Title: Reviving an Ancient Therapy to Manage Chronic Pain
Reference: Podiatry Today, December 2003, pg. 46-53
Author: Nicholas A Grumbine, DPM
Rating: 4/5
Abstract
Objective: This article was written to increase people’s awareness of leech therapy in healthcare to manage chronic pain. Case studies on were designed to determine whether leeching would improve chronic pain in a safe and effective manner.
Background: Chronic pain results when there is delayed healing. Grumbine claims that chronic pain ‘produces a fear in the patient and a panicked feeling that the pain will return or increase’.
Grumbine also explores other biological treatments like leech therapy, and the effects that medical leeches have on their patients. Usually, medications were used to control chronic pain, such as sleep medications and antidepressants. Now it has been observed that leeching prevents blood clotting and severe burning pain. The ingredients of leech saliva help stabilize cellular membranes and the overall well-being of the skin and body functions improve. As blood flow increases and improves circulation, the arteries, veins and capillaries dilate, and there is a reduction of oedema, shunting and congestion.
Study Design: Case studies were designed to determine whether leeching procedures would affect patients with chronic pain, and by what amounts. These were patients aged from 13 to 96 that were defiant to usual tradition procedures. Five case studies were made. The case studies were performed on two elderly patients; one diagnosed with RSD , and the other patient suffering from burnings, oedema and hyperesthesia. Three other patients were also treated; a 16-year-old adolescent also with RSD and a severe hypertrophic scar, as well as a patient with Berger’s disease and a war veteran with ‘scrape metal wounds’.
Results: Preoperatively, patients’ levels of pains were at an average of 8.6 out of 10. After leeching procedures, pains were significantly reduced to an average of 3.5 out of 10. Not only did the pain dramatically decrease, but there were dermatological signs of improvement.
Leech therapy aided all of the patients that were case-studied. One of the elderly patients, a 53-year-old with RSD, had oedema reduced from her foot and her pain controlled with medication and fitted orthotics. The 16-year-old patient recovered well from her severe painful hypertrophic scar, after having 10 leeches ‘engorged 3 to 5 cc of blood’ and having 50 percent of the incision faded and 80 percent reduction of pain which allowed her to walk again ‘pain-free’. The third patient, a 52-year-old, had reduced swelling of her feet from severe burning, hyperesthesia and ‘forefoot oedema’ after the application of 12 leeches.
A. Chronic pain signifies a developing public health issue of huge magnitudes, mainly in view of aging populations in developed countries (Russo).
What exactly is pain? According to Webster's dictionary, pain is "physical suffering typically from injury or illness; a distressing sensation in a part of the body; severe mental or emotional distress". Most everyone reading this paper has experienced some form of physical pain at some point during their lives; most everyone has even experienced the common daily pains such as stubbing our toe as we walk through the living room, accidentally biting our tongue as we chew, and having the afternoon headache after a long day of work. No matter the fact that it is unpleasant, pain has a very important role in telling the body that something is not right and leading to behavior that will remove the body from a source of potential injury. Imagine if we could not experience pain. We would not be able to change our behavior in any way when touching the burning hot dish in the oven, resulting in potentially serious burns. We could not recognize that perhaps we twisted an ankle when walking down the stairs, thus continued walking on that foot would exacerbate the injury to the point of not being able to walk at all. Indeed, pain is not pleasant, but in many cases it is an important way for our nervous system to learn from and react to the environment.
Pain is not always curable but effects the life of millions of people. This essay examines the Essence of Care 2010: Benchmarks for the Prevention and Management of Pain (DH, 2010). Particularly reflecting on a practical working knowledge of its implementation and its relevance to nursing practice. It is part of the wider ranging Essence of Care policy, that includes all the latest benchmarks developed since it was first launched in 2001.
...tive pain management and Improvement in patients outcomes and satisfaction [Magazine]. Critical Care Nurse, 35(3), 37,35,42. Retrieved from
Assessing and managing pain is an inevitable part of nursing and the care of patients. Incomplete relief of pain remains prevalent despite years of research due to barriers such as lack of kn...
After the use of deep peeling procedure, patients often feel unwell for several hours. Pain-killers can be used to control moderate to severe pain.
...amount of pain) is a great teaching tool for the patient who is able to self-report (Nevius & D’Arcy, 2008). This will put the patient and nurse on the same level of understanding regarding the patient’s pain. The patient should also be aware of the added information included with the pain scale: quality, duration, and location of the pain. During patient teaching, it should be noted that obtaining a zero out of ten on the pain scale is not always attainable after a painful procedure. A realistic pain management goal can be set by the patient for his pain level each day.
Belvoir Media Group (2010) realised an article claiming that although pressure on the skin is the focal cause of decubitus ulcers, other factors frequently fund this problem. These factors include; shearing and friction causing the skin to stretch and blood vessels to curve which results in impair blood circulation, Moisture, circulatory problems, age, and people with poor nutrition. It further claims that ulcers can be categorised in different stages (stage 1; being the initial stage, and stage 4; being the most severe), and treatments for ulcers include distinct dressings to be applied to promote healing. Cooper (2013) likewise clarifies that many different factors contributing to the progress of ulcers in supplement to pressure such as moisture, shear and friction. She additionally goes on to say that hydrocolloid dressings do not relieve pressure, nonetheless do reduce friction and shearing of the wound.
The carnivorous worm Hirudo medicinalis, commonly known as a leech, has recently been approved by the FDA as a medicinal device. In June, 2004 the FDA gave the French company Ricarimpex SAS a license to market leeches for medical use in the United States. Leeches are commonly used post-operatively in reconstructive surgery. It is difficult for ruptured veins to rejoin after surgery without any vessels to drain blood away. This can cause cells to die from oxygen deprivation. Leeches can eliminate this by sucking the pooled blood, which allows the body to re-establish the network of blood vessels (Pilcher 2004). There are also recent studies being done on the use of leeches in the treatment of osteoarthritis. This condition occurs when cartilage in the knee joint breaks down. This causes a great ...
Conclusions. An adequate and clear understanding of the concept of pain and implementing interventions of pain treatment and management is essential in the clinical settings. Understanding the concept of pain is necessary for its relationships with other concepts that are related and similar to the pain experience for theory building. The in the end, understanding the concept of pain will ultimately benefit the patient and lead to better and approp...
He then began a course of applications with bromine to destroy the gangrenous slough and to prevent the development of pyemia. After ten days the wound showed signs of granulation and the patient’s appetite slowly began to improve.
Pain, which is defined in its widest sense as an emotion which is the opposite of pleasure (White, 2004, p.455), is one of the major symptoms of cancer, affecting a majority of sufferers at some point during their condition (De Conno & Caraceni, 1996, p.8). The World Health Organization (WHO, 2009, online) suggests that relief from pain may be achieved in more than 90 percent of patients; however, Fitzgibbon and Loeser (2010, p.190) stress that pain may often be undertreated, even in the UK. Foley and Abernathy (2008, p.2759) identify numerous barriers to effective pain management, among which are professional barriers such as inadequate knowledge of pain mechanisms, assessment and management strategies.
Management of pain is very important when it comes to palliative care patients, considering that 55-95% of this patient population requires analgesia for pain relief (Creedon & O’Regan, 2010, p. [ 257]). But what is considered pain management? And why does pain continue to be inadequately treated? According to the article on chronic non-cancer pain in older people: evidence for prescribing, in the past few decades significant improvements have been made to the management of pain in palliative care. However, it is universally acknowledged that pain on a global scale remains inadequately treated because of cultural, attitudinal, educational, legal, and systemic reasons (Creedon & O’Regan, 2010, p. ...
...rocess and is cost effective for many patients. It has also generated a positive impact on patient’s comfort and convenience. Yet still, the selection of an optimal modality remains amongst the scientific and medical communities. Further research and clinical trials to support these positive effects on wound healing may help generate that consensus and help ES therapy gain full support in the US. In reviewing the above studies the evidence of the numerous beneficial effects ES therapy has are clear, however, the evidence that the lack of consensus on standardization of parameters to devise systematic protocols for its use and the lack of uniformity in reports on ES dosages, application modes and waveforms is also clear. Further research trials are needed in order to prove the effectiveness and benefits of electrical stimulation therapy as it relates to wound healing
When a wound is determined as non-healable, as described by Sibbald et al (1), it should not be treated with a moist treatment and should be kept dry in order to reduce the risk of infection that would compromise the limb. It is also important to consider the patient 's preferences and try to control his pain, his discomfort in activities of daily living and the odour that their wound may produce. In this case, special attention must be given to infection prevention and control. Some charcoal dressing would be interesting in the care of our non-healable wounds at St. Mary 's Hospital.