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Therapy with leeches (Hirudo medicinalis) is one of the oldest medical procedures of mankind. The first records from Mesopotamia go back to 4000 years. Leeches that are used for treatment in humans are grown in special breeding stations. Each leech is used only once. So there is no risk of transmission of diseases.

For which diseases are leeches used?

  • Osteoarthritis and joint inflammation
  • knee
  • wrist
  • finger
  • foot
  • Elbow
  • Tendinitis
  • hand
  • Achilles tendon
  • tendons of the knee joint
  • Nerve pain
  • Wound healing disorders

Non-orthopedic diseases:

  • migraines, headaches and nerve pain (neuralgia)
  • for tinnitus and sudden hearing loss
  • after plastic surgery, e.g. breast reconstruction
  • for vein diseases such as varicose veins (varicose, varicosis, varices) and broom tear, supportive for high blood pressure.

Mode of action

While the leeches suck the blood, they also release certain active ingredients. The best known are Hirudin and Eglin. The following active ingredients and effects have been demonstrated:

  • Hirudin (anticoagulant, diuretic, antibiotic)
  • Histamine (vasodilator, influence on histamine)
  • Heparin (anticoagulant)
  • Calin (anticoagulant – responsible for post-bleeding)
  • Hyaluronidase (antibiotic, tissue loosening)
  • Egelin (anti-inflammatory, antibiotic, etc.)
  • Bdellin (anti-inflammatory, antibiotic, etc.)
  • Apyrase (anti-inflammatory, antibiotic, etc.)
  • Collagenase (anti-inflammatory, antibiotic, etc.)
  • Hementin (promotes blood circulation)
  • Organase (promotes blood circulation)
  • Anesthetic Substance (insensitivity to pain when sucking)

How is the treatment done?

The leeches are placed on the area to be treated. The leeches should not be placed directly on an inflamed area, but directly around it. To garuantee that the leeches suck where they should, they are placed on the skin with a tube.

Leeches are sensitive and may not want to “bite”. Therefore some rules must be followed:

  • 1 day before the treatment, the intended area should no longer be washed with soap
  • Do not use local creams
  • No perfume
  • No treatment on days with thunderstorms

The patient feels the bite like a mosquito bite. After that, the area around may burn or hurt a little for a few minutes. This is probably due to the fact that the vessels expand at this point.

The duration of treatment depends on how long the leech sucks and usually lasts 10-45 minutes. Here he sucks 2-15ml of blood (not much more than with a blood sample)

After the treatment

You will be given a loose bandage after the treatment. Pressure bandages should be avoided. At the bites sites there is a bleeding of up to 40 ml of blood from the bite wound, which can last up to 24 hours. This is desirable and should not be prevented because it increases the effectiveness of leech therapy.

The patient should refrain from showering and bathing and cleaning the wound about 2 days after the treatment.


  • known anemia and
  • bone marrow suppression drug
  • Taking blood thinners or other blood clotting disorders
  • Suppression of the immune response (immunosuppression)
  • acute infectious diseases with high fever
  • Skin disease at the application site
  • peripheral arterial disease
  • Treatment should be avoided during pregnancy and in children under 30 kg, as there is insufficient experience to date

Complications (rare)

  • prolonged and increased bleeding that lasts longer than 24 hours
  • allergic reactions to the histamine released by the leech
  • itchy reddening of the skin around the bite site
  • Pigment disorders, scarring at the bite site

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