Abstract: Effect of Leeches Therapy in Periarticular Symptoms of Rheumatoid Arthritis and Osteoarthritis

Background: Complex clinical and instrumental investigations (kinesthesical method, thermovision, ultrasonography) showed significant involvement (up to 69%) of periarticular structures (muscles, tendons) in rheumatoid arthritis (RA) and osteoarthritis (OA) aggravating the clinical picture of the disease and leading to the decrease of life quality of the patients. The substrate of myofascial pain syndrome are local densities in muscular tissue and in the places of detachment of tendons to the bones.

Objectives: The goal of our study was to evaluate the effect of leeches therapy (hirudotherapy) in treatment of RA and OA with muscular syndrome.

Methods: 105 patients with local densities in muscular tissue (54 with RA and 51 with OA) were enrolled and assessed before and after therapy of leeches. The efficacy of therapy was estimated by Lee and Reachy indices of muscular syndrome, duration of early morning stiffness and the range of active and passive movements of joints.

We did hirudotherapy from1 to 5 times to each patient (4-20 Hirudo medicinalis for course) using leeches on the area of painful trigger zones in the muscles surrounding the joints.

Results: We found in all patients clinical improvement after leeches therapy which included decrease or disappearance of myalgias and arthralgias, duration of early morning stiffness. Also the range of movements in joints increased as well as functional activity of patients improved. Laboratory tests showed changes – decrease of erythrocyte sedimentation rate, C reactive protein, sialic acid, prothrombin index (PTI), activated partial thromboplastin time (APTT) and prolongation of coagulation time. No significant side effects after treatment of leeches were found.

Conclusion: The using of leeches for local therapy of myofascial pain syndrome are effective and safe in patients with RA and OA.

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