Case Study Review - Reviving an Ancient Therapy to Manage Chronic Pain

Case Study Review - Reviving an Ancient Therapy to Manage Chronic Pain

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Title: Reviving an Ancient Therapy to Manage Chronic Pain
Reference: Podiatry Today, December 2003, pg. 46-53
Author: Nicholas A Grumbine, DPM
Rating: 4/5


Objective: This article was written to increase people’s awareness of leech therapy in healthcare to manage chronic pain. Case studies on were designed to determine whether leeching would improve chronic pain in a safe and effective manner.

Background: Chronic pain results when there is delayed healing. Grumbine claims that chronic pain ‘produces a fear in the patient and a panicked feeling that the pain will
return or increase’.

Grumbine also explores other biological treatments like leech therapy, and the effects that medical leeches have on their patients. Usually, medications were used to control chronic pain, such as sleep medications and antidepressants. Now it has been observed that leeching prevents blood clotting and severe burning pain. The ingredients of leech saliva help stabilize cellular membranes and the overall well-being of the skin and body functions improve. As blood flow increases and improves circulation, the arteries, veins and capillaries dilate, and there is a reduction of oedema, shunting and congestion.

Study Design: Case studies were designed to determine whether leeching procedures would affect patients with chronic pain, and by what amounts. These were patients aged from 13 to 96 that were defiant to usual tradition procedures. Five case studies were made. The case studies were performed on two elderly patients; one diagnosed with RSD , and the other patient suffering from burnings, oedema and hyperesthesia. Three other patients were also treated; a 16-year-old adolescent also with RSD and a severe hypertrophic scar, as well as a patient with Berger’s disease and a war veteran with ‘scrape metal wounds’.

Results: Preoperatively, patients’ levels of pains were at an average of 8.6 out of 10. After leeching procedures, pains were significantly reduced to an average of 3.5 out of 10. Not only did the pain dramatically decrease, but there were dermatological signs of improvement.

Leech therapy aided all of the patients that were case-studied. One of the elderly patients, a 53-year-old with RSD, had oedema reduced from her foot and her pain controlled with medication and fitted orthotics. The 16-year-old patient recovered well from her severe painful hypertrophic scar, after having 10 leeches ‘engorged 3 to 5 cc of blood’ and having 50 percent of the incision faded and 80 percent reduction of pain which allowed her to walk again ‘pain-free’. The third patient, a 52-year-old, had reduced swelling of her feet from severe burning, hyperesthesia and ‘forefoot oedema’ after the application of 12 leeches.

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The patient with Berger’s disease and the war veteran also both responded very well after leeching procedures. Overall, all patients’ cases showed significant changes and they reacted equally well to leech therapy.

Conclusions: According to the numerous case studies and researches made by Dr. Grumbine, using biological treatments such as leech therapy in healthcare decreases chronic pain in a more safe and effective manner.


This is a very well designed and carried out study. The article is clear and concise. The before-and-after images and extra guidelines all help in understanding leeching procedures for chronic pain management. While leech therapy is an ancient method, it is not an obsolete one.

I was amazed when I found an online paper reporting that leeching procedures (to reduce pain) surpass topical anti-inflammatory treatments. However, the author does not provide enough substantiation. There is no mention of what some of the topical anti-inflammatory treatments are. The author only states that patients had leeches attached ‘70 minutes a day for up to 90 days’.

A similar paper by the Jackson Health System reports that ‘in some cases’ leeches do a better job by removing clotted blood and reduce severe pain than any other medical healing. In Grumbine’s article, he is quite certain that ‘in fact’ leech therapy is ‘much more effective than other traditional chronic pain treatments’.

Evidently, papers comprise of vague and different details on how much leech therapy surpasses topical treatments. Further research should be performed on leech therapy. As Grumbine claims, comparative studies are still required to confirm the effectiveness of leeching procedures for chronic pain management.

We know there are many advantages; leech therapy is cost effective and it can save ‘lives and limbs’. Yet for the moment, the biggest problem is that many people are afraid of these creatures crawling in packs on their bodies.

In summation, I find Grumbine’s article a very well done informative study, and hopefully we will see further studies on this procedure.

Related References

(2004, February 5). Patient Education: Jackson Memorial Hospital. Retrieved April 2, 2004 from

(2004, January 22). About, Inc. Retrieved April 2, 2004 from

(2003, December 21). PBS NATURE. Retrieved April 13, 2004 from

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