Comparative Effectiveness of Dry Cupping and Graston Techniques in Scapulocostal Syndrome. (CMR = Compress)

Comparative Effectiveness of Dry Cupping and Graston Techniques in Office Workers With Scapulocostal Syndrome; A Randomised Clinical Trail

The goal of this clinical trial is to check the comparative effectiveness of Graston Techniques and Dry cupping in Office Workers with Scapulocostal syndrome. The main questions it aims to answer are:

1. To evaluate the relative effectiveness of dry cupping and the Graston technique.
2. How well each technique reduces symptoms and enhances work productivity and functional outcomes.
3. To assess whether integrating either Graston Technique or Dry Cupping provides more beneficial effects than conventional treatment alone.

1) Be divided into 2 Groups (Group A= Dry Cupping; B: Graston Techniques) 2) get the treatment for 4 weeks (3 days a week). 3) Receive the same conventional treatment.

Study Overview

• Status: Completed
• Conditions: Scapulocostal Syndrome
• Intervention / Treatment: Other: Experimental: Group A = Dry Cupping; Other: Experimental: Group B = Graston Technique

Detailed Description

This study aims to compare the effectiveness of Graston and Dry cupping in treating Scapulocostal syndrome in office workers, focusing on specific outcomes like pain severity, functional outcomes, and work productivity.

This study will be a randomized clinical trial with a sample size of 46 participants with work-related SCS. The participants will be obtained by non-probability convenient sampling based on the inclusion and exclusion criteria. Participants will be randomly assigned into two groups, with 23 subjects in each group. Group A will receive dry cupping along with conventional therapy while Group B will receive IASTM along with conventional therapy.

• Study Type: Interventional
• Enrollment (Actual): 46
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Lahore, Pakistan, 54910
    • Bethania Hospital
  • Sialkot, Pakistan, 54000
    • University of Management and technology Sialkot Campus
  • Sialkot, Pakistan
    • Bethania Hospital
  • Punjab Province
    • Sialkot, Punjab Province, Pakistan, 51310
      • Bethania Hospital Sialkot

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. 18-30 age group
2. Males and females
3. Office Workers.
4. Subjects that have symptoms of musculoskeletal nature (
5. Subjects with pain lasting for longer than 3 months (

Exclusion Criteria:

1. Subjects with underlying pathology such as TOS, brachial neuralgia, cervical radiculopathy, polymyositis or Fibro myositis
2. Subjects with systemic diseases such as rheumatoid arthritis, ankylosing spondylitis
3. Subjects with the presence of any fractures
4. Heart/diabetic patients
5. Pregnant women

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group A = Dry Cupping; Group A will receive Dru cupping along with conventional treatment.	Other: Experimental: Group A = Dry Cupping; Dry cupping, originating in Middle Eastern and Asian countries, gained popularity in the United States after the 2016 Summer Olympics. It has two main forms: wet and dry cupping. Wet cupping involves laceration of the skin, while dry cupping uses negative pressure to pull the skin into the cup. Cupping is used to reduce musculoskeletal or myofascial pain, with the most accepted mechanism being localized hyperemia, which improves microcirculation and promotes healing
Experimental: Group B = Graston Technique; Group B will receive Graston Technique with Conventional treatment.	Other: Experimental: Group B = Graston Technique; Instrument-assisted soft tissue mobilization (IASTM), derived from Cyriax cross-friction massage, is a popular alternative to traditional manual therapy techniques, with its first controlled study published in 1997 (Seffrin & Gardiner-Shires, 2019) .The Graston Technique(GT), also known as instrument-assisted soft tissue mobilization (IASTM), is used by chiropractors, doctors, and therapists to alleviate pain and range-of-motion restrictions caused by musculoskeletal injuries and scar tissue. (McKivigan, J. M., & Tulimero, G. et al. , 2020) . The Graston technique, is also used to alleviate upper cervical pain.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change From Baseline in Pain Intensity as Measured by the Visual Analog Scale	Pain intensity will be measured using the Visual Analog Scale (VAS), a 100 mm horizontal line anchored by two extremes: 0 mm represents "no pain" and 100 mm represents "worst imaginable pain." Participants will mark the point that best represents their pain intensity. The score is the distance in millimeters from the left end to the mark. Change in pain intensity will be calculated by subtracting the Week 4 score from the baseline score. A decrease in VAS score indicates an improvement in pain levels.	4 Weeks
Cervical Range of Motion (ROM)	Cervical spine Range of Motion (ROM) will be assessed and measured using a universal goniometer by utilizing moving and stationary arm of angles in cervical spine range of motion..	4 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Neck Disability Index (NDI) Total Score	The Neck Disability Index (NDI) is a validated 10-item questionnaire assessing neck-specific disability. Each item is scored from 0 to 5, resulting in a total score range of 0 to 50. Higher scores indicate greater disability. The change in total NDI score from baseline to Week 4 will be calculated. A decrease in score indicates clinical improvement.	4 Weeks
Treatment-Related Adverse Events During the 4-Week Intervention	Treatment-related adverse events (AEs), such as skin irritation, bruising, or discomfort, will be recorded throughout the study. The number of participants experiencing at least one AE will be counted. All AEs will be assessed for severity and relatedness to the intervention.	4 weeks

Collaborators and Investigators

• Sponsor: University of Management and Technology Sialkot Pakistan
• Investigators: Principal Investigator: Danyal Ahmad, PhD Scholar, University of Management and Technology Sialkot Pakistan

Publications and helpful links

General Publications

• Seffrin CB, Cattano NM, Reed MA, Gardiner-Shires AM. Instrument-Assisted Soft Tissue Mobilization: A Systematic Review and Effect-Size Analysis. J Athl Train. 2019 Jul;54(7):808-821. doi: 10.4085/1062-6050-481-17. Epub 2019 Jul 19.
• Buttagat V, Taepa N, Suwannived N, Rattanachan N. Effects of scapular stabilization exercise on pain related parameters in patients with scapulocostal syndrome: A randomized controlled trial. J Bodyw Mov Ther. 2016 Jan;20(1):115-122. doi: 10.1016/j.jbmt.2015.07.036. Epub 2015 Jul 26.
• Elsayyad MM, Abdel-Aal NM, Helal ME. Effect of Adding Neural Mobilization Versus Myofascial Release to Stabilization Exercises after Lumbar Spine Fusion: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2021 Feb;102(2):251-260. doi: 10.1016/j.apmr.2020.07.009. Epub 2020 Aug 19.
• Brandl A, Bartsch K, James H, Miller ME, Schleip R. Influence of Rolfing Structural Integration on Active Range of Motion: A Retrospective Cohort Study. J Clin Med. 2022 Oct 5;11(19):5878. doi: 10.3390/jcm11195878.
• Sharma S, Kaur H, Verma N, Adhya B. Looking beyond Piriformis Syndrome: Is It Really the Piriformis? Hip Pelvis. 2023 Mar;35(1):1-5. doi: 10.5371/hp.2023.35.1.1. Epub 2023 Mar 6.
• Aslam S, Rahim R, Ejaz U, Tariq ZB, Guftar F. Effects of Myofascial Release Technique on Pain, Range of Motion and Functional Disability in Patients with Piriformis Syndrome. HJPRS [Internet]. 2025 Aug 23 [cited 2025 Oct 19];5(2):56-61.

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2024
• Primary Completion (Actual): January 25, 2025
• Study Completion (Actual): September 13, 2025

Study Registration Dates

• First Submitted: November 18, 2024
• First Submitted That Met QC Criteria: July 31, 2025
• First Posted (Actual): August 3, 2025

Study Record Updates

• Last Update Posted (Actual): December 30, 2025
• Last Update Submitted That Met QC Criteria: December 22, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Scapulocostal Syndrome; Graston Technique; Myofascilal pain syndrome,; Dry Cupping Therapy; Cervical Range of Motion
• Additional Relevant MeSH Terms: Pathologic Processes; Disease; Syndrome
• Other Study ID Numbers: kuhs/dpt/umt-skt-016

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: Individual Participant Data (IPD) will not be shared, or may not be shared, due to concerns regarding participant confidentiality and privacy, limitations of informed consent that did not explicitly include data sharing, and the risk of re-identification even after anonymization.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No