Smart Library

Off-label use with one small RCT (Michalsen 2008, 32 women) in which single-session leech therapy reduced pain and improved hand function more than topical diclofenac for about 2 months.

Off-label use with one small RCT (Bäcker 2011, n=40) in which a single leech session reduced pain more than topical diclofenac at day 7; the pain difference was no longer significant at day 45.

Off-label adjunct to compression; the evidence is one small open-label randomized trial in varicose veins (n=50) and a 20-patient uncontrolled series.

Investigational use for chronic rhinosinusitis; no clinical study of leech therapy for this condition was identified, and the rationale is mechanistic.

Investigational use for lumbar radiculopathy; the closest randomized evidence is in chronic low back pain (Hohmann 2018, n=44), not radicular pain.

Investigational use for symptomatic relief of varicose tributary discomfort and inflammation; does not eliminate underlying venous reflux.

Investigational for primary dysmenorrhea; one small randomized trial of leeches plus cupping versus an oral contraceptive pill reported lower pain scores.

Investigational adjunct for microvascular complications of type 2 diabetes; one small randomized trial in neuropathy plus case reports; glycemic control and standard pharmacotherapy remain primary.

Investigational adjunct for symptomatic diabetic peripheral neuropathy; glycemic control, foot care, and pharmacotherapy (duloxetine, pregabalin, gabapentin) remain evidence-based.