Focus on Alternative and Complementary Therapies
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Focus Alternat Complement Ther©2005 Pharmaceutical Press
Focus Altern Complement Ther 2006; 11: 04–5
To test the effectiveness of leech therapy compared to topical diclofenac in lateral epicondylitis.
Forty patients with lateral epicondylitis of at least 1 month’s duration were randomised to a single treatment with two to four locally applied leeches or a 30-day course with topical diclofenac twice a day. Primary outcome was change of mean pain 7 days after treatment calculated from three scores on a VAS for pain at rest, in motion and during grip. Secondary outcomes were functional disability (DASH questionnaire), physical quality of life (pQoL/SF-36) and grip strength. Patients were examined at days −3, 0, 7 and 45.
Leech therapy reduced the mean pain score significantly more (P = 0.0075) compared to diclofenac at day 7 [leech group: 143.7 (±36.9) to 95.3 (±45.1), diclofenac: 131.6 (±29.6) to 134.7 (±70.7)]. Functional disability showed a significant (P = 0.0007) stronger decrease in the leech group, most prominent after 6 weeks with a DASH decrease from 41.3 (±15.9) to 21.4 (±14.6) and from 35.9 (±13.8) to 31.9 (±15.5) in the diclofenac group. There was a moderate increase in pQoL and grip strength in both groups without any significant group difference. When adjusting for outcome expectation and baseline differences results remained unchanged.
A single course of leech therapy was effective in relieving pain and improving function in the short and intermediate term. Leeches might therefore be considered as a therapeutic option within an integrative therapeutic approach to lateral epicondylitis.
The study was funded by the Karl and Veronica Carstens-Foundation, Germany.
