title: [Leeches, phytotherapy and physiotherapy in osteo-arthrosis of the knee--a geriatric case study].
abstract: BACKGROUND
  Chronic pain is a serious problem for geriatric patients. Conventional pharmacotherapy with nonsteroidal anti-inflammatory drugs or opiates is often accompanied by serious side effects.
  
  
  OBJECTIVE
  An 87-year-old woman with severe joint pain due to osteoarthritis of the knee presented with side effects from fentanyl therapy. She was subsequently treated in an inpatient setting with leeches, phytotherapy, physiotherapy and three single doses of metamizol.
  
  
  METHODS
  Prospective single-case study.
  
  
  METHODS
  Pain reduction was assessed with a numeric rating scale (0-10; 0 = minimum; 10 = maximum), mobility by walking distance, and activities of daily living by Barthel index. The association between complementary therapy and the changes observed in the patient under treatment were evaluated using cognition-based medicine.
  
  
  RESULTS
  Under complementary therapy, the patient experienced a clear reduction in pain (from 8 to 3 points on the numeric rating scale); regained the ability to walk (increase in walking distance from 0 to 70 m); and showed improvements in activities of daily living (increase in Barthel index from 45 to 65). An association between pain reduction and the complementary treatment setting seems likely.
  
  
  CONCLUSIONS
  The role of complementary pain therapy in geriatric patients should be evaluated systematically.
authors.affiliation: Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, CHAMP, Berlin, Deutschland. michael.teut@charite.de
authors.forename: Michael
authors.initials: M
authors.lastname: Teut
authors.forename: Albrecht
authors.initials: A
authors.lastname: Warning
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003131:Combined Modality Therapy; D015897:Comorbidity; D004177:Dipyrone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D024763:Leeching; D051346:Mobility Limitation; D020370:Osteoarthritis, Knee / Q000534:rehabilitation*; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use; D011446:Prospective Studies
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; C469611:Doloteffin; D010936:Plant Extracts; C092917:Phytodolor N; D004177:Dipyrone