What is soft tissue injury?
Soft tissues are the tissues that cover, surround and support the internal organs of our body. These tissues do not get hardened by ossification or calcification and include the muscles, ligaments, tendons, nerves, fat, fibrous tissue, lymph, blood vessels, fasciae, and synovial membranes.
Injury to these tissues is termed as soft tissue injury and it shows up as swelling, redness, pain, bruising, lumps, stiffness and loss of function.
It can be either an acute injury as a result of a trauma or due to overuse of the tissue in activities that are frequently repeated without giving enough time for the tissues to rest or heal.
For superficial tissues and lighter injuries; rest, ice pack and compression helps in healing. For deeper tissues and serious injuries like ligament tear, menisci damage, intervertebral disc compression and tendonitis, a more intensive treatment plan is required. This might include internal medicines and surgery. In my practice, I use internal Ayurvedic medicines and leech therapy. I have been able to help my patients avoid a surgical intervention with my treatment.
What is Leech Therapy?
Leeches are invertebrates that suck blood.
Out of the available 700 to 1000 varieties only a few are used for medicinal purposes. One such variety is Hirudo medicinalis which has been used by traditional medical practitioners in India for over 4000 years.
I procure my leeches from a medical supplier who supplies medicinal leeches only to Registered Medical Practitioners. Although leeches are not the known vectors of diseases like HIV, Hepatitis B and Malaria, I do not repeat a leech on another patient. Every patient gets their own sets of fresh leeches which I take care of, once the leech therapy sessions are completed. These leeches live out their natural lives on my farm for 8 to 10 months and then released into their natural environment..
The process of Leech Therapy
Since this is a medical procedure there are protocols that the patient is expected to follow, before, during and after every procedure. These protocols are shared with all my patients before they opt for the therapy. The number of leeches, their size, the exact area where the leeches would be applied is all decided by me based on what is needed to treat the condition.
The leeches have a round mouth that has tripartite suckers which they use to latch on to the patient. You would feel a prick as if you were getting an injection or a shot and the process begins. There is hardly any pain afterwards.
The saliva of the leeches contains over 100 bioactive compounds that act as anti-inflammatory, analgesic, vasodilators, bacteriostatic and anti oedematous. The modern world is researching extensively about these and their efficacy. Although, it might take a while before we get to know the extent of their medicinal properties in modern terminologies, leeches have been always used in India to treat numerous disorders.
Sushruta, a physician from 6th century BC who is also known as the father of plastic surgery has used leeches extensively for treating all sort of disorders for bones, joints and also as a post-operative procedure in some of the surgeries that he has described in his treatises.
Did you know that the first written description of Caesarean section has been described by Shushruta? Read here to find out more about Sushruta, the Father of Indian Medicine and the Father of Plastic Surgery.
The leeches might take 5 to 15 minutes to latch on and once that is done they continue to suck blood until they are full. This could take anything between 30 mins to 2 hours depending on their size, the patient’s body constitution and the extent of inflammation at the application site. They secrete an anticoagulant called hirudin, which helps them to continue drinking the blood. On an average, one leech can suck about 15 to 30 ml of blood. Just to give you some relativity, a blood donor would donate about 350 ml of blood in one session.
Once the leech drops off, I use a special herb to trap the platelets and stop the bleeding for the patient. Hirudin in the system interferes with the blood coagulation so this herb is an essential part of the post- leech therapy procedure. Once the bleeding stops the patient is free to leave and follow the post procedure protocols. They can pretty much return to a normal life after the procedure and only need to see me for dressing and followup of their treatment.
The bacteria in a leech’s gut can survive up to 8 months, so they live on my farm for 8 to 10 months and then they are released in the wild, in their natural habitat.
How do the leeches work?
The enzymes and bioactive substances from the saliva of the leeches get absorbed into the human body. These help in reducing pain, inflammation and swelling. They increase the blood supply to the affected region and in some cases also inhibit the growth of harmful bacteria.
They are instrumental in angiogenesis and thus are used in reconstructive surgeries to establish venous drainage around new wounds.
Ayurveda describes bloodletting as one of the five basic shodhan (detox) procedures. To know about the detox procedures in Ayurveda, click here. Leech Therapy is one of the local bloodletting procedures and detoxify the region where they are applied. They get rid of the Rakta (blood) which is vitiated by Vata, Pitta, Kapha thus curing the inflammation, swelling and pain in the region. The number of leech therapy sessions depends on the extent of the disease, the constitution of the patient and the season.
Where are Leeches used?
I use leeches for different types of soft tissue injuries like ACL tear, Menisci tear, other ligament injuries in other joints, spondylitis, spondylosis, spinal stenosis, frozen shoulder, osteoarthritis, rheumatoid arthritis, lesions in gout, premature cataract, migraine, alopecia aerata and many more diseases which have pathogenesis in vitiation of Vata, Rakta and Kapha. I derive the diagnosis and prognosis of disease through careful analysis of the case history of every patient and my treatment plan is formulated around managing the systemic dysfunction and local disease.
Few of my notable cases are:
1. Male patient, 44 years old- An active athlete, a regular volleyball player. Injured his left knee while playing. He had a history of ACL tear in the right knee which was operated a couple of years back. He wanted to avoid a surgery so decided to consult me.
His MRI report showed a high-grade femoral attachment anterior cruciate ligament (ACL) tear, complex tear of the medial meniscus and radial tear of the lateral meniscus. He was in tremendous pain, had stopped any form of exercise due to the pain but continued his work.
I put him on a treatment plan that included Ayurvedic medicines, kashayam (Ayurvedic herbal tea), yoga and leech therapy. His medicines completely stopped after 18 months. Now he is free of any kind of pain, has an active lifestyle and pursues running as a form of exercise.
2. Female, 34 years, regular yoga practitioner presented with a crick in the neck which had remained persistent even after 10 days. She had tried hot and cold fomentation, application of warm oils, application of anti-inflammatory sprays and rest. Nothing worked.
Although she continued her work, she had to stop practising yoga because that would aggravate her condition. After careful history taking, I diagnosed it as acute soft tissue damage which must have happened due to faulty posture in one of her asanas. I created her treatment plan using a combination of kashayams (Ayurvedic herbal teas), ayurvedic internal medicines and organised 2 sessions of leech therapy 1 week apart.
She had 80% pain relief in the first 48 hours. After 4 weeks of medication, she was completely cured.
3. Female, 55 years, with no exercise regimen. She consulted me for osteoarthritis of the knee joint. She had tremendous pain in her left knee joint which showed KL grade-4 osteoarthritis. She had been on medication for over a year, on and off with Non-Steroidal Anti Inflammatories (NSAIDs) and sometimes steroids for pain management.
After recording her case history I formulated a treatment plan with Ayurvedic Internal medicines, Ayurvedic Basti treatment, Leech therapy and Yoga. We did multiple sessions of Basti and Leech therapies. Her internal medicines stopped after 24 months and her pain had reduced considerably. It has been 9 years since she first consulted me, and we have been able to avoid an otherwise imminent surgical intervention for her. She undergoes a leech therapy whenever her pain increases.
Osteoarthritis is a degenerative condition and there is no known treatment for it, but with careful non-invasive management we can delay the progression of the disease.
If you are considering a Leech Therapy for your condition, want to know more or would like to know if Leech Therapy could help someone avoid surgery, get in touch with me through this website. You could even write to me at dr.prafullata@gmail.com.
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