Leeches, phytotherapy, and physiotherapy in osteoarthritis of the knee—A case study in a geriatric patient

Abstract

Background Chronic pain is a serious problem for geriatric patients. Conventional pharmacotherapy with non-steroidal anti-inflammatory drugs or opiates is often accompanied by serious side effects. Objectives An 87-year-old woman with severe joint pain due to osteoarthritis of the knee presented with side effects from fentanyl therapy. She was subsequently treated in an inpatient setting with leeches, phytotherapy, and physiotherapy. Design Prospective single-case study. Outcome Pain reduction was assessed with a numeric rating scale, mobility by walking distance, and activities of daily living by Barthel index. The association between complementary therapy and the changes observed in the patient under treatment were evaluated using cognition-based medicine. Results Under complementary therapy, the patient experienced a clear reduction in pain (from 8 to 3 points on the numeric rating scale); regained the ability to walk (increase in walking distance from 0 to 70 m); and showed improvements in activities of daily living (increase from 45 to 65 on the Barthel index). The case was analyzed and discussed according to the criteria of cognition-based medicine. An association between pain reduction and the complementary treatment setting seems likely, as does a therapeutic effect of leech therapy. Conclusion The role of complementary pain therapy in geriatric patients should be evaluated systematically.