American Society of Hirudotherapy

Medicinal leech therapy in pain syndromes: a narrative review

Narrative review published in Wiener medizinische Wochenschrift (1946) (2014)

Last Updated: November 1, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewSalivary PharmacologyClinical LiteratureKoeppen D, Aurich M, Rampp T · Wiener medizinische Wochenschrift (1946), 2014

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.

Publication typeJournal ArticleReview
Indexed MeSH termsAnimalsChronic PainEdemaHematomaHumansLeechesLeechingOsteoarthritisPalliative CareRandomized Controlled Trials as TopicSalivaTennis ElbowThrombophlebitisVaricose Veins

Summary

This narrative review gathers studies and case reports on the analgesic effects of medicinal leech therapy, noting rapid, effective, and durable pain relief across many conditions, while a specific pain-relieving substance in leech saliva remains unidentified.

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. The review 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

Reference (Vancouver style)

Koeppen D, Aurich M, Rampp T. Medicinal leech therapy in pain syndromes: a narrative review. Wien Med Wochenschr. 2014;164(5-6):95-102. doi:10.1007/s10354-013-0236-y. PMID: 24081747

Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.

Added to ASH library: March 18, 2026 · Site last updated: November 1, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.