Medicinal leech therapy in pain syndromes: a narrative review
Case report published in Wiener medizinische Wochenschrift (1946) (2014)
Hirudopedia
Evidence grade: MODERATE- Study design
- Narrative review
- Sample size
- —
- Population
- Patients with various pain syndromes — knee OA, lateral epicondylitis, lumbar radiculopathy, migraine, fibromyalgia (across reviewed studies)
- Intervention
- Medicinal leech therapy across pain indications
- Primary outcome
- Pain reduction (VAS, WOMAC, PRTEE), function
- Result
- Strongest evidence in knee OA and lateral epicondylitis (RCT-supported); other indications observational only
- Notes
- Narrative (not systematic) review; consolidated context for clinicians evaluating MLT in pain practice. Cited from PubMed.
Abstract: Narrative review of medicinal leech therapy across pain syndromes. RCT-grade evidence is strongest for knee osteoarthritis (Michalsen 2003) and lateral epicondylitis (Bäcker 2011); remaining indications rest on observational data.
Abstract
Medicinal leech therapy is used in a variety of conditions; most of which have pain as a major symptom. Its mode of action relies on the injection of leech saliva into patients' tissues during the process of blood withdrawal. Leech saliva contains active ingredients with anti-inflammatory, thrombolytic, anti-coagulant and blood- and lymph-circulation enhancing properties. A specific analgesic substance within the leech saliva is yet to be identified. Pain relief from leech therapy is rapid, effective and long-lasting in many conditions. This review compiles studies and case reports that provide clinical evidence for leech therapy's analgesic effects.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Medicinal leech therapy is used in a variety of conditions; most of which have pain as a major symptom. Its mode of action relies on the injection of leech saliva into patients' tissues during the process of blood withdrawal.
Why This Matters for Hirudotherapy
This review compiles studies and case reports providing clinical evidence for the analgesic effects of medicinal leech therapy across a variety of painful conditions. The abstract describes leech saliva as containing bioactive components with anti-inflammatory, thrombolytic, anticoagulant, and blood- and lymph-circulation-enhancing properties, while noting that a specific analgesic substance has not yet been identified. This is directly relevant to hirudotherapy and ASH's domain, as it synthesizes clinical evidence supporting leech therapy for pain relief and describes salivary secretome mechanisms thought to underlie that effect. As a review, it generates no new primary data and instead summarizes previously published literature without itself providing original quantitative outcomes.
Citation
Medicinal leech therapy in pain syndromes: a narrative review.
Koeppen D, Aurich M, Rampp T · Wiener medizinische Wochenschrift (1946), 2014
Added to ASH library: March 18, 2026 · Site last updated: June 18, 2026