Cupping therapy for acute and chronic pain management : a systematic review of randomized clinical trials

Objective: Cupping as a traditional therapy is used to treat a myriad of health conditions, including pain. This systematic review assessed the effectiveness and safety of cupping for different types of pain. Methods: Thirteen databases and four trial registries were searched for randomized clinical trials. Meta-analysis of data was conducted if there was non-significant clinical and statistical heterogeneity (measured by I2 test) among trials. Results: Sixteen trials with 921 participants were eligible and included. Six trials were assessed as low risk of bias, another six trials were of unclear risk of bias, and the remaining four trials were of high risk of bias. Pain was related to three acute and seven chronic diseases. Meta-analysis showed a beneficial effect of cupping compared to wait-list control (visual analogue scale (VAS), MD −1.85 cm, 95%CI −2.66 to −1.04) and heat therapy (numerical rating scale, MD −2.05 cm, 95%CI −2.93 to −1.17). Cupping combined with acupuncture was superior to acupuncture alone on post-treatment pain intensity (VAS, MD −1.18 cm, 95%CI −1.68 to −0.68), however, no difference was found between this comparison based on changes in pain intensity (difference of VAS, MD 0.16 cm, 95%CI −0.54 to 0.87). Results from other single studies showed significant benefit of cupping compared with conventional drugs or usual care. Hematoma and pain at the treated site, increasing local pain or tingling were reported as mild adverse effects of cupping. Conclusion: This review suggests a potential positive short-term effect of cupping therapy on reducing pain intensity compared with no treatment, heat therapy, usual care, or conventional drugs.