Effectiveness of leech therapy in chronic lateral epicondylitis: a randomized controlled trial
RCT published in The Clinical Journal of Pain (2011)
Abstract
OBJECTIVES: Leech therapy has been found to be effective in osteoarthritis of the knee and hand in previous trials. Chronic epicondylitis is a prevalent pain syndrome with limited treatment options. In this study, we tested whether leech therapy would be beneficial in the symptomatic treatment of chronic lateral epicondylitis. METHODS: Forty patients with manifestation of epicondylitis of at least 1-month duration were randomized to a single treatment with 2 to 4 locally applied leeches or a 30-day course with topical diclofenac. The primary outcome was change of pain sum score on day 7 calculated from 3 visual analog scales for pain during motion, grip, and rest. Secondary outcomes included disability (Disability of the Arm, Shoulder, Hand questionnaire), physical quality of life (Short Form-36), and grip strength. Outcomes and safety were assessed on days -3, 0, 7, and 45. RESULTS: Leeches induced a significantly stronger decrease of the pain score (143.7±36.9 to 95.3±45.1) compared with topical diclofenac (131.6±29.6 to 134.7±70.7; mean difference -49.0; 95% confidence interval,-82.9--15.1; P=0.0075) after 7 days. On day 45, this group difference was reduced (-27.5; confidence interval, -60.8-5.8; P=0.110) due to delayed pain relief with diclofenac. Functional disability showed a stronger decrease in the leech group, which was most prominent after 45 days (P=0.0007). Quality of life increased nonsignificantly in the leech group. Results were not affected by outcome expectation. DISCUSSION: A single course of leech therapy was effective in relieving pain in the short-term and improved disability in intermediate-term. Leeches might be considered as an additional option in the therapeutic approach to lateral epicondylitis.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Forty patients with chronic lateral epicondylitis randomized to single leech application versus 30-day topical diclofenac; leech therapy produced significantly stronger short-term pain relief and improved disability at day 45.
Por qué esto importa para la hirudoterapia
Este ensayo controlado aleatorizado comparó una sola sesión de terapia con sanguijuelas (2-4 sanguijuelas aplicadas localmente) con un curso de 30 días de diclofenaco tópico en 40 pacientes con epicondilitis lateral crónica. La terapia con sanguijuelas produjo una reducción significativamente mayor en las puntuaciones de dolor en el día 7, y la discapacidad funcional mostró una disminución más pronunciada en el grupo de sanguijuelas, más prominente en el día 45. Este ensayo es directamente relevante para el ámbito de la ASH, ya que proporciona evidencia de nivel de ECA para la terapia con sanguijuelas en una afección musculoesquelética dolorosa más allá de la osteoartritis de rodilla y de mano previamente estudiada. Los autores sugieren las sanguijuelas como una opción adicional para la epicondilitis lateral. Sin embargo, el tamaño muestral es modesto con 40 pacientes, la diferencia de dolor a largo plazo disminuyó hacia el día 45, y el estudio no esclarece los mecanismos de acción subyacentes ni la durabilidad del beneficio más allá del período de estudio.
Citación
Effectiveness of leech therapy in chronic lateral epicondylitis: a randomized controlled trial.
Bäcker M, Lüdtke R, Afra D et al. · The Clinical journal of pain, 2011
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 26, 2026 · Última actualización del sitio: 18 de junio de 2026