Smart Library

Investigational use for primary Raynaud's phenomenon; the only clinical report is three patients in a 2025 Azerbaijani case series, with no controlled trial.

Investigational use for androgenic alopecia; the only clinical report is a single-patient Ayurvedic case study, with no controlled trial.

Investigational use for acute monoarticular gout when NSAIDs and colchicine are contraindicated; evidence limited to a few small Ayurvedic pilot studies.

Investigational use for chronic mid-substance Achilles tendinopathy; evidence limited to isolated single-patient reports.

Investigational use for non-surgical rotator cuff tendinopathy and chronic shoulder impingement; evidence limited to isolated case reports.

Investigational use for stenosing tenosynovitis of the digital flexor pulleys; evidence limited to a single Ayurvedic case report.

Investigational use in Dupuytren's disease; evidence limited to one uncontrolled Russian-language report in patients with contracture.

Investigational use for plantar fascia nodules in early Ledderhose disease; no clinical study of leech therapy for this condition was identified.

Not recommended: the only published report of leech therapy in hidradenitis suppurativa describes a harmful outcome.

Investigational use for pulsatile vascular-origin tinnitus distinct from subjective tinnitus; no clinical study of leech therapy for this subtype was identified.

Investigational adjunct for vestibular attack frequency in Meniere's disease; evidence limited to one uncontrolled Russian case series (n=42).

Investigational adjunct in acute idiopathic facial nerve palsy; no controlled trial identified, only uncontrolled series and single-case reports.

Investigational use for classical trigeminal neuralgia refractory to first-line carbamazepine; only two single-patient case reports were located.

Investigational use for lumbosacral radicular pain without disc herniation (foraminal stenosis, facet hypertrophy, lateral recess); no study specific to this subtype was identified.

Investigational adjunct in frozen shoulder; the only clinical reports identified are two single-patient case reports, with no controlled data.

Investigational use for insertional Achilles tendinopathy; no clinical study of leech therapy for it was identified.

Investigational use for stenosing tenosynovitis of the first dorsal extensor compartment; no clinical study of leech therapy for it was identified.

Investigational use for trigger finger recurrent after corticosteroid injection failure; no clinical study of leech therapy for it was identified.

Investigational use for symptomatic plantar calcaneal spur; distinguished from plantar fasciitis by radiographic spur with localized pain.

Investigational use for chronic subacromial bursitis (not acute septic bursitis); no clinical study of leech therapy was identified.

Investigational use for chronic greater trochanteric pain syndrome; no clinical study of leech therapy was identified.

Investigational use for chronic costochondritis after cardiac causes are excluded; no clinical study of leech therapy was identified.

Investigational use for SI joint mechanical pain with positive provocation tests; no clinical study of leech therapy was identified.

Investigational use for chronic coccyx pain after fall, childbirth, or idiopathic onset; no clinical study of leech therapy was identified.

Investigational use for isolated piriformis syndrome (positive FAIR test, lumbar pathology excluded); no clinical study of leech therapy was identified.

Investigational adjunct for chronic migraine (≥15 days/month, ≥8 migrainous) refractory to two preventive classes; distinct from episodic migraine.

Highly investigational use for episodic cluster headache between attack cycles; very limited anecdotal data, not for active attacks.

Investigational adjunct for Hurley stage I localized hidradenitis suppurativa; distinct from Hurley II-III with extensive disease.

Investigational adjunct for keloid scars refractory to intralesional corticosteroid; evidence is limited to five single-patient case reports.

Investigational use for localized cutaneous lichen planus refractory to topical corticosteroid; very limited case-report evidence.

Highly investigational use for small subcutaneous lipoma (<3 cm) with cosmetic concern; surgical excision remains standard; very limited data.

Investigational adjunct for post-mastectomy lymphedema in late survivorship phase (≥2 years post-treatment); distinct from early post-treatment period.

Investigational use for superficial thrombophlebitis of saphenous tributaries (not DVT); evidence limited to small, mostly Soviet and Russian series.

Investigational adjunct for acute external thrombosed hemorrhoids presenting within 72 hours; distinct from internal hemorrhoidal disease.

Highly investigational use for refractory plantar warts (HPV-mediated) after cryotherapy and salicylic acid failure; very limited anecdotal evidence.

Investigational adjunct after drainage of small localized skin abscess; not for undrained abscesses; evidence limited to reports in related infections.

Highly investigational adjunct for paroxysmal atrial fibrillation; no controlled trials; conventional anticoagulation and rate/rhythm control remain primary.

Highly investigational adjunct for intermittent claudication; ABI must be assessed first; critical limb ischemia is an absolute contraindication.

Highly investigational adjunct for CRPS Type I; one case report and no controlled study identified; multidisciplinary pain management and physiotherapy remain primary.

Highly investigational adjunct for distal ulcerative proctitis; no clinical study found; topical 5-ASA and corticosteroids remain primary.

Highly investigational adjunct for limited stable vitiligo; case reports only; topical calcineurin inhibitors, narrow-band UVB, and ruxolitinib cream remain primary.

Investigational adjunct for stable patchy alopecia areata; case reports only; intralesional corticosteroids and JAK inhibitors (baricitinib, ritlecitinib) remain primary.

Investigational adjunct in Hurley Stage II HS refractory to conventional therapy; the only clinical report found describes harm; biologics (adalimumab, secukinumab) and surgical management remain primary.

Highly investigational adjunct for refractory melasma; uncontrolled reports only; sun protection, hydroquinone, tretinoin, tranexamic acid, and chemical peels remain primary.

Highly investigational adjunct for refractory PIH; no clinical study found; sun protection, topical hypopigmenting agents, and chemical peels remain primary.

Highly investigational cervical adjunct for chronic tonsillitis; no clinical study found; tonsillectomy and antibiotics remain primary; cervical leech placement carries carotid-proximity risk.

Highly investigational adjunct for adult recurrent otitis media; no condition-specific study found; antibiotics and ENT evaluation remain primary.

Investigational adjunct for nonallergic vasomotor rhinitis; one uncontrolled Russian series only; intranasal ipratropium and antihistamine remain primary.

Highly investigational cervical adjunct for chronic laryngitis; no clinical study found; ENT evaluation for underlying causes remains primary.

Highly investigational adjunct for chronic glossitis; no study in glossitis found; treating nutritional, infectious or allergic causes remains primary.