Medical Leech Therapy (Hirudotherapy) in Rotator Cuff Syndrome Resistant to Conventional Treatments: A Case Report

Rotator cuff syndrome is a common condition that disrupts the biomechanics of the shoulder and leads to severe pain and loss of function. This case report evaluates the efficacy of medical leech therapy (hirudotherapy) in a patient with a traumatic rotator cuff injury that did not respond to conservative treatments. A 52-year-old male patient presented with a five-month history of right shoulder pain resulting from a fall, which had not responded to NSAIDs, corticosteroid injections, or physical therapy. Magnetic Resonance Imaging (MRI) revealed supraspinatus tendinosis and subacromial effusion. Initially, the patient’s Visual Analog Scale (VAS) score was 80, and he experienced severe night pain. Three sessions of Hirudo verbana application were administered to the peri-acromial region and the supraspinatus muscle, with sessions conducted every two weeks. Following the first session, the VAS score dropped to 30, and the night pain resolved. After the third session, the VAS score decreased to 5. Active shoulder flexion improved from 90° to 100°, and abduction increased from 70° to 80°. No complications were observed. The bioactive peptides in leech saliva likely reduced inflammation and improved microcirculation. Hirudotherapy may be considered as a complementary medical approach for rotator cuff pathologies resistant to conventional treatment.