Effectiveness of leech therapy in women with symptomatic arthrosis of the first carpometacarpal joint: a randomized controlled trial
RCT published in Pain (2008)
Abstract
Leech therapy has been shown to be effective for symptomatic treatment of osteoarthritis of the knee. We aimed to investigate the effectiveness of leech therapy in another type of osteoarthritis, osteoarthritis of the first carpometacarpal joint (thumb saddle joint). Thirty-two women with symptomatic painful osteoarthritis of the first carpometacarpal joint and who scored>40 mm on a 100mm VAS pain scale were randomized to a single treatment with 2-3 locally applied leeches (leech group) or a 30-day course with topical diclofenac twice a day. Primary outcome measure was change of overall pain (mean of VAS for pain at rest, in motion, during grip) from baseline to day 7. Secondary outcomes were functional disability (DASH-questionnaire), quality of life (QoL, SF-36) and grip strength. Patients were examined baseline and at days 7, 30 and 60 after treatment. Overall pain score at day 7 was reduced from 59.6+/-13.8 to 27.1+/-20.6 in the leech group (n=16) and from 50.6+/-13.3 to 46.9+/-18.5 with diclofenac (n=16) (group difference -26.5, 95%CI -40.3; -12.7; p=0.0003). Group differences for pain relief favoring the leech treatment increased at days 30 and 60. Significant treatment effects were also observed for the DASH score, QoL and grip. Results were not affected by outcome expectation or consumption of analgetics. A single course of leech therapy is effective in relieving pain, improving disability and QoL for at least 2 months. The potential of leech therapy for treatment of arthritic pain and underlying mechanisms should be further investigated.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
RCT in 32 women with symptomatic first carpometacarpal joint arthrosis comparing single leech application versus 30-day topical diclofenac: leech therapy demonstrated significant superiority for pain, DASH score, quality of life, and grip strength over 2 months.
Why This Matters for Hirudotherapy
This randomized controlled trial enrolled 32 women with symptomatic osteoarthritis of the first carpometacarpal joint, comparing a single treatment with 2-3 locally applied leeches to a 30-day course of topical diclofenac. The leech group showed significantly greater pain reduction at day 7, with group differences increasing at days 30 and 60, and significant treatment effects were also observed for disability, quality of life, and grip strength. This RCT expands the evidence base for leech therapy beyond knee osteoarthritis to thumb saddle joint arthrosis, demonstrating benefits lasting at least two months from a single session. However, the sample size is small at 32 participants, all female, and the study examines only short-to-intermediate term outcomes; the underlying mechanisms and long-term durability require further investigation as the authors acknowledge.
Citation
Effectiveness of leech therapy in women with symptomatic arthrosis of the first carpometacarpal joint: a randomized controlled trial.
Michalsen A, Lüdtke R, Cesur Ö et al. · Pain, 2008
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