A German study published in 2003 described the use of leeches in the treatment of osteoarthritis (OA) of the knee (Michaelsen A, Klotz S, Ludtke R, et. Al .Annals Intern Med. 2003; 139: 724-730).

Subsequently, these researchers described the effectiveness of leech therapy for arthritis involving the knee, hip, thumb, and wrist.

In 2004, the FDA approved the use of leech therapy for use as a medical device to clear away pooled blood in skin grafts and surgical wounds to prevent tissue damage.

According to investigators at New York's Beth Israel medical Center, where another study of leech therapy in OA is ongoing, it is critical for patients to feel comfortable about the anticipated treatment. Each therapy session takes about two and a half hours.

Strict sterile technique along with the use of prophylactic antibiotics and hydration are used with each patient.

Leeches are placed in a sequential pattern to surround the knee joint. About 4 to 6 leeches are used for each session. Leeches have several biologically active substances in their saliva that help with knee OA. These include hirudin, hyaluronidase, and other anti-inflammatory compounds. Once the leeches have completed their ?assignment?, they fall off and are collected in a waste container.

In the German study, leech therapy was compared against a topical non-steroidal anti-inflammatory drug. The overall mobility and function was better in the leech treated group.

In the New York experience, patient also report less pain and greater mobility. The treatment can be repeated every six months.

To switch gears?

Another interesting application of an animal from nature is the use of products derived from honeybees including bee venom and raw honey. Hippocrates is said to have treated arthritis with bee venom.

Today, bee venom is administered either by injection or live bee stings, for the treatment of arthritis. Advocates claim that bee venom works by stimulating the immune system to produce anti-inflammatory substances that help relieve the pain and swelling from the venom and, as a byproduct, also relieve the pain and inflammation from the arthritis.

Also, ingesting bee pollen and raw honey is claimed to increase energy and endurance.

Some practitioners inject bee venom using a syringe and tiny gauge neddle, but most prefer to use live bee stings. (Alcohol or iodine tincture used to cleanse the site may destroy the activity of the bee venom.) Treatment involves repeated bee stings administered at specific sites over a given time period for example, 4 to 8 weeks for arthritis.

Bee products such as bee pollen and royal jelly can cause life-threatening allergic reactions in sensitive people. Bee venom can cause inflammation, itching, and swelling, as well as nausea, vomiting, headache, hypotension, and anaphylaxis.

If a patient is considering using bee products, they should be warned about the possibility of allergic reactions, including anaphylactic shock. Bee pollen may continue impurities such as bee feces and bacteria.

While bee venom has been claimed to be effective for rheumatoid and other types of arthritis, conclusive scientific controlled evidence is lacking. Reports to date have been mostly anecdotal, and therefore, are subject to placebo effect and investigator bias.