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Abstract
Objective: To assess the treatment effect of moving cupping therapy on nonspecific low back pain(NLBP). Method: Randomly divided 70 outpatients of NLBP into two groups among which one group as study group of 37 cases was treated with moving cupping therapy and another 33 cases control group was given dexibuprofen (one kind of nonsteroidal anti-inflammatory drugs, NSAIDs). For study group, a period of moving cupping therapy included 6-times moving cupping therapy in all (one time with two days) interval; For control group, dexibuprofen was prescribed 0.15g per oral and 3 times per day, and 12 days were as a course of treatment. Before and after a course of treatment using visual analog scale(VAS) and 36-Item Short Form(SF-36) assessed the degree of low back pain, the capability of daily activity, and the total state of heath. Result: 0n the whole, in two groups the changes of VAS index and SF-36 scores were both significantly improved(P<0.01), which indicated both moving cupping therapy and dexibuprofen alleviated nonspecific low back pain, and improve their total state of heath. However, in comparison with control group, the changes of VAS in study group index and SF-36 scores were more significant (P< 0.01), it demonstrated that the effect of moving cupping therapy on NLBP was better than that of dexibuprofen. Furthermore, the effective rate of study group was 91.9% that was much higher than 75.8% of control group, which also revealed that moving cupping therapy was more effective than dexibuprofen. Conclusion: Being a sort of economical and effective method, moving cupping therapy can alleviate or even cure NLBP, therefore it might be recommended to treat and prevent NLBP.
... Hand searching was retrieved one eligible article from the Journal of Journal of Acupuncture and Meridian Studies 60 Seven non-retrieval articles were excluded from the retrieval articles (n = 36). A total of 29 studies were eligible at full paper screening, a further 18 studies were excluded due to not related with the cupping intervention (n = 7) 61-67 not followed the randomization process (n = 5) 68-72 inaccessible full-text reading 73,74 and unavailable raw data not suitable for data synthesis [75][76][77][78] Retrieving 11 eligible studies in this study 60,[79][80][81][82][83][84][85][86][87][88] A PRSIMA diagram 50 of the searching process as shown in Fig. 1. ...
... One study was published in Chinese language 79 79 A total of 1201 participant with low back pain were included to the meta-analysis, 609 participants were involved in the cupping group, and 592 participants were involved in the control group. The control group interventional treatment included: medication 79, 83-85 usual care 80,82,87 sham cupping 60, 88 and waiting list with permitted standard exercise and medication 81 Dosage of control medication included maximum 3 tablets of 150 mg dexibuprofen per day, maximum 3 tablets of 500 mg acetaminophen per day, and maximum 4 tablets of 500 mg paracetamol per day. ...
... One study was published in Chinese language 79 79 A total of 1201 participant with low back pain were included to the meta-analysis, 609 participants were involved in the cupping group, and 592 participants were involved in the control group. The control group interventional treatment included: medication 79, 83-85 usual care 80,82,87 sham cupping 60, 88 and waiting list with permitted standard exercise and medication 81 Dosage of control medication included maximum 3 tablets of 150 mg dexibuprofen per day, maximum 3 tablets of 500 mg acetaminophen per day, and maximum 4 tablets of 500 mg paracetamol per day. ...
... After full-text articles assessed for eligibility, 13 articles were excluded for reasons as follows: cupping combined with acupuncture (n = 7), conference abstract (n = 1), without comparison group (n = 2), sample size < 15 (n = 1), and acute LBP (n = 2). Finally 6 RCTs [18][19][20][21][22][23] accorded with eligibility criteria were included qualitative synthesis, 3 published in Chinese, 3 published in English (See flow diagram of study selection, Fig. 1). ...
... Six RCTs were included in this meta-analysis, 3 RCTs [18][19][20] published in Chinese were from China, 2 RCTs [21,22] published in English were from Iran, 1 RCT [23] published in English was from Saudi Arabia. All the trials included were RCTs. ...
... A total of 458 participants enrolled in this study, including 230 participants in cupping groups and 228 participants in control (medication or usual care) groups respectively. The participants in 4 RCTs [18][19][20][21]23] were diagnosed as nonspecific low back pain (NLBP), and participants in 1 RCT [22] were diagnosed as low back pain among postpartum women (Table 1). ...
Background:
LBP is one of the most common symptoms with high prevalence throughout the world. Conflicting conclusions exist in RCTs on cupping for LBP.
Objective:
To assess the effects and safety of cupping for the patients with LBP.
Methods:
Pubmed, Cochrane Library databases, and Embase database were electronically researched. RCTs reporting the cupping for the patients with LBP were included. The meta-analysis was conducted using Review Manager software (version 5.3, Nordic Cochrane Centre). The primary outcome was VAS scores. The secondary outcomes included ODI scores, MPPI scores and complications.
Results:
Six RCTs were included in this synthesized analysis. The results showed that cupping therapy was superior to the control management with respect to VAS scores (SMD: -0.73, [95% CI: -1.42 to -0.04]; P= 0.04), and ODI scores (SMD: -3.64, [95% CI: -5.85 to -1.42]; P= 0.001). There was no statistical significant difference as regard to MPPI scores. No serious adverse event was reported in the included studies.
Conclusions:
Cupping therapy can significantly decrease the VAS scores and ODI scores for patients with LBP compared to the control management. High heterogeneity and risk of bias existing in studies limit the authenticity of the findings.
... The full-text of 243 articles were assessed for eligibility, 75 studies were included in the systematic review ( Fig. 1). Of these studies, 12 studies [35,36,59,[78][79][80][81][90][91][92][93] were in Chinese (2 unpublished trials about Chinese herbal medicine), others in English. The kappa value for agreement between the reviewers (YQL and LL) was 0.90 which indicated an excellent agreement. ...
... Six RCTs pertaining to cupping therapy were identified [76,[78][79][80][81]83]. Four studies were in Chinese which compared cupping with medications, and all these studies were of poor quality [78][79][80][81]. ...
... Six RCTs pertaining to cupping therapy were identified [76,[78][79][80][81]83]. Four studies were in Chinese which compared cupping with medications, and all these studies were of poor quality [78][79][80][81]. The other two fair-quality studies were in English. ...
Neck pain (NP) and low back pain (LBP) are common symptoms bothering people in daily life. Traditional Chinese medicine (TCM) has been used to treat various symptoms and diseases in China and has been demonstrated to be effective. The objective of the present study was to review and analyze the existing data about pain and disability in TCM treatments for NP and LBP.
Studies were identified by a comprehensive search of databases, such as MEDLINE, EMBASE, and Cochrane Library, up to September 1, 2013. A meta-analysis was performed to evaluate the efficacy and safety of TCM in managing NP and LBP.
Seventy five randomized controlled trials (n = 11077) were included. Almost all of the studies investigated individuals experiencing chronic NP (CNP) or chronic LBP (CLBP). We found moderate evidence that acupuncture was more effective than sham-acupuncture in reducing pain immediately post-treatment for CNP (visual analogue scale (VAS) 10 cm, mean difference (MD) = -0.58 (-0.94, -0.22), 95% confidence interval, p = 0.01), CLBP (standardized mean difference = -0.47 (-0.77, -0.17), p = 0.003), and acute LBP (VAS 10 cm, MD = -0.99 (-1.24, -0.73), p< 0.001). Cupping could be more effective than waitlist in VAS (100 mm) (MD = -19.10 (-27.61, -10.58), p < 0. 001) for CNP or medications (e.g. NSAID) for CLBP (MD = -5.4 (-8.9, -0.19), p = 0.003). No serious or life-threatening adverse effects were found.
Acupuncture, acupressure, and cupping could be efficacious in treating the pain and disability associated with CNP or CLBP in the immediate term. Gua sha, tai chi, qigong, and Chinese manipulation showed fair effects, but we were unable to draw any definite conclusions, and further research is still needed. The efficacy of tuina and moxibustion is unknown because no direct evidence was obtained. These TCM modalities are relatively safe.
... The number of treatment sessions ranged from one to about nine, with a duration of 5–20 min per session. The rationale for the selection of cupping points was stated in three RCTs to be according to traditional Chinese medicine (TCM) theory [7, 8], clinical experience of expert [9], empirical date [11, 12] or to classical TCM textbook [13]. One RCT followed traditional Iranian Medicine [10]. ...
... Four RCTs employed the methods of randomization [7, 8, 10, 11] but none adopted both assessor and subject blinding. Assessor blinding was judged to have been achieved in one [12] of the RCTs and three used allocation concealment [10–12]. ...
... One RCT [7] compared the effects of dry cupping on cancer pain with conventional drug therapy and reported favorable effects for cupping after 3-day intervention (RR, 67% versus 43%, P < .05). Another RCT [8] compared dry cupping with nonsteroidal anti-inflammatory drugs in nonspecific low back pain and suggested a significant difference in pain relief on VAS after treatment duration (MD, 22.8 of 100 mm VAS; 95% CI, 11.4–34.2, P < .001). ...
The objective of this study was to assess the evidence for or against the effectiveness of cupping as a treatment option for pain. Fourteen databases were searched. Randomized clinical trials (RCTs) testing cupping in patients with pain of any origin were considered. Trials using cupping with or without drawing blood were included, while trials comparing cupping with other treatments of unproven efficacy were excluded. Trials with cupping as concomitant treatment together with other treatments of unproven efficacy were excluded. Trials were also excluded if pain was not a central symptom of the condition. The selection of studies, data extraction and validation were performed independently by three reviewers. Seven RCTs met all the inclusion criteria. Two RCTs suggested significant pain reduction for cupping in low back pain compared with usual care (P < .01) and analgesia (P < .001). Another two RCTs also showed positive effects of cupping in cancer pain (P < .05) and trigeminal neuralgia (P < .01) compared with anticancer drugs and analgesics, respectively. Two RCTs reported favorable effects of cupping on pain in brachialgia compared with usual care (P = .03) or heat pad (P < .001). The other RCT failed to show superior effects of cupping on pain in herpes zoster compared with anti-viral medication (P = .065). Currently there are few RCTs testing the effectiveness of cupping in the management of pain. Most of the existing trials are of poor quality. Therefore, more rigorous studies are required before the effectiveness of cupping for the treatment of pain can be determined.
... Seven randomized clinical trials fulfilled all the inclusion criteria. Two randomized clinical trials indicated better reduction in low back pain with cupping compared with analgesia (P < 0.001) and usual care (P < 0.01) (Hong et al. 2006;Farhadi et al. 2009). Another two randomized clinical trials demonstrated beneficial effects of cupping in trigeminal neuralgia (P < 0.01) (Zhang 1997) and cancer pain (P < 0.05) (Huang et al. 2006) compared with analgesics. ...
Pain is the oldest medical ailment affecting humanity, making the history of pain
management as old as humankind. The World Health Organization (WHO)
specified traditional medicine as a combination of knowledge, skills, and practices to sustain wellness and improve, prevent, diagnose, or cure physical and
mental illnesses. Traditional medicine is based on the theories, convictions, and
experiences of various cultures. Some medications and maneuvers have been in
use since antiquity for pain control and management, and such drugs and schemes
are now categorized under the domain of traditional medicine, which is used extensively in countries such as Saudi Arabia. Interest in traditional medicine has
risen dramatically, not just by members of the public but also among medical
practitioners, decision-makers, and researchers in Saudi Arabia. The leading
traditional therapies in Saudi Arabia are religious healing, cupping therapy,
healing with honey, and herbal medicine. Cultural and religious beliefs encourage
to seek traditional pain relief in Saudi Arabia. Most traditional pain management
methods are presumably innocuous; however, some may be deleterious. Moreover, doubts exist on the management of pain with traditional medicine, particularly for controlling intractable and unremitting pain. There is a scarcity of
reliable information on the use, safety, and effectiveness of traditional pain
management treatments in Saudi Arabia. This chapter reviews aspect of traditional methods for pain management in Saudi Arabia.
... Nonspesifik bel ağrılı 40 hasta üzerinde iki hafta boyunca altı seans yapılan yaş kupa tedavisinin ağrıyı ve ağrıya bağlı engelliliği azalttığı, ilaç kullanımını düşürdüğü gösterilmiştir (23). Nonspesifik bel ağrısı olan 70 hasta üzerinde dexibuprofen ve iki günde bir yapılan altı seans kupa uygulamasının karşılaştırıldığı çalışmada kupa tedavisinin ağrı ve SF-36 yaşam kalitesi üzerine dexibuprofenden daha etkili olduğu bildirilmiştir (24). ...
... In this therapy fire heats the inside of cup and small amount of suction is created by the air cooling down again and contracting. In the "moving cupping [13] " massage oil is applied over muscle group. 14. ...
... The improvement in the AROM was very significant both on the 28th day and after the completion of protocol therapy in the test group. The statistical difference for AROM was extremely significant when comparing the test and control groups [47,[57][58][59][60][61][62][63][64][65][66][67][68] . ...
In Unani system of medicine, Arthritis is described under a broad term Waja-ul-Mafasil which encompasses entire joint disorders like inflammatory, non-inflammatory, infectious, metabolic and other musculoskeletal disorders. Arthritis is one of the commonest joint disorder affecting millions of people worldwide with an estimated 15% (40 million) of Americans had some form of arthritis in 1995 and by the year 2020, an estimated 59.4 million will be affected. In India it affects 15% (180 million) people. On deep insight of Unani literature, arthritis can be correlated with various types of Waja-ul-Mafasil in resemblance to the predisposing factors, aggravating factors and pattern of joint involvement. The principles of management of different varieties of Waja-ul-Mafasil differ from one another. The aim of treatment for patient with Waja-ul-Mafasil is to reduce morbidity and disability. The principle of treatment aims at restoring the normal temperament, and correcting the imbalance in the Khilt (humour) through Imala (Diversion of morbid material) and Istifraagh (Evacuation of morbid material). This review article highlight the salient features describing arthritis with reference to Waja-ul-Mafasil for empathizing disease condition as enunciated by Unani scholars to provide a better alternative in terms of cost effective managements and side effects by adapting both non-pharmacological and pharmacological methods of treatment.
... Recently Huang and colleagues (2017) summarized seven cupping (wet cupping, moving cupping, balance-cupping, cupping with retention) studies that reported level I and level II evidence of cupping in chronic conditions including low back pain and acute lumber sprain [44]. Although precise mechanism of action and effects underpinning cupping therapy and cupping points is not precisely known, several hypothesis and theories have been put forward to explain how precise application of cupping points helps cupping therapy in producing good outcome in various illnesses [3,6,[45][46][47][48][49][50][51]. ...
... However, the mean of the emotional dimension of perineal pain intensity increased after 2 weeks compared to 24 hr after the intervention which might be due to the disruption of the patients' relationship with the therapist. In fact, the psychological effects of cupping therapy which result from the continuous nature of treatment as well as the close physical and psychological relationships between the cupping therapists and the patients play a critical role in the emotional dimension of pain intensity (32). ...
Background:
Perineal pain is a major morbidity in the first few days after delivery. This study aimed to investigate the effect of dry cupping therapy and acupressure at BL23 point on the intensity of postpartum perineal pain based on the short-form of McGill pain questionnaire (SMPQ).
Methods:
The present clinical trial was conducted on 150 subjects in 3 groups of 50 cases. After at least 4-8 hr of delivery, cupping therapy was performed for 15-20 min up to 3 times a week (once a day) and acupressure was performed for 15-20 min based on clockwise model. The short-form of McGill pain questionnaire was completed both before and after the intervention. The SPSS statistical software was used to analyze the data using repeated measures ANOVA. Besides, p<0.05 was considered statistically significant.
Results:
In the cupping therapy group, mean of the perineal pain intensity reduced from 37.5±6.8 before the intervention to 11.1±6.1, 6.9±4.7, and 3.8±3.6 immediately, 24 hr, and 2 weeks after the intervention, respectively. The results of study showed that the differences between the intervention and control groups were statistically significant (p<0.01). Mean difference of the perineal pain intensity in the acupressure group reached from 35.6±8.1 before the intervention to 10.4±5.5 two weeks after the intervention, so the variation between intervention and control groups was statistically significant.
Conclusion:
The study findings showed that cupping therapy and acupressure reduced perineal pain. Therefore, they may be considered as effective treatments for reducing pain intensity of allowing delivery.
... P < 0.001). [36] Farhadi K et al, in a clinical study entitled "The effectiveness of wet-cupping for nonspecific low back pain in Iran: A randomized controlled trial", concluded, Wet cupping plus usual care for pain reduction compared with usual care in non-specific low back pain suggested significant differences in pain relief (McGill Pain Questionnaire) at 3 months after three treatment sessions (MD, 2.2 of 6 points present pain intensity; 95% CI, 1.7-2.6, P < 0.01). ...
... 7) Hong YF et al., in a study " The effect of moving cupping therapy on non-specific low back pain, " compared dry cupping with non-steroidal anti-inflammatory drugs in nonspecific low back pain and suggested a significant difference in pain relief on VAS after treatment duration (MD, 22.8 of 100 mm VAS; 95% CI, 11.4–34.2, P < 0.001) [34]. 8) Zhang Z, in a study, " Observation on therapeutic effects of blood-letting puncture with cupping in acute trigeminal neuralgia, " suggested that wet cupping reduced pain compared with analgesics in acute trigeminal neuralgia after the intervention period (RR, 93% versus 47%, P < 0.01) [35]. ...
Alhijamah (cupping therapy) refers to a Unani regimental mode of treatment. Alhijamah is an ancient method which was practically used among the Chinese, Babylonians, Egyptians, Greeks, Romans, Arabs and Indians. The earliest recorded evidence of Alhijamah was discovered in Egyptian medical document Ebers Papyrus dating back to 1550 BC. In Chinese medicine too, Alhijamah is used for the treatment of various diseases. The treatment by vacuum cups has been mentioned in the book of Al-Ambratoor Al-Seeni about 4000 years ago. In Greece, history of cupping dates back to Hippocrates (460–377 BC). This therapy entered Europe through Spain when the Muslim physicians and their scientific literature were the primary sources of medical sciences. This mode of treatment was unavailable for a long period of time. With the advancement in the field of science and technology, this mode of treatment was also proved to be beneficial scientifically in a large number of diseased conditions. With its re-evaluation after scientific validation, nowadays it is used in various countries. In India, several clinical trials have been performed under the supervision of various Unani institutions all over country.
... As was found in several studies (Cramer et al., 2011;Hong et al., 2006;Lauche et al., 2011Lauche et al., , 2012, cupping application seems to be effective in treating various musculoskeletal pain conditions. However, further studies are necessary to confirm these results and evaluate the effectiveness of cupping compared to standard treatments. ...
Cupping is an ancient technique used in treating pain and various disorders. Different techniques have been developed over time, however, applying a cup to create suction over a painful area, is common to all. Dry or fire cupping, used on the intact skin, leaves bluish circular hematomas. Recently, interest in cupping has re-emerged and subsequently, several studies have begun to investigate the mechanisms of cupping therapy. Mechanically, cupping increases blood circulation, whereas physiologically it activates the immune system and stimulates the mechanosensitive fibers, thus leading to a reduction in pain.
There is initial scientific evidence that dry cupping is able to reduce musculoskeletal pain. Since cupping is an inexpensive, noninvasive and low-risk (if performed by a trained practitioner) therapeutic modality, we believe that it should be included in the arsenal of musculoskeletal medicine. It is essential to perform additional studies clarifying the biological mechanism and clinical effects of cupping.
... Michalsen et al. (2009) in Germany, where wet cupping for 10 min once was applied in 52 patients suffering from carpal tunnel syndrome. Hong et al. (2006) in China, where dry moving cupping was used for 11 days in 70 patients suffering from non specific low back pain of 1 week to 3.1 year duration. Huang et al. (2006) in China, where dry cupping once a day for 3 days was applied in 60 patients suffering from cancer of 5-17 month duration. ...
When medicine is unable to cure, and the end becomes imminent, or when the patient is tired of the side effects associated with chronic use of drugs, the search for alternative and new ways of healing is begun. Coincidentally, sometimes the alternative is the origin, as is the case for traditional Arab medicine and traditional American Indian healing. Traditional healing is the first healing that all people have used for 200,000 years, since the beginning of Homo sapiens. The sources and elements of traditional Arab medicine have been examined in books and by consulting with traditional Arab healers. Arabic medicine is a career combining both elements of science and philosophy based on religion and traditions, and includes a diversity of healing approaches: spiritual, physical, and using natural products. These approaches are discussed with emphasis on wet cupping (Alhijamah), a practice that is undergoing a revival nowadays in Arab countries. American Indian healing is a career based on religion, tradition, an innate healing gift and extensive training, both in a medical school setting and as an apprentice. Arabic healing approaches are compared to American Indian healing approaches.
... Furthermore, being a sort of economical and effective method, cupping therapy can be employed to alleviate or even cure nonspecific low back pains (NLBPs), therefore it might be recommended to be included and incorporated to treat and prevent all related NLBPs (Hong et al., 2006). ...
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.
... 28 One study evaluated the effect of various branches of CAM, such as acupuncture, massage, and cupping therapy, in 68 patients with obstinate myofascitis and showed that a combination of these methods could lead to elimination of blood stagnation, improvement of blood circulation, energy channels enema, modification of metabolism, repair of tissues, and relaxation of the involved muscles. 29 One year later (2008), the same researchers investigated the effect of cupping therapy at back-shu point on the chronic fatigue syndrome. In that study, 142 patients were recruited into the intervention group and underwent cupping therapy at both sides of the spinal cord. ...
Background: Continuous low back pain is associated with the symptoms of the pregnancy period. In spite of the improvement of low back pain within 6 months after the delivery, some women may develop chronic problems. This study aimed to investigate the effect of dry cupping therapy at BL23 point on the intensity of low back pain in primiparous women.
Methods: In the present randomized clinical trial, 100 samples were randomly allocated to either the cupping therapy or the control group (each containing 50 subjects). Cupping therapy was performed for 15-20 minutes every day up to 4 consecutive times. Visual Analogue Scale (VAS) and short-form McGill pain questionnaire were completed by the two groups before the intervention and immediately, 24 hours, and 2 weeks after that. Then, the data were entered into the SPSS statistical software (v. 16) and analyzed using chi-square test and repeated measures ANOVA.
Results: According to VAS, the mean intensity of low back pain in the cupping therapy group decreased from 7.8±2.7 before the intervention to 3.7±1.8, 2.5±1.7, and 1.4±1.4 immediately, 24 hours, and 2 weeks after the intervention, respectively. Besides, these measures were respectively obtained as 31.8±10.8, 9.0±6.7, 7.5±6.6, and 3.6±4.1 in the short-form McGill pain questionnaire. According to repeated measures ANOVA, a significant difference was observed among the various stages of follow-up (P=0.01).
Conclusion: The study results showed cupping therapy to be effective in sedation of pain. Thus, it can be used as an effective treatment for reducing the low back pain.
Trial Registration Number: 2013072611944N3
... According to our pre-defined methodological quality criteria, none of the 135 trials were low risk of bias and the majority was high risk of bias (Table 1). Three trials [23], [69], [73] reported sample size calculations, 25 trials [11], [14], [17], [23], [26], [32], [35], [41], [48], [57], [60], [69], [70], [72], [73], [79], [81], [85], [88], [94], [97], [99], [107], [111], [116] described randomization procedures (such as random number table or computer-generated random numbers), with only 2 [23], [73] of the 25 trials using sealed envelope allocation concealment. Four trials [17], [48], [94], [99] mentioned blinding, of which only 2 [48], [94] reported that they blinded outcome assessors, the other 2 trials did not report who were blinded. ...
Since 1950, traditional Chinese medicine (TCM) cupping therapy has been applied as a formal modality in hospitals throughout China and elsewhere in the world. Based on a previous systematic literature review of clinical studies on cupping therapy, this study presents a thorough review of randomized controlled trials (RCTs) to evaluate the therapeutic effect of cupping therapy.
Six databases were searched for articles published through 2010. RCTs on cupping therapy for various diseases were included. Studies on cupping therapy combined with other TCM treatments versus non-TCM therapies were excluded.
135 RCTs published from 1992 through 2010 were identified. The studies were generally of low methodological quality. Diseases for which cupping therapy was commonly applied were herpes zoster, facial paralysis (Bell palsy), cough and dyspnea, acne, lumbar disc herniation, and cervical spondylosis. Wet cupping was used in most trials, followed by retained cupping, moving cupping, and flash cupping. Meta-analysis showed cupping therapy combined with other TCM treatments was significantly superior to other treatments alone in increasing the number of cured patients with herpes zoster, facial paralysis, acne, and cervical spondylosis. No serious adverse effects were reported in the trials.
Numerous RCTs on cupping therapy have been conducted and published during the past decades. This review showed that cupping has potential effect in the treatment of herpes zoster and other specific conditions. However, further rigorously designed trials on its use for other conditions are warranted.
Most meta-analytic methods examine effects across a collection of primary studies. We introduce an application of meta-analytic techniques to estimate effects and homogeneity within a single, primary study consisting of multiple, pretest-intervention-posttest units. This novel assessment was used to validate the recently created “Common Cause” (CC) design. In each case, we established the CC design by eliminating control groups from randomized studies, thereby deconstructing each experiment. This deconstruction enabled us to compare difference-in-difference results in randomized designs with a control group to pretest-posttest differences in a CC design without a control group. Meta-analysis results of multiple OXO effects from the CC designs were compared to meta-analytic effects of multiple randomized studies. This within-study-comparison logic and associated analyses produced consistent similarity between CC and validating-study results when directions of findings and patterns of statistical significance were considered. We provide plausible explanations for varying CC effect-size estimates, describe strengths and limitations, and address future research directions.
Complementary/alternative medicine" (CAM) is defined as a diverse range of medical treatments, largely non-allopathic, mostly traditional, and not integrated into the authoritarian healthcare system. Interestingly for some schools, allopathy is alternative/complementary therapy. Osteoporosis is an ever-known disease treated before the era of allopathic medicine. Even though the customary medical system of India is among the most well-known in the world, every continent has its own alternative therapies for various chronic diseases.
This review of the scientific information is to help the readers understand how crucial the conceptual underpinnings of alternative medical therapy systems are to the advancement of conventional allopathic practices.
Many older and recent articles about alternative medical therapy in the management of osteoporosis published in scientific journals are reviewed. Relevant information from cross-references on methods of evaluating the efficacy of different modalities and their scientific pathways is included. An effort has been made to summarise the treatment of osteoporosis by these systems. Opinions, impressions, and inferences are added while describing various aspects of these modalities.
The National Library of Medicine has played an active role in publishing studies of the management of osteoporosis by alternative therapies. Many issues of management of osteoporosis still lack reliable treatment. However, good information is now available about choosing alternate medical therapy that has been studied scientifically and has shown promising results.
Medicinal plants and certain natural treatments can treat osteoporosis and its problems. The use of alternate medical therapy has been proven recently by clinical practice and conventional wisdom. This sharing may help the medical practitioner to understand and judiciously allow complementary therapy while treating osteoporosis.
Introduction: Dysmenorrhea is one of the most common disorders of the female reproductive system that causes the inability of a person to perform daily activities and disorders in communication with family members. Therefore, this study was performed with aim to evaluate the effect of leech and cupping therapy in comparison with LD contraceptive pill on the improvement of dysmenorrhea.
Methods: This randomized clinical trial study was performed in 2020-2021 on 40 women with primary dysmenorrhea. The subjects were divided into two intervention groups. In the intervention group1, after menstruation, leeches and cupping therapy for 3 sessions (each week) in each month was performed for two months. In the intervention group 2, the LD pill was taken for 21 days from the first day of menstruation and after 7 days, the next pack was started. Pain levels before the intervention, first, second and third months after the intervention were measured using a VAS questionnaire. In this study, the intervention was performed for two months, but the subjects were followed up for three months. Data were analyzed by SPSS software version 16) and Mann-Whitney, Friedman, Chi-square and Independent t-tests. P<0.05 was considered statistically significant.Results: The mean pain intensity in the first, second and third months after the intervention was higher in the LD contraceptive pill group than the leech and cupping therapy group and the two groups were significantly different in the second (P=0.048) and third (P=0.022) months, but in the first month after the intervention, there was no statistically significant difference (P=0.061).
Conclusion: The use of leeches and cupping therapy in specific areas of the ankle, back and uterus in comparison with LD contraceptive pills reduces the severity of menstrual pain.
98 Effect of wet cupping on some blood parameters on male young ال المعاٍَر بعض علي الرطبة الحجامة تأثَر ذم وٍة .الشباب لذى ١عجٞس ٝكبم , ١اُجبص ؽش٣ذ ٓؾٔذ , ١ٝاُلزال ٝ , ح ٝ ٝ ١عجٞس ,ع٤٘بء ١اُجبص ٢اُقبك ػالء , ١ٜٓذ ٖ٤ؽغ اُقشكخ ُِِّٞؼ اُزشث٤خ ًِ٤خ / ًشثالء عبٓؼخ Summary الخالصة ثؼ ٠ِػ َٛاٌُب ٓ٘طوخ ٢ك اُشهجخ اُؾغبٓخ ربص٤ش ٓؼشكخ ٠ُا اُؾبُ٤خ اُذساعخ رٜذف ُا أُؼب٣٤ش ل ٓذ ٞ٣خ اعش٣ذ كوذ ,اُؾجبة ُٟذ اُذساعخ ٠ِػ 200 (ْٛأػٔبس ٍٓؼذ رشاٝؽذ ؽبة 20-25 ُِّؼب اُضبُش اُؾٜش ٢ك ّ)ػب 2010) .) ّاُذ َكقبئ اخزجبس اعشاء ٍخال ٖٓ ُِؾجبة ّاُذ َكقبئ ٓؼشكخ ثؼذ blood group ثؼل اعش٣ذ كوذ اال ُا خزجبساد ٓذ ٞ٣خ ٓشٝس ٝثؼذ َهج ٟاالخش ٖ٤عبػز ٟٞٓغز ه٤بط ٜٓ٘ب اُؾغبٓخ ػِٔ٤خ اعشاء ٖٓ ٖ٤اُٜ٤ٔٞؿِٞث hemoglobin estimation (Hb) أُشفٞفخ ّاُذ خال٣ب ْٝؽغ ّاُذ ٢ك packed cell volume(Pcv) اُزخضش ٖٓٝص clotting time ٢اُزلش٣و ٝاُؼذ اُج٤نبء ّاُذ ُخال٣ب deferential leukocytes مـ ُو٤بط ثبالمبكخ و ٢االؽقبئ َ٤ِاُزؾ اعشاء ثؼذ. ٢ٝاُٞاه ٢ُاُؼب ّاُذ (أُؼ٘ٞ٣خ اُض٣بدح ُٞؽع P< 0.05 ّاُذ ُٔغبٓ٤غ أُشفٞفخ ّاُذ خال٣ب ْٝؽغ ٖ٤اُٜ٤ٔٞؿِٞث ٟٞٓغز ٢ك) A ٝ B ٝ AB ٝ O (١ٞ٘ٓؼ ٝاٗخلبك P< 0.05) (١ٞ٘ٓؼ اٗخلبك ُٞؽع ًٔب أُخزِلخ ّاُذ ُٔغبٓ٤غ اُزخضش ٖٓص ٢ك P< 0.05) ّاُذ مـو ٢ك ّاُذ ُٔغبٓ٤غ ٢ٝاُٞاه ٢ُاُؼب A ٝ B ٝ O ّاُذ ٓغٔٞػخ ٢ك رالؽع ُْٝ AB ثؼذ اُ٘لغ٤خ ثبُشاؽخ اُؾجبة ؽؼٞس ٠ُا ثبالمبكخ ٛزا , اُؾغبٓخ اعشاء أُخزِلخ ّاُذ ُٔغبٓ٤غ. ا اُؾبُ٤خ اُذساعخ ٖٓ ٗغز٘زظ ٖٓٝص أُنـٞهخ ّاُذ خال٣ب ْٝؽغ ٖ٤اُٜ٤ٔٞؿِٞث ٟٞٓغز ٢ك ٢ا٣غبث ربص٤ش ُٜب اُشهجخ اُؾغبٓخ ٕ ٢اُزلش٣و ٝاُؼذ اُزخضش. اُزًٞس ُِؾجبة اُ٘لغ٤خ ثبُشاؽخ اُؾؼٞس ٠ُا ثبالمبكخ ٛزا , ٢ُٝاُؼب ٢اُٞاه ّاُذ ٝمـو اُج٤نبء ّاُذ ُخال٣ب Summary The aim oPf this study was to determined some blood effect caused y wet cupping therapy , the study occur on 200 in male young in March 2010. After take types of blood group of young some other parameters were determined before and after 3 hours wet cupping like hemoglobin estimation ,packed cell volume , deferential leukocytes , clotting time and systolic and diastolic blood pressure. The statistical analysis showed significant increase (p<0.05) in the hemoglobin estimation ,packed cell volume in A,B and AB groups and significant decrease (p<0.05) in clotting time in all blood groups and also found significant decrease (p<0.05) in systolic and diastolic blood pressure in A,B and O groups. The study also revealed to male young show with good physiological feeling after wet cupping therapy.
98 Effect of wet cupping on some blood parameters on male young ال المعاٍَر بعض علي الرطبة الحجامة تأثَر ذم وٍة .الشباب لذى ١عجٞس ٝكبم , ١اُجبص ؽش٣ذ ٓؾٔذ , ١ٝاُلزال ٝ , ح ٝ ٝ ١عجٞس ,ع٤٘بء ١اُجبص ٢اُقبك ػالء , ١ٜٓذ ٖ٤ؽغ اُقشكخ ُِِّٞؼ اُزشث٤خ ًِ٤خ / ًشثالء عبٓؼخ Summary الخالصة ثؼ ٠ِػ َٛاٌُب ٓ٘طوخ ٢ك اُشهجخ اُؾغبٓخ ربص٤ش ٓؼشكخ ٠ُا اُؾبُ٤خ اُذساعخ رٜذف ُا أُؼب٣٤ش ل ٓذ ٞ٣خ اعش٣ذ كوذ ,اُؾجبة ُٟذ اُذساعخ ٠ِػ 200 (ْٛأػٔبس ٍٓؼذ رشاٝؽذ ؽبة 20-25 ُِّؼب اُضبُش اُؾٜش ٢ك ّ)ػب 2010) .) ّاُذ َكقبئ اخزجبس اعشاء ٍخال ٖٓ ُِؾجبة ّاُذ َكقبئ ٓؼشكخ ثؼذ blood group ثؼل اعش٣ذ كوذ اال ُا خزجبساد ٓذ ٞ٣خ ٓشٝس ٝثؼذ َهج ٟاالخش ٖ٤عبػز ٟٞٓغز ه٤بط ٜٓ٘ب اُؾغبٓخ ػِٔ٤خ اعشاء ٖٓ ٖ٤اُٜ٤ٔٞؿِٞث hemoglobin estimation (Hb) أُشفٞفخ ّاُذ خال٣ب ْٝؽغ ّاُذ ٢ك packed cell volume(Pcv) اُزخضش ٖٓٝص clotting time ٢اُزلش٣و ٝاُؼذ اُج٤نبء ّاُذ ُخال٣ب deferential leukocytes مـ ُو٤بط ثبالمبكخ و ٢االؽقبئ َ٤ِاُزؾ اعشاء ثؼذ. ٢ٝاُٞاه ٢ُاُؼب ّاُذ (أُؼ٘ٞ٣خ اُض٣بدح ُٞؽع P< 0.05 ّاُذ ُٔغبٓ٤غ أُشفٞفخ ّاُذ خال٣ب ْٝؽغ ٖ٤اُٜ٤ٔٞؿِٞث ٟٞٓغز ٢ك) A ٝ B ٝ AB ٝ O (١ٞ٘ٓؼ ٝاٗخلبك P< 0.05) (١ٞ٘ٓؼ اٗخلبك ُٞؽع ًٔب أُخزِلخ ّاُذ ُٔغبٓ٤غ اُزخضش ٖٓص ٢ك P< 0.05) ّاُذ مـو ٢ك ّاُذ ُٔغبٓ٤غ ٢ٝاُٞاه ٢ُاُؼب A ٝ B ٝ O ّاُذ ٓغٔٞػخ ٢ك رالؽع ُْٝ AB ثؼذ اُ٘لغ٤خ ثبُشاؽخ اُؾجبة ؽؼٞس ٠ُا ثبالمبكخ ٛزا , اُؾغبٓخ اعشاء أُخزِلخ ّاُذ ُٔغبٓ٤غ. ا اُؾبُ٤خ اُذساعخ ٖٓ ٗغز٘زظ ٖٓٝص أُنـٞهخ ّاُذ خال٣ب ْٝؽغ ٖ٤اُٜ٤ٔٞؿِٞث ٟٞٓغز ٢ك ٢ا٣غبث ربص٤ش ُٜب اُشهجخ اُؾغبٓخ ٕ ٢اُزلش٣و ٝاُؼذ اُزخضش. اُزًٞس ُِؾجبة اُ٘لغ٤خ ثبُشاؽخ اُؾؼٞس ٠ُا ثبالمبكخ ٛزا , ٢ُٝاُؼب ٢اُٞاه ّاُذ ٝمـو اُج٤نبء ّاُذ ُخال٣ب Summary The aim oPf this study was to determined some blood effect caused y wet cupping therapy , the study occur on 200 in male young in March 2010. After take types of blood group of young some other parameters were determined before and after 3 hours wet cupping like hemoglobin estimation ,packed cell volume , deferential leukocytes , clotting time and systolic and diastolic blood pressure. The statistical analysis showed significant increase (p<0.05) in the hemoglobin estimation ,packed cell volume in A,B and AB groups and significant decrease (p<0.05) in clotting time in all blood groups and also found significant decrease (p<0.05) in systolic and diastolic blood pressure in A,B and O groups. The study also revealed to male young show with good physiological feeling after wet cupping therapy.
Objective
To observe the efficacy of acupuncture at points of Shaoyang meridians plus moving cupping on neck and shoulder for migraine.
Methods
A total of 64 migraine cases were randomly allocated into an observation group and a control group, 32 cases in each group. Random number table method was used in allocation. Acupuncture at points of Shaoyang meridians and cupping on neck and shoulder were used for cases in the observation group, which contain acupuncture 5 times a week and cupping once a week. Oral flunarizine hydrochloride capsules were used for cases in the control group, 10 mg for each dose, 1 dose a day. 2 weeks constitutes a course of treatment. The patients were treated for two courses of treatment in both groups. After that, the changes of visual analogue scale (VAS) and the migraine disability assessment questionnaire (MIDAS) were observed, as well as the clinical efficacy.
Results
The total effective rate and recovery and marked effective rate in the observation group were 93.8% and 71.0% respectively, versus 78.1% and 43.8% in the control group, showing statistical significant differences (both P<0.05). There were significant decreases in VAS and MIDAS scores after treatments in both groups (both P<0.05). VAS and MIDAS scores in the observation group were significantly different from those in the control group (both P<0.05).
Conclusion
Combining acupuncture at points of Shaoyang meridians and cupping on neck and shoulder can relieve headache and reduce influence of migraine on life. It can produce a better efficacy than oral flunarizine hydrochloride capsules in treating migraine patients.
Back pain is a health problem with high prevalence and tendency to chronicity. The study, review and investigation of techniques for specific treatment or idiopathic back pain is vital. Hence, this review of the technique of cupping applied in the past and present in different cultures and civilizations, for their effectiveness as an alternative analgesic treatment. In this work we have performed a search of articles in the medical databases of Pubmed, Scopus and Science Diverse, getting seven studies related to the search "Cupping back pain". The studies analyzed have rigor and evidence showing that the application with suction cups for back pain treatment is effective. The application specific diseases requires further analysis and a deepening of research. That is why we have chosen to focus on the revision of the generalized back pain. Also when making treatments for study because of its low cost, ease of application and its few adverse effects, can be considered as an interesting option overall treatment of this pathology.
Chinese medicine is more than 5000 years old. Even in more recent times, it has been noticed that the use of hollow horns, which sucked on the skin, have a beneficial effect in treating respiratory disease or nagging pains in the spine. Vacuum treatment, which is formed in the cupping by removing the air , causes sucking of the the skin and tissues lying under the cupping. This action has an impact on their intense hyperemia and a marked improvement of inelastic skin. In the Chinese tradition, cupping is used to treat many serious ailments. This kind of treatment is ideally suited for curing infections, colds, muscle pain and inflammatory conditions. The article provides an overview of the literature on the procedures performed while usage of different types of cupping as well as presentation of methodology of treatments and the use of massage cupping. This material is the outcome of many scientific studies. According to the research which we can read about in the literature, cupping therapy is important in reducing the pain of different origins and supports the treatment of diseases of the musculoskeletal system, nervous system diseases, respiratory diseases, may also be applied in biological regeneration and cosmetology.
Back pain is a health problem with high prevalence and tendency to chronicity. The study, review and investigation of techniques for specific treatment or idiopathic back pain is vital. Hence, this review of the technique of cupping applied in the past and present in different cultures and civilizations, for their effectiveness as an alternative analgesic treatment.
In this work we have performed a search of articles in the medical databases of Pubmed, Scopus and Science Diverse, getting seven studies related to the search �Cupping back pain�. The studies analyzed have rigor and evidence showing that the application with suction cups for back pain treatment is effective. The application specific diseases requires further analysis and a deepening of research. That is why we have chosen to focus on the revision of the generalized back pain.
Also when making treatments for study because of its low cost, ease of application and its few adverse effects, can be considered as an interesting option overall treatment of this pathology
Though cupping therapy has been used in China for thousands of years, there has been no systematic summary of clinical research on it.This review is to evaluate the therapeutic effect of cupping therapy using evidence-based approach based on all available clinical studies.
We included all clinical studies on cupping therapy for all kinds of diseases. We searched six electronic databases, all searches ended in December 2008. We extracted data on the type of cupping and type of diseases treated.
550 clinical studies were identified published between 1959 and 2008, including 73 randomized controlled trials (RCTs), 22 clinical controlled trials, 373 case series, and 82 case reports. Number of RCTs obviously increased during past decades, but the quality of the RCTs was generally poor according to the risk of bias of the Cochrane standard for important outcome within each trials. The diseases in which cupping was commonly employed included pain conditions, herpes zoster, cough or asthma, etc. Wet cupping was used in majority studies, followed by retained cupping, moving cupping, medicinal cupping, etc. 38 studies used combination of two types of cupping therapies. No serious adverse effects were reported in the studies.
According to the above results, quality and quantity of RCTs on cupping therapy appears to be improved during the past 50 years in China, and majority of studies show potential benefit on pain conditions, herpes zoster and other diseases. However, further rigorous designed trials in relevant conditions are warranted to support their use in practice.
The aims of this study were to develop a sham cupping device and to validate its use as a placebo control for healthy volunteers.
A sham cupping device was developed by establishing a small hole to reduce the negative pressure after suction such that inner pressure could not be maintained in the cup. We enrolled 34 healthy participants to evaluate the validity of the sham cupping device as a placebo control. The participants were informed that they would receive either real or sham cupping and were asked which treatment they thought they had received. Other sensations and adverse events related to cupping therapy were investigated.
17 patients received real cupping therapy and 17 received sham cupping. The two groups felt similar sensations. There was a tendency for subjects to feel that real cupping created a stronger sensation than sham cupping (48.9±21.4 vs 33.3±20.3 on a 100mm visual analogue scale). There were only mild to moderate adverse events observed in both groups.
We developed a new sham cupping device that seems to provide a credible control for real cupping therapy by producing little or no negative pressure. This conclusion was supported by a pilot study, but more rigorous research is warranted regarding the use of this device.
Background:
Chronic back pain is an important health problem. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used to treat people with low back pain, especially people with acute back pain. Short term NSAID use is also recommended for pain relief in people with chronic back pain. Two types of NSAIDs are available and used to treat back pain: non-selective NSAIDs and selective COX-2 NSAIDs. In 2008, a Cochrane review identified a small but significant effect from NSAIDs compared to placebo in people with chronic back pain. This is an update of the Cochrane review published in 2008 and focuses on people with chronic low back pain.
Objectives:
To determine if NSAIDs are more efficacious than various comparison treatments for non-specific chronic low back pain and if so, which type of NSAID is most efficacious.
Search methods:
We searched CENTRAL, MEDLINE, EMBASE, PubMed and two clinical trials registry databases up to 24 June 2015 for randomized controlled trials (RCTs) published in English, German or Dutch. We also screened references cited in relevant reviews.
Selection criteria:
We included RCTs (double-blind and single-blind) of NSAIDs used to treat people with chronic low back pain.
Data collection and analysis:
Two review authors independently screened trials for inclusion in this Cochrane review according to the inclusion criteria. One review author extracted the data, and a second review author checked the data. Two review authors independently evaluated the risk of bias of all included trials. If data were clinically homogeneous, we performed a meta-analysis and assessed the quality of evidence using the GRADE approach.
Main results:
We included 13 trials in this Cochrane review. Ten studies were at 'low' risk of bias. Six studies compared NSAIDs with placebo, and included 1354 participants in total. There is low quality evidence that NSAIDs are more effective than placebo, with a mean difference in pain intensity score from baseline of -3.30 (95% CI -5.33 to -1.27) on a 0 to 100 visual analogue scale (VAS) with a median follow-up of 56 days (interquartile range (IQR) 13 to 91 days). Four studies measured disability using the Roland Morris Disability Questionnaire. There is low quality evidence that NSAIDs are more effective than placebo on disability, with a mean difference from baseline of -0.85 (95% CI -1.30 to -0.40) on a scale from 0 to 24 with a median follow-up of 84 days (IQR 42 to 105 days). All six placebo controlled studies also reported adverse events, and suggested that adverse events are not statistically significant more frequent in participants using NSAIDs compared to placebo (RR 1.04, 95% CI 0.92 to 1.17). Due to the relatively small sample size and relatively short follow-up in most included trials, it is likely that the proportion of patients experiencing an adverse event is underestimated.Two studies compared different types of non-selective NSAIDs, namely ibuprofen versus diclofenac and piroxicam versus indomethacin. The trials did not find any differences between these NSAID types, but both trials had small sample sizes. One trial reported no differences in pain intensity between treatment groups that used selective or non-selective NSAIDs. One other trial compared diflunisal with paracetamol and showed no difference in improvement from baseline on pain intensity score. One trial showed a better global improvement in favour of celecoxib versus tramadol.One included trial compared NSAIDs with 'home-based exercise'. Disability improved more in participants who did exercises versus participants receiving NSAIDs, but pain scores were similar.
Authors' conclusions:
Six of the 13 included RCTs showed that NSAIDs are more effective than placebo regarding pain intensity. NSAIDs are slightly more effective than placebo regarding disability. However, the magnitude of the effects is small, and the level of evidence was low. When we only included RCTs at low risk of bias, differences in effect between NSAIDs and placebo were reduced. We identified no difference in efficacy between different NSAID types, including selective versus non-selective NSAIDs. Due to inclusion of RCTs only, the relatively small sample sizes and relatively short follow-up in most included trials, we cannot make firm statements about the occurrence of adverse events or whether NSAIDs are safe for long-term use.
A systematic review of randomized controlled trials.
To assess the effects of nonsteroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors in the treatment of nonspecific low back pain and to assess which type of NSAID is most effective.
NSAIDs are the most frequently prescribed medications worldwide and are widely used for patients with low back pain. Selective COX-2 inhibitors are currently available and used for patients with low back pain.
We searched the MEDLINE and EMBASE databases and the Cochrane Central Register of Controlled Trials up to and including June 2007 if reported in English, Dutch, or German. We also screened references given in relevant reviews and identified trials. Randomized trials and double-blind controlled trials of NSAIDs in nonspecific low back pain with or without sciatica were included.
In total, 65 trials (total number of patients = 11,237) were included in this review. Twenty-eight trials (42%) were considered high quality. Statistically significant effects were found in favor of NSAIDs compared with placebo, but at the cost of statistically significant more side effects. There is moderate evidence that NSAIDs are not more effective than paracetamol for acute low back pain, but paracetamol had fewer side effects. There is moderate evidence that NSAIDs are not more effective than other drugs for acute low back pain. There is strong evidence that various types of NSAIDs, including COX-2 NSAIDs, are equally effective for acute low back pain. COX-2 NSAIDs had statistically significantly fewer side effects than traditional NSAIDs.
The evidence from the 65 trials included in this review suggests that NSAIDs are effective for short-term symptomatic relief in patients with acute and chronic low back pain without sciatica. However, effect sizes are small. Furthermore, there does not seem to be a specific type of NSAID, which is clearly more effective than others. The selective COX-2 inhibitors showed fewer side effects compared with traditional NSAIDs in the randomized controlled trials included in this review. However, recent studies have shown that COX-2 inhibitors are associated with increased cardiovascular risks in specific patient populations.
Retrospective cohort study was conducted.
To evaluate the association of prescribed work restrictions with work absenteeism and recurrence in cases of nonspecific low back pain.
The efficacy of commonly prescribed work restrictions in limiting sickness-related absence because of back pain has not been evaluated.
Employees who had back pain-related sickness absence were identified from medical records of a utility company. The workers were grouped into those who had received a work restriction for their back pain and those who had not. The duration of work disability was compared between the two groups. Employees who returned back to regular, full duty within 1 year of onset were followed for one additional year to determine rates of recurrence. The Cox Proportional Hazards model was used to generate hazard ratios adjusted for age, gender, and job category.
Restrictions were given to 43% of the workers. Sickness absence duration did not differ between those who had received restrictions and those who had not (adjusted hazard ratio, 1.12; P = 0.41). The median duration of restricted duty was 32.5 days. For 22% of the workers, restricted duty was never lifted. Recurrence appeared less likely to occur among those who had work restrictions in their initial episode. However, this difference was not statistically significant (adjusted hazard ratio, 0.77; P = 0.48).
No evidence of an association between a prescription of work restriction and early return to work was found. More research is needed to clarify the utility of restricted duty in promoting a positive outcome for work-related low back pain.
Low back pain is a very common disorder among adults. However, most low back pain is nonspecific; it has no known cause and cannot be given a precise pathoanatomical diagnosis. Nonspecific low back pain can be very painful, but it is not serious; it is basically an age-related disorder that is affected by differences in occupation, genetics, and personal behavior. There are many different treatments for nonspecific low back pain, but most of them are ineffective. Most patients improve considerably during the first 4 weeks-with or without medical treatment. There is increasing support in the medical literature for patients to assume more responsibility for self-care, and less dependence upon the health care provider. Evidence-based self-care guidelines are presented for use by both the health care provider and the patient. The guidelines offer advice regarding medication, exercise, physical activity, coping skills, and prevention of the next episode.