The effectiveness of wet-cupping for nonspecific low back pain in Iran: a randomized controlled trial. Complement Ther Med

Department of Anesthesiology, Critical Care and Pain Management, Pain research center, Kermanshah University of Medical Sciences, Iran.
Complementary therapies in medicine (Impact Factor: 1.55). 01/2009; 17(1):9-15. DOI: 10.1016/j.ctim.2008.05.003
Source: PubMed


To determine the efficacy of wet-cupping for treating persistent nonspecific low back pain.
Wet-cupping therapy is one of the oldest known medical techniques. It is still used in several contemporary societies. Very minimal empirical study has been conducted on its efficacy.
Randomized controlled trial with two parallel groups. Patients in the experimental group were offered the option of referral to the wet-cupping service; all accepted that option. The control group received usual care.
Medical clinic in Kermanshah, Iran.
In total, 98 patients aged 17-68 years with nonspecific low back pain; 48 were randomly assigned to experimental group and 50 to the control group.
Patients in the experimental group were prescribed a series of three staged wet-cupping treatments, placed at 3 days intervals (i.e., 0, 3, and 6 days). Patients in the control group received usual care from their general practitioner.
Three outcomes assessed at baseline and again 3 months following intervention: the McGill Present Pain Index, Oswestry Pain Disability Index, and the Medication Quantification Scale.
Wet-cupping care was associated with clinically significant improvement at 3-month follow-up. The experimental group who received wet-cupping care had significantly lower levels of pain intensity ([95% confidence interval (CI) 1.72-2.60] mean difference=2.17, p<0.01), pain-related disability (95% CI=11.18-18.82, means difference=14.99, p<0.01), and medication use (95% CI=3.60-9.50, mean difference=6.55, p<0.01) than the control group. The differences in all three measures were maintained after controlling for age, gender, and duration of lower back pain in regression models (p<0.01).
Traditional wet-cupping care delivered in a primary care setting was safe and acceptable to patients with nonspecific low back pain. Wet-cupping care was significantly more effective in reducing bodily pain than usual care at 3-month follow-up.

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    • "From here it may be said that current research findings are promising, as it is the case with other research works, where results showed cupping therapy fruitful not only for pain control, but for improvement of quality of life and the minimizing of all potential risks of treatment (Huang et al., 2013). It is clear that the present findings not solely lessen and desensitize chronic back pain, rather, they are in line with many other earlier research findings such as Hänninen and Vaskilampi (1982), Li et al. (2006), Chen (2006), Chen (2007), Farhadi et al. (2009) and Jang et al. (2010). "
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    ABSTRACT: The present study is designed to determine whether chronic pain syndrome (lower and upper back pain) before and after cupping is the same or there are significant treatment differences. Perception due to cupping of here and now pain sensation; sensation of pain at worst conditions; sensation of pain at best conditions; and tolerated sensation of pain; all before and after cupping were rated on 0 to 10 pain scale. It was hypothesized that there is a significant statistical difference before and after cupping, and cupping is effective in lessening and desensitizing chronic pain among lower and upper back pain subjects. Subjects were drawn on convenience sampling basis, where 95 males and females were recruited for the purpose of investigation. Results indicate that cupping therapy is effective procedure in reducing and alleviating chronic pain, where true statistical differences were obtained. It was found after the study that cupping therapy as an alternative medical technique is an effective and fruitful enough either for the management of upper and lower back pain or the control of such annoying medical conditions.
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    • "9 - Al Bedah et al , 2011 : 12 - 6 . 10 - Farhadi et al , 2009 : 9 – 15 . 11 - Michalsen et al , 2009 : 601 – 608 . "
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    ABSTRACT: Dry cupping is one of the main procedures in many traditional medicine systems all around the world with its root in antiquity. Traditional method of dry cupping is depend-ed on practitioner proficiency and can lead to skin burn if the practitioner is a beginner. On the other hand, Zahrawi (11th century AD), the Muslim physician from Andulus (current Spain) presented two novel forms of cup for cupping to improve and correct cupping problems. In this regards, based on the model described in Al-Tasreef, we tried to redesign and manufacture the tools. These tools were made from galvanized iron owing to its nonconductivity of heat. Zahrawi models were compared with traditional model (with the same material and size) by negative pressure of mercury as well as qualitative test performed by a traditional practitioner. The results showed the superior-ity of Zahrawi's models (9792Pa and 10200Pa) over the traditional model, displaying a better and more stable vacuum pressure (mean: 8704 Pa with variation in repeat the test). Furthermore, the introduced models are user friendly; i.e., every practitioner, even the beginner without specialized skill, may work with them easily. Therefore, the new model is suggested for dry cupping.
    • "Study (first author, year) Case numbers Reason for cupping Practitioner type Cupping method and duration Cupping points Concurrent treatment Diagnosis and severity of AEs Causality a Jang, 2011 [3] 1 case (F/43) Lower back pain KMD Not reported/unidentifiable Unspecified (hands, feet, arms, legs, trunk and face) Acupuncture Erythema multiforme and herpes/moderate Probable Jung, 2011 [4] 1 case (F/56) Pain and myalgia of left forearm Not reported Not reported/unidentifiable Left elbow Acupuncture Herpes simplex virus infec- tion/moderate Possible Kim, 2012 [5] 1 case (F/77) Lower back pain and Rt. leg pain Unqualified person Dry cupping/multiple session for 2 months Anterior and posterior trunk Not reported Anemia and skin pigmenta- tion/moderate Probable Lee, 1995 [6] 1 case (F/54) Myalgia Not reported Not reported/several occasions Upper and lower extremities Acupuncture Factitial panni- culitis/moderate Possible Lee, 2008 [7] 1 case (M/39) Chronic musculoskeletal pain Not reported Wet-cupping for 6 months Broad area of back Not reported Iron deficiency anemia/moderate Probable Lee, 2011 [8] 3 cases a) M/52, b) F/52 c) M/35 a) Fatigue, myalgia "
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    ABSTRACT: Aims To assess the adverse events (AEs) related to cupping therapy identified from studies conducted in Korea. Methods Four Korean databases were searched from their inception to April 2013. We also searched PubMed and the Cochrane Library for literature from Korea. Regardless of the patient's condition, disease status, and study design, all studies were included in this review if they reported any AEs related to cupping therapy. If a case study was identified, causality was assessed through the WHO-UMC causality scale. In addition, if any randomized controlled trials (RCTs) were located, the quality of the reporting of AEs was evaluated. Results Abstracts were retrieved for the 572 articles identified through the searches as having a relevant title which could be included in the review. Among them, a total of 16 studies were included in this review. Articles included various study designs; cross-sectional surveys, a prospective audit, case studies or series, and RCTs (or quasi-RCTs). Anemia (n = 5), factitial panniculitis (n = 2), and herpes viral infection (n = 2) were the most frequently reported AEs in the observational studies. The results from the RCTs indicated that AEs related to cupping were infrequent. Conclusions Various AEs related to cupping therapy were reported but were rare. Most of the AEs were avoidable, if trained personnel provided the treatment. Cupping should be administered by qualified medical experts and in compliance with safety guidelines. In addition, future clinical trials using cupping should pay more attention to recording AEs directly related to cupping to identify potential risks.
    European Journal of Integrative Medicine 01/2013; 6(4). DOI:10.1016/j.eujim.2013.06.006 · 0.78 Impact Factor
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