Cupping for treating pain: a systematic review

Jong-In Kim, Myeong Soo Lee, Dong-Hyo Lee, Kate Boddy, Edzard Ernst, Jong-In Kim, Myeong Soo Lee, Dong-Hyo Lee, Kate Boddy, Edzard Ernst

Abstract

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.

Figures

Figure 1
Figure 1
Flowchart of trial selection process. RCT: randomized clinical trial; CCT: non-randomized controlled clinical trial; UCT: uncontrolled clinical trial.

References

    1. Astin JA. Why patients use alternative medicine: results of a national study. Journal of the American Medical Association. 1998;279(19):1548–1553.
    1. Fleming S, Rabago DP, Mundt MP, Fleming MF. CAM therapies among primary care patients using opioid therapy for chronic pain. BMC Complementary and Alternative Medicine. 2007;7 Article ID 15.
    1. Chirali IZ. Cupping Therapy. Philadelphia, Pa, USA: Elservier; 2007.
    1. Yoo SS, Tausk F. Cupping: East meets West. International Journal of Dermatology. 2004;43(9):664–665.
    1. Kwon YD, Cho HJ. Systematic review of cupping including bloodletting therapy for musculoskeletal diseases in Korea. Korean Journal of Oriental Physiology & Pathology. 2007;21:789–793.
    1. Julian PTH, Douglas GA. Assessing risk of bias in included studies. In: Julian PTH, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions. West Sussex, UK: Wiley-Blackwell; 2008. pp. 187–241.
    1. Huang ZF, Li HZ, Zhang ZJ, Tan ZQ, Chen C, Chen W. Observations on the efficacy of cupping for treating 30 patients with cancer pain. Shanghai Journal of Acupuncture and Moxibustion. 2006;25:14–15.
    1. Hong YF, Wu JX, Wang B, Li H, He YC. The effect of moving cupping therapy on non-specific low back pain. Chinese Journal of Rehabilitation Medicine. 2006;21:340–343.
    1. Zhang Z. Observation on therapeutic effects of blood-letting puncture with cupping in acute trigeminal neuralgia. Journal of Traditional Chinese Medicine. 1997;17(4):272–274.
    1. Farhadi K, Schwebel DC, Saeb M, Choubsaz M, Mohammadi R, Ahmadi A. The effectiveness of wet-cupping for nonspecific low back pain in Iran: a randomized controlled trial. Complementary Therapies in Medicine. 2009;17(1):9–15.
    1. Lüdtke R, Albrecht U, Stange R, Uehleke B. Brachialgia paraesthetica nocturna can be relieved by “wet cupping”-results of a randomised pilot study. Complementary Therapies in Medicine. 2006;14(4):247–253.
    1. Michalsen A, Bock S, Ludtke R, et al. Effectiveness of cupping therapy in brachialgia paraestetica nocturna: results of a randomized controlled trial. Forsch Komplementarmed. 2007;14:p. 19.
    1. Xu L, Yang XJ. Therapeutic effect of aciclovir combination with callateral-puncturing and cupping in the treatment of 40 cases of herpes zoster. Tianjin Pharmacy. 2004;16:23–4.
    1. Moore A, McQuay H. Bandolier's Little Book of Making Sense of the Medical Evidence. Oxford, UK: Oxford University Press; 2006.
    1. Ernst E, Lee M. A trial design that generates only “positive” results. Journal of Postgraduate Medicine. 2008;54(3):214–216.
    1. Egger M, Smith GD. Bias in location and selection of studies. British Medical Journal. 1998;316(7124):61–66.
    1. Ernst E, Pittler MH. Alternative therapy bias. Nature. 1997;385(6616):p. 480.
    1. Vickers A, Goyal N, Harland R, Rees R. Do certain countries produce only positive results? A systematic review of controlled trials. Controlled Clinical Trials. 1998;19(2):159–166.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa