diverse patient populations and should be studied more in the future.
References
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