The lumbar spine disc herniation is mostly related to builders, office workers, car mechanics, sportspeople or drivers. The risk factors associated with disc herniation are smoking, obesity, The injury occurs mainly due to constant overuse and pressure on the intervertebral disc or sudden jerk movement under the load of the lumbar spine.
Intervertebral discs (IVD) are complicated structures build-up from annulus fibrosus (AF) and nucleus pulposus (NP) - and for me, also adjacent ligament as there merge into each other.
Annulus fibrosus is a tough ring made of many collagen fibres. Fibres run multidirectional and connect the two vertebrae to provide shock absorption and allow movement of the spine. Also, AF provides protection for NP to prevent migration.
Nucleus pulposus is a jelly-like substance made of water, proteoglycans and loose collagen components. It is basically a spinal "cushion" that helps to absorb the load and prevents friction between vertebrae.
How does herniation of IVD occur?
Disc herniation occurs due to progressive load exerted on the IVD and damaging annulus fibrosus structures. This allows the nucleus pulposus to migrate outwards the IVD. This process has a few stages.
Bulging: extension of the disc margin beyond the margins of the adjacent vertebral endplates.
Protrusion: the posterior longitudinal ligament remains intact but the nucleus pulposus impinges on the annulus fibrosus.
Extrusion: the nuclear material emerges through the annular fibres but the posterior longitudinal ligament remains intact.
Sequestration: the nuclear material emerges through the annular fibres and the posterior longitudinal ligament is disrupted. A portion of the nucleus pulposus has protruded into the epidural space.
Why and How medicinal leeches can help heal IVD herniation?
Hirudotherapy or Medicinal Leech Therapy is a therapeutic method when medicinal leeches through biting release their enzymes into the patients' body. Because it is still not possible to synthesize leeches enzymes in the laboratory. Therefore, it is still used in the traditional throughway since ancient times., otherwise, the application could be done through a syringe.
The real healing power comes from leeches' saliva and also from bloodletting. It is a very complex biological 'cocktail' and contains more than 120 - 140 bioactive beneficial substances for the treatment and regulation of the human and animal organisms.
The most important enzymes are:
Hirudin: An active principle in the salivary gland secretion of leeches, which acts as a potent anticoagulant (blood thinner). It inhibits blood coagulation by binding to thrombin.
Hyaluronidase (spreading factor): Facilitates the penetration and diffusion of pharmacologically active substances into the tissues, especially in joint pain and has antibiotic properties.
Calin: Inhibits blood coagulation by blocking the binding of the Von Willebrand factor to collagen. It inhibits collagen-mediated platelet aggregation.
Destabilase: Dissolves fibrin and has thrombolytic effects.
Hirustasin: Inhibits kallikrein, trypsin, chymotrypsin and neutrophilic cathepsin G.
Bdellins: Anti-inflammatory effect and inhibits trypsin, plasmin and acrocin.
Chloromycetin: Potent antibiotic.
Tryptase inhibitor: Inhibits proteolytic enzymes of host mast cells.
Eglins: Anti-inflammatory. They inhibit the activity of alpha-chymotrypsin, chymase, substilisin, elastase, and cathepsin G.
Factor Xa inhibitor: Inhibits the activity of coagulation factor Xa (very important role during the treatment of Osteo-arthritis and Rheumatoid arthritis).
Anesthetic-like substances: Reduce pain during biting by a leech.
Histamine-like substances: A vasodilator increases the inflow of blood at the bite site.
Complement inhibitors: Replace natural complement inhibitors if they are deficient.
Carboxypeptidase-A inhibitors: Increase the inflow of blood.
Acetylcholine: Vasodilator.
Collagenase: Reduces collagen.
MLT and disc herniation?
During the treatment leech release approximately 100 bioactive substances. MLT has a long history but it is only recently that its effect mechanisms have started to be clarified. When leech release, hyaluronidase and collagenase allows access to the tissues and blood vessels; vasodilatation occurs by the action of histamine-like molecules; platelet functions, kinin activity, and the coagulation cascade are inhibited; and inflammatory reactions are suppressed. In addition, analgesic and antimicrobial effects are observed. All those cascades of action allow to much quicker tissue repair and reduction of the symptoms.
From my experience of treating disc herniation using medicinal leeches, I can only say that patients were significant results after 1-3 treatments.
Below is an MRI scan of one of my patients, (35 years old, male, painter) showing disc herniation of the lumbar spine. Before the first treatment he was limping, 5 days later when he arrived for the second treatment he could walk normally and reported a significant reduction of the pain and improvement in disability.
Summary:
Intervertebral disc injury may heal range from a few months up to a few years in some cases, due to prolonged healing sufferers may be exposed to high stress related to disability e.g. job loss, inability to perform daily activities/sport, or financial loss.
Leech therapy may offer faster recovery and therefore reduction of anxiety and related issues, however, must always be performed correctly by an experienced hirudotherapist, after a very detailed health history, medication review and with the use of certified leeches only.
Bibliography:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334223/