Is cupping therapy effective in patients with neck pain? A systematic review and meta-analysis

Seoyoun Kim, Sook-Hyun Lee, Me-Riong Kim, Eun-Jung Kim, Deok-Sang Hwang, Jinho Lee, Joon-Shik Shin, In-Hyuk Ha, Yoon Jae Lee, Seoyoun Kim, Sook-Hyun Lee, Me-Riong Kim, Eun-Jung Kim, Deok-Sang Hwang, Jinho Lee, Joon-Shik Shin, In-Hyuk Ha, Yoon Jae Lee

Abstract

Objectives: Neck pain is a significant condition that is second only to depression as a cause of years lived with disability worldwide. Thus, identifying and understanding effective treatment modalities for neck pain is of heightened importance. This systematic review aimed to investigate the effects of cupping on neck pain from the current literature.

Design: Systematic review and meta-analysis of randomised controlled trials (RCTs).

Setting: Nine databases, including Chinese, Korean and Japanese databases, were searched for data up to January 2018 with no restrictions on publication language.

Participants: Patients with neck pain.

Interventions: Cupping therapy as the sole or add-on intervention compared with no treatment or active controls.

Primary and secondary outcome measures: Pain severity, functional disability and quality of life.

Results: Eighteen RCTs were selected. Compared with the no intervention group, the cupping group exhibited significant reduction in pain (mean difference (MD) -2.42(95% CI -3.98 to -0.86)) and improvement in function (MD -4.34(95% CI -6.77 to -1.19)). Compared with the active control, the cupping group reported significant reduction in pain (p=0.0009) and significantly improved quality of life (p=0.001). The group that received control treatment with cupping therapy (add-on group) displayed significant pain reduction compared with the active control group (p=0.001). Of the 18 studies, only 8 reported occurrence of adverse events, which were mostly mild and temporary.

Conclusions: Cupping was found to reduce neck pain in patients compared with no intervention or active control groups, or as an add-on treatment. Depending on the type of control group, cupping was also associated with significant improvement in terms of function and quality of life; however, due to the low quality of evidence of the included studies, definitive conclusions could not be drawn from this review. Future well-designed studies are needed to substantiate the effectiveness of cupping on neck pain.

Prospero registration number: CRD42016047218.

Keywords: complementary therapies; meta-analysis; neck pain; systematic review.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the literature search. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta Analyses.
Figure 2
Figure 2
Risk of bias in the included studies, as assessed using the Cochrane Collaboration’s risk of bias tool. +, high risk of bias; ?, unclear risk of bias; -, low risk of bias.
Figure 3
Figure 3
Forest plots demonstrating the effect of cupping as the sole intervention versus no treatment on neck pain.
Figure 4
Figure 4
Forest plots demonstrating the effect of cupping as the sole intervention versus active control on neck pain.
Figure 5
Figure 5
Forest plots demonstrating the effect of cupping as an add-on intervention on neck pain.

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