The influence of a series of five dry cupping treatments on pain and mechanical thresholds in patients with chronic non-specific neck pain--a randomised controlled pilot study

Romy Lauche, Holger Cramer, Kyung-Eun Choi, Thomas Rampp, Felix Joyonto Saha, Gustav J Dobos, Frauke Musial, Romy Lauche, Holger Cramer, Kyung-Eun Choi, Thomas Rampp, Felix Joyonto Saha, Gustav J Dobos, Frauke Musial

Abstract

Background: In this preliminary trial we investigated the effects of dry cupping, an ancient method for treating pain syndromes, on patients with chronic non-specific neck pain. Sensory mechanical thresholds and the participants' self-reported outcome measures of pain and quality of life were evaluated.

Methods: Fifty patients (50.5 ± 11.9 years) were randomised to a treatment group (TG) or a waiting-list control group (WL). Patients in the TG received a series of 5 cupping treatments over a period of 2 weeks; the control group did not. Self-reported outcome measures before and after the cupping series included the following: Pain at rest (PR) and maximal pain related to movement (PM) on a 100-mm visual analogue scale (VAS), pain diary (PD) data on a 0-10 numeric rating scale (NRS), Neck Disability Index (NDI), and health-related quality of life (SF-36). In addition, the mechanical-detection thresholds (MDT), vibration-detection thresholds (VDT), and pressure-pain thresholds (PPT) were determined at pain-related and control areas.

Results: Patients of the TG had significantly less pain after cupping therapy than patients of the WL group (PR: Δ-22.5 mm, p = 0.00002; PM: Δ-17.8 mm, p = 0.01). Pain diaries (PD) revealed that neck pain decreased gradually in the TG patients and that pain reported by the two groups differed significantly after the fifth cupping session (Δ-1.1, p = 0.001). There were also significant differences in the SF-36 subscales for bodily pain (Δ13.8, p = 0.006) and vitality (Δ10.2, p = 0.006). Group differences in PPT were significant at pain-related and control areas (all p < 0.05), but were not significant for MDT or VDT.

Conclusions: A series of five dry cupping treatments appeared to be effective in relieving chronic non-specific neck pain. Not only subjective measures improved, but also mechanical pain sensitivity differed significantly between the two groups, suggesting that cupping has an influence on functional pain processing.

Trial registration: The trial was registered at clinicaltrials.gov (NCT01289964).

Figures

Figure 1
Figure 1
Study design.
Figure 2
Figure 2
Consort flow chart of recruitment and trial conditions.
Figure 3
Figure 3
Pain ratings decrease in the treatment group (pain diary, NRS, Mean ± SEM). Pain ratings of the TG were averaged between two cupping sessions. For the WL group we divided the number of days between T1 and T2 by the number of treatments in the TG. This resulted in pain ratings averaged every 3.5 days.
Figure 4
Figure 4
Course of pressure-pain thresholds over time (a) and differences in pressure-pain thresholds (T2-T1) (b) at pain-related and control areas (Mean ± SEM). Please note: Raw data instead of log-transformed data were used for illustration purposes.

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