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Is Cupping an Effective Treatment? An Overview of Systematic Reviews

DOI:10.1016/S2005-2901(11)60001-0
Authors:
Myeong Soo Lee at Korea Institute of Oriental Medicine
Myeong Soo Lee
Jong-In Kim at Kyung Hee University
Jong-In Kim
Edzard Ernst at University of Exeter
Edzard Ernst
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Abstract

Several systematic reviews (SRs) have assessed the effectiveness of cupping for a range of conditions. Our aim was to provide a critical evaluation and summary of these data. Electronic searches were conducted to locate all SRs concerning cupping for any condition. Data were extracted by two authors according to predefined criteria. Five SRs met our inclusion criteria, which related to the following conditions: pain conditions, stroke rehabilitation, hypertension, and herpes zoster. The numbers of studies included in each SR were small. Relatively clear evidence emerged only for one indication, that cupping may be effective for reducing pain. Based on evidence from the currently available SRs, the effectiveness of cupping has been demonstrated only as a treatment for pain, and even for this indication doubts remain.
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... Unfortunately, their conclusions are far from uniform. [28] Conflicting decisions about cupping regarding pain treatment outcomes could be related to the differences in cupping therapy practice, which employ different cupping therapy forms and give different results, and are often lumped together at RCTs. [26,29] Contradictory conclusions may be found from cupping therapy practice. [30,31] As we know, the classification of cupping therapy practice is categorized broadly into dry and wet cupping. ...
... Two RCTs used automatic cupping machines. [16,53] Only one experiment used the distance pulled the skin up in the tank to measure negative pressure, [20] the 4 RCTs used manual suction pumps, [21,28,35,37] and the last one RCTs did not specify equipment for cupping. [19] Eight studies compared the effects of dry and wet cupping on reducing physical disability. ...
... The finding was not similar to the past study, which is in that cupping significantly decreased pain symptoms. [28,57,58] A classification of cupping types or a score based on self-management could explain this. ...
Effectiveness of self-management of dry and wet cupping therapy for low back pain: A systematic review and meta-analysis
Article
Full-text available
Background: Low back pain (LBP) can significantly affect a person's quality of life. Cupping has been used to treat LBP. However, various cupping methods are typically included in evaluating the efficacy of cupping therapy. Therefore, the objectives of this study were to evaluate the evidence from the literature regarding the effects of dry and wet cupping therapy on LBP in adults. Dry and wet cupping therapy are analyzed categorically in this study. Methods: We searched for randomized clinical trials with cupping in LBP published between 2008 and 2022. In dry or wet cupping clinical studies, pain intensity was assessed using the Visual Analogue Scale and present pain intensity, and the quality of life intensity was measured using the Oswestry disability index. Results: The 656 studies were identified, of which 10 studies for 690 patients with LBP were included in the meta-analysis. There was a significant reduction in the pain intensity score with present pain intensity using wet cupping therapy (P < .01). In addition, both cupping therapy groups displayed significant Oswestry disability index score reduction compared to the control group (both P < .01). The patients with LBP have a substantial reduction by using wet cupping but have not shown a considerable decrease by using dry cupping (P = .19). In addition, only wet cupping therapy groups displayed a significantly improved quality of life compared to the control group. The study had a very high heterogeneity (I2 > 50%). It means there is no standardization in the treatment protocol in randomized clinical trials. In the meta-regression, there was statistically significant evidence that the number of treatment times and intercepts were related (P < .01). Conclusion: The present meta-analysis shows that wet cupping therapy effectively reduces the pain intensity of LBP. Furthermore, both dry wet cupping therapy improved patients with LBP quality of life.
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... A Ventosaterapia ou Cupping Therapy é uma técnica antiga do Leste da Asia com prevalência Chinesa e outros países têm sido utilizada há milhares de anos para tratar uma variedade de condições de saúde, incluindo dor e inflamação, e tem se tornado popular em países ocidentais. Segundo Lee, Kim, e Ernst, (2011), envolve a aplicação de copos de vidro, acrílico ou silicone na pele do paciente podendo ser seca ou úmida sobre pontos de acupuntura, áreas dolorosas e trigger points. Os copos de aplicação podem ser mobilizados por várias técnicas, como a modalidade fixa que é a mais conhecida, há a deslizante onde há uma movimentação dos copos sob pressão do vácuo aplicado na derme, flash onde os copos são aplicados criando um vácuo e logo são retiradas sob tração da derme, ventosa associadas a sangria ou mais conhecida como ventosa úmida Choi (2021). ...
Ventosaterapia como tratamento complementar da enxaqueca: uma revisão sistemática
Article
Full-text available
  • Jun 2023
A enxaqueca atinge cerca de 15% da população brasileira, sendo que 11% dos indivíduos relatam uma forma transitória da doença, com sintomas aliviados em até 48 horas. Diversas teorias foram propostas para explicar sua causa, incluindo o envolvimento do V par de nervos cranianos, bem como alterações neurogênicas e vasculares. Entre as técnicas utilizadas para tratar a dor e a inflamação, destaca-se a ventosaerapia, uma antiga prática originária da Ásia, aprimorada pela china. Essa técnica envolve a aplicação de copos de vidro, acrílico ou silicone sobre a pele, podendo ser seca ou úmida, em pontos de acupuntura, áreas dolorosas e pontos de gatilho. Com o objetivo de analisar a eficácia da ventosaterapia como tratamento complementar para enxaqueca, com foco na redução do consumo de medicamentos, foi realizada uma revisão sistemática. A pesquisa abrangeu as bases de dados BVS, PubMed e Science, a seleção dos artigos ocorreu em três etapas: título, resumo e leitura completa. Os estudos que respaldaram a aplicação da técnica foram incluídos na análise, e foi elaborada uma tabela PICO (Population, Intervention, Comparison, Outcome) e um fluxograma PRISMA para justificar as exclusões e facilitar a coleta de dados. Embora haja poucos estudos sobre relacionados a ventosaterapia no tratamento da enxaqueca, os dados obtidos permitem observar sua eficácia. Destaca-se a ventosa úmida ou sangria como uma das técnicas mais promissoras, podendo ser utilizada por profissionais de saúde como ferramenta complementar na fisioterapia, com o intuito de reduzir a incapacidade causada pela intensa dor associada a essa condição.
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... Because it involves piercing the skin and removal of body fluids, the physiological response to wet cupping would be expected to be different than its "dry" counterpart, and is not evaluated in this paper. Moving cupping is a technique in which a lubricant is used and after the cups are applied, they are slid along the skin [8] . ...
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... In retrospective research on hypertension patients, three sessions of wet cupping reduced SBP from 149.2 to 130.8mm Hg (P value < 0.01) (Al-Tabakha et al., 2018). Finally, a thorough study showed that cupping may reduce discomfort (Lee et al., 2011). Some Saudi Arabian research examined alternative medicine and cupping awareness, attitude, public understanding and practice. ...
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... Terapi kuno ini memiliki banyak cara Aplikasi. Dua jenis utama bekam adalah bekam kering dan bekam basah (Lee and Ernst, 2011). Terapi bekam adalah pengobatan sejarah yang populer di negara-negara Arab dan Islam. ...
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... Cupping therapy or cupping therapy is an alternative therapy that is popular in Arab countries and even in China and has begun to be used in Indonesia for the treatment of various diseases such as fibrositis, pain in the spine, diarrhea including cardiovascular diseases: hypertension and atherosclerosis (Mahmoud et al., 2013). The existence of various diseases that can be prevented and the incomplete proof with cupping therapy makes researchers interested in conducting further investigations about the benefits of cupping therapy in lowering blood pressure in the elderly who are a group of people who are vulnerable to cardiovascular disease (Lee et al., 2011;Aboushanab & AlSanad, 2018). ...
effect of cupping therapy on cholesterol levels in elderly patients
Article
Full-text available
  • Nov 2022
High cholesterol levels can increase the risk of hypertension. Hypertension is called the silent killer because it often appears without symptoms and is the main cause of heart disease, stroke and kidney failure. The elderly are a vulnerable group to be diagnosed with cardiovascular disease. Cupping therapy is a popular alternative treatment option carried out by the community. As time goes by, it encourages nurses to fully prove the benefits of cupping therapy. To examine the effect of cupping therapy on reducing cholesterol levels in the elderly. This research uses a quasi-experimental method which is one group pretest-posttest. Researchers examined cholesterol levels before cupping therapy and measured again after 30 minutes after cupping therapy. The sample used was 15 elderly patients with cupping at Alghaffar Care, Bone Regency, which were selected using purposive sampling technique. After performing statistical analysis using the Paired sample t test, the Systolic Pressure was obtained a significant value (p 0.001 < 0.05) with an average decrease in systolic pressure of 5.133 mmHg and a significant diastolic pressure was obtained (p 1,000 > 0, 05).
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... Notably, the number of clinical trials of CT has increased as an official practice. CT is an easily handled, natural, safe, cost effective and holistic relaxation resource in treatment of chronic or sub-acute painful conditions such as back pain, headache or migraine, muscle soreness, knee, neck, shoulder pain, and fibromyalgia by resolving inflammation and increasing in endogenous opioid production similar to analgesic effect [25][26][27][28][29][30][31][32][33]. Despite the possibilities of the favorable multidimensional effects of CT, few randomized controlled trials the benefits of CT on PPP are available and also we did not encounter any previous trials testing the effectiveness of dry CT with lavender oil massage in the treatment of PPP. ...
TMR Non-Drug Therapy The effect of dry-cupping combined with lavender oil massage on postpartum perineal pain: a case study
Article
Full-text available
  • Sep 2022
Background: Perineal pain is an important complaint in the postpartum period for several weeks. This study aimed to examine the effect of dry cupping therapy with lavender oil massage on the intensity of postpartum perineal pain. Methods: A 33 years old female had suffered with postpartum perineal pain. She experienced bilateral episiotomy on the third birth. Dry cupping therapy was administrated on selected areas two times. Before giving cupping therapy , at the 4th and 24th hours of birth was investigated effectiveness of dry cupping therapy on postpartum perineal pain based on the short-form of McGill pain scale. Results: According to the McGill pain scale, the mean of postpartum perineal pain intensity decreased from 37.9 ± 10.5 before the dry cupping therapy with lavender oil massage to 12.1 ± 5.3 in 4th hour, and 6.3 ± 1.3.2 in 24th hour after delivery. The patient on cupping therapy with lavender oil message showed better results terms of pain intensity (P < 0.001). Conclusion: The study confirmed that dry cupping therapy with lavender oil massage reduced postpartum perineal pain. In this regard, this intervention may be considered as affective method for reducing postpartum perineal pain. However, further trials are required to identify the effectiveness of this therapy regiment.
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... before bekam therapy to 2.66±1.64 after two sessions of therapy and to 2.25±1.32 for the twenty eight respondents who had completed six sessions of bekam therapy strongly suggests that bekam does give respondents a sense of pain relief, a finding others have reported. 5,9,10 The Wilcoxon Sign Rank test supports that. It would appear that bekam does not reduce pain much more after two sessions. ...
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Using Near-Infrared Spectroscopy to Investigate the Effects of Pressures and Durations of Cupping Therapy on Muscle Blood Volume and Oxygenation
Article
Cupping therapy has been widely used to manage musculoskeletal impairment. However, the effects of pressure and duration of cupping therapy on the hemodynamic activity of the muscle have not been investigated. A 2×2 repeated measures factorial design was used to examine the main effect and interaction of pressure (-225 and -300 mmHg) and duration (5 and 10 min) on biceps muscle blood flow using near-infrared spectroscopy in 18 participants. The results showed that a significant interaction is between pressure and duration on deoxy-hemoglobin (P=0.045). A significant main effect of pressure is on oxyhemoglobin (P=0.005) and a significant main effect of duration is on oxyhemoglobin (P=0.005). Cupping therapy at -300 mmHg for 10 min results in a higher oxyhemoglobin (6.75±2.08μM) and deoxy-hemoglobin (1.71±0.78μM) compared to other three combinations. Our study provides first evidence that the pressure and duration factors of cupping therapy can significantly affect muscle blood volume and oxygenation. This article is protected by copyright. All rights reserved.
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Public knowledge and perceptions toward cupping therapy (hijamah)
Article
Full-text available
  • Dec 2021
Introduction: Complementary and Alternative Medicine (CAM) is a well-known and widely used component of the healthcare system. Wet cupping therapy is one of the therapies that many people employ (hijamah). Wet cupping therapy (hijamah) is becoming increasingly popular and widely employed in today's society. The public's understanding and perception of cupping therapy, on the other hand, is unknown. This study describes public knowledge and perceptions of cupping therapy (hijamah) in Kalirandu.Method: In this study, using a cross-sectional approach. The sample was 62 people with purposive sampling stress, which is a sampling technique with specific considerations. This study used a questionnaire of knowledge and perceptions of the people.Results: The results of this study indicate that the level of public knowledge regarding cupping (hijamah) is low as many as 41 people (66.1%), and the level of knowledge is moderate as many as 21 people (33.9%). An overview of the medium category of community perceptions of cupping (hijamah) is 49 people (79.0%), for the good perception of 12 people (19.4%), and the last for a bad perception of 1 person (1.6 %).Conclusions: This study indicates that the knowledge and perception of the public about cupping therapy need to improve.
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Wet cupping therapy for treatment of herpes zoster: a systematic review of randomized controlled trials
Article
Full-text available
Wet cupping is a traditional Chinese medicine therapy commonly used in treating herpes zoster in China, and clinical studies have shown that wet cupping may have beneficial effect on herpes zoster compared with Western medication. We included randomized controlled trials (RCTs) on wet cupping for herpes zoster. We searched PubMed, the Cochrane Library (Issue 3, 2008), China Network Knowledge Infrastructure (CNKI), Chinese Scientific Journals Fulltext Database VIP, and Wan Fang Database. All searches ended in February 2009. Two authors extracted data and assessed the trials' quality independently. RevMan 5.0.18 software (The Cochrane Collaboration, The Nordic Cochrane Centre, Copenhagen, Denmark) was used for data analysis with effect estimate presented as relative risk (RR) and mean difference (MD) with a 95% confidence interval (CI). Eight RCTs involving 651 patients were included, and the methodological quality of trials was generally fair in terms of randomization, blinding, and intention-to-treat analysis. Meta-analyses showed wet cupping was superior to medication in the number of cured patients (RR 2.49, 95% CI 1.91 to 3.24, P < .00001), the number of patients with improved symptoms (RR 1.15, 95% CI 1.05 to 1.26, P = .003), and reducing the incidence rate of postherpetic neuralgia (RR 0.06, 95% CI 0.02 to 0.25, P = .0001). Wet cupping plus medication was significantly better than medication alone on number of cured patients (RR 1.93, 95% CI 1.23 to 3.04, P = .005) but demonstrated no difference in symptom improvement (RR 1.00, 95% CI 0.92 to 1.08, P = .98). There were no serious adverse effects related to wet cupping therapy in the included trials. Wet cupping appears to be effective in the treatment of herpes zoster. However, further large, rigorously designed
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CONSORT 2010 statement: updated Guidelines for Reporting Parallel Group Randomised Trials
Article
Full-text available
The CONSORT statement is used worldwide to improve the reporting of randomised controlled trials. Kenneth Schulz and colleagues describe the latest version, CONSORT 2010, which updates the reporting guideline based on new methodological evidence and accumulating experience. To encourage dissemination of the CONSORT 2010 Statement, this article is freely accessible on bmj.com and will also be published in the Lancet, Obstetrics and Gynecology, PLoS Medicine, Annals of Internal Medicine, Open Medicine, Journal of Clinical Epidemiology, BMC Medicine, and Trials.
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Cupping for Treating Pain: A Systematic Review
Article
Full-text available
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.
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Do Certain Countries Produce Only Positive Results? A Systematic Review of Controlled Trials
Article
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Article
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[CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials (Chinese version)]
Article
  • Jul 2010
The CONSORT statement is used worldwide to improve the reporting of randomised controlled trials. Kenneth Schulz and colleagues describe the latest version, CONSORT 2010, which updates the reporting guideline based on new methodological evidence and accumulating experience. To encourage dissemination of the CONSORT 2010 Statement, this article is freely accessible on bmj.com and will also be published in the Lancet, Obstetrics and Gynecology, PLoS Medicine, Annals of Internal Medicine, Open Medicine, Journal of Clinical Epidemiology, BMC Medicine, and Trials.
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Cupping for stroke rehabilitation: A systematic review
Article
  • Jul 2010
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Article
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