With this therapy, 4 to 12 leeches are applied every one to two weeks depending on the size of the joint or the area of pain. After feeding the leeches come off by themselves, then a loose bandage is applied to the area so that the treated area can continue to bleed slightly over the next 12 to 24 hours. Side effects include itching, which can be treated effectively with antihistamine-based gels or diluted vinegar; this form of treatment very rarely causes stronger irritations and even less often results in allergic reactions. The traces of the bites from the leeches will be visible as scars (small dots) so care should be taken if the skin is in perfect condition. This therapy is suitable for treating most inflammatory processes of the musculoskeletal system, persistent muscular pain syndromes, superficial venous thrombosis and other rarer types of diseases. Our core experience at the practice is the treatment of knee arthrosis, tennis elbow and inflammation of the shoulders. Two to three treatments are usually enough; the patient rarely needs more in chronic cases.