Journal of Research in Ayurvedic Sciences

Register      Login

VOLUME 2 , ISSUE 2 ( April-June, 2018 ) > List of Articles


Jalaukavacharana (Leech Application) in Pain Management: A Pilot Open-Label Clinical Trial

Krishna K Pandey, Gyanendra D Shukla, Arun K Tripathi

Keywords : Leech therapy, Musculoskeletal disorders, Pain management,Jalaukavacharana

Citation Information : Pandey KK, Shukla GD, Tripathi AK. Jalaukavacharana (Leech Application) in Pain Management: A Pilot Open-Label Clinical Trial. J Res Ayurvedic Sci 2018; 2 (2):99-107.

DOI: 10.5005/jp-journals-10064-0045

License: CC BY-NC 3.0

Published Online: 00-06-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Introduction: In most musculoskeletal disorders, primary medicine seeking symptom is a pain, but due to “time taking the line of treatment” of Ayurveda in chronic conditions common mass adopts non-sectorial anti-inflamatory drug (NSAIDs) and other analgesics even if undesirable. This study is an attempt to provide an alternative to NSAIDs for pain management by Ayurvedic means. Materials and Methods: Eighteen patients suffering from painful musculoskeletal disorders of varied etiology, i.e., osteoarthritis (OA)/rheumatoid arthristis (RA)/low back pain (LBA)/ Gout, primarily having knee joint pain, were randomly divided in three groups with six patients in each group, These patients were unable to perform their routine activity without NSAIDs. Group A patients were given Etoricoxib. Group B patients were given three sittings of Leech therapy (Jalaukavacharana) within 3 days. While Group C patients were given sugar-coated tablets. The assessment was done on 1st day, 9th day and 15th day based on changes in subjective criterias and outcome was statistically analyzed. Results: Pain was significantly reduced in the patients treated with Leech therapy, and the relief consistency was better than NSAID treated group. However, the results obtained in Group C patient were not significant. Conclusion: In this pilot study, Leech therapy has shown promising results in pain management and can be used as a substitute for modern analgesics. However, more studies with large sample sizes are required to justify this clinical outcome so that Leech therapy can be implemented as a pain management module instead of NSAIDs in painful musculoskeletal conditions.

PDF Share
  1. Gaskin DJ, Richard P. The Economic Costs of Pain in the United States. In: Institute of Medicine (US) Committee on Advancing Pain Research, Care, and Education. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington (DC): National Academies Press (US); 2011. Appendix C.
  2. Chronic diseases and health promotion. Retrieved January 17, 2015, from en/
  3. Pirmohamed Munir, James Sally, Meakin Shaun, Green Chris, Scott Andrew K, Walley Thomas J. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ 2004; 329:15.
  4. Howard RL, Avery AJ, Slavenburg S, Royal S, Pipe G, Lucassen P. Which drugs cause preventable admissions to hospital? A systematic review. Br J Clin Pharmacol. 2007;63(2):136-147.
  5. Cena C, Lolli ML, Lazzarato L, Guaita E, Morini G, Coruzzi G, et al. Antiinflammatory, gastrosparing, and antiplatelet properties of new NO-donor esters of aspirin. J Med Chem. 2003;46(5): 747-754.
  6. Dubois RW, Melmed GY, Laine L, Henning JM. Guidelines for the appropriate use of non-steroidal anti-inflammatory drugs, COX- 2 Specific inhibitors and proton pump inhibitors in patients requiring Chronic anti-inflammatory therapy. Ailment Pharmacol. Ther. 2004; 19:197.
  7. Raut A, Bichile L, Chopra A, Patwardhan B, Vaidya A. Comparative study of amrutbhallataka and glucosamine sulphate in osteoarthritis: Six months open label randomized controlled clinical trial. J Ayurveda Integr Med. 2013;4(4):229-236.
  8. Chopra A, Saluja M, Tillu G. Ayurveda -modern medicine interface: A critical appraisal of studies of Ayurvedic medicines to treat osteoarthritis and rheumatoid arthritis. J Ayurveda Integr Med. 2010;1(3);190-208.
  9. Vallath N. Perspectives on Yoga Inputs in the Management of Chronic Pain. Indian Journal of Palliative Care. 2010;16(1):1-7.
  10. Pain management and Yoga. Retrieved on January 17, 2015, from
  11. Leech Retreieved March 17,2015, from http://en.wikipedia. org/wiki/Leech
  12. Koeppen D1, Aurich M, Rampp T, Medicinal leech therapy in pain syndromes: a narrative review. Wien Med Wochenschr. 2014 Mar;164(5-6):95-102
  13. Shastri Kaviraj Ambika Dutt. Chapter 13th Sutra Sthana. Sushrut Samhita, “Ayurveda Tatwa Sandeepika” Hindi Commentary Part I. Varanasi, Chaukhmbha Sanskrit Sansthan; Edition 11th
  14. Ritchie DM, Boyle JA, McInnes JM, Jasani MK, Dalakos TG, Grieveson P, Buchanan WW. Clinical studies with an articular index for the assessment of joint tenderness in patients with rheumatoid arthritis. Q J Med. 1968 Jul;37(147):393-406
  15. Chopra A. Rheumatology: Made in India. J Indian Rheumatol Assoc. 2004;12:43-53.
  16. I.P. Baskova, G.I. Nikonov, Destabilase “ An enzyme of medicinal leech salivary gland secretion that hydrolyses isopeptide bonds in stabilized fibrin” Biokhimia (USSR) 50(1985) 363-375.
  17. Michalsen A, Lüdtke R, Cesur O, Afra D, Musial F, Baecker M, Fink M, Dobos GJ. Effectiveness of leech therapy in women with symptomatic arthrosis of the first carpometacarpal joint: a randomized controlled trial. Pain. 2008 Jul 15;137(2):452-9. doi: 10.1016/j.pain.2008.03.012. Epub 2008 Apr 14.
  18. Knobloch K, Gohritz A, Busch K, Spies M, Vogt PM. Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery-a literature review (Article in German). Handchir Mikrochir Plast Chir. 2007;39(2):103-7.
  19. Singh AK, Singh OP. Analgesic and anti-inflammatory activity of leech therapy in the management of arthritis. International Research Journal of Pharmacy 2011;2(12):172- 4.
  20. Sviridkina LP, Borovaia EP, Makhneva AV. Hirudotherapy in combined sanatorium-spa treatment of patients with coronary heart disease (Article in Russian). Vopr Kurortol Fizioter Lech Fiz Kult. 2008;3:12-5.
  21. Baskova IP, Zavalova LL, Kostrjukova ES, Titova GA, Lazarev VN, Zgoda VG. Proteomic analysis methods for characterization of proteins from the salivary gland secretions of the medicinal leech during different seasons. Biochemistry (Moscow) 2007;72(2):219-25.
PDF Share