Leeches to treat tennis elbow

Chronic epicondylitis (tennis elbow) is a painful condition with few treatments.  It’s caused by overuse of the extensor muscles of the forearm.

Researchers in Germany tested whether leech therapy might provide symptomatic relief.


First, the details.

  • 40 patients with epicondylitis for at least 1 month were randomly assigned to a treatment group.
    • A single treatment with 2 to 4 locally applied leeches
    • A 30–day course of topical diclofenac (Voltaren, others)
  • Change in the pain sum score on day 7 (calculated from 3 visual analog scales for pain during motion, grip, and rest) was the main outcome measured.
  • Outcomes and safety were assessed on days –3, 0, 7, and 45.

And, the results.

  • Treatment with leeches was associated with a significant decrease in pain vs topical diclofenac after 7 days.
  • On day 45, the difference between groups was reduced due to the delayed onset of pain relief with diclofenac.
  • Functional disability showed a significantly stronger decrease in the leech group, which was most prominent after 45 days.
  • Quality of life did not change.

The bottom line?

The authors concluded, “A single course of leech therapy was effective in relieving pain in the short-term and improved disability in intermediate-term.”

They proposed, “Leeches might be considered as an additional option in the therapeutic approach to lateral epicondylitis.”

A PubMed search revealed no other studies of leeches to treat tennis elbow.

In a 2010 review, researchers from Germany concluded, “During the acute phase topical NSAIDs, steroid injections, ultrasound, and acupuncture are helpful. There is no consensus about the effectiveness of physiotherapy, orthoses [a device to control movement of the limb), laser, electrotherapy, or botulinumtoxin injections.”

“During the chronic phase none of the different treatment modalities is effective.”


5/11/11 17:20 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.