Cupping may ease short-term pain, disability

Cupping seems to help ease short-term pain intensity and disability, reports a recent meta-analysis, although further studies are needed due to high clinical heterogeneity and risks of bias in the existing literature.

From the databases of PubMed, the Cochrane Library, and Scopus, researchers retrieved 18 randomized controlled trials (RCTs) that looked at the impact of any cupping intervention on adult patients with chronic pain conditions, including lower back or neck pain, rheumatoid arthritis, fibromyalgia, neuropathic pain, osteoarthritis, or headaches/migraines.

Cupping had a strong and significant short-term impact on pain intensity relative to no treatment (standardized mean difference [SMD], –1.03, 95 percent confidence interval [CI], –1.41 to –0.65; p<0.00001), but not against sham cupping (SMD, –0.27, 95 percent CI, –0.58 to 0.05; p=0.09) or active treatment (SMD, –0.24, 95 percent CI, –0.57 to 0.09; p=0.15).

Similarly, cupping yielded a medium-sized short-term benefit in terms of disability as compared with no treatment (SMD, –0.66, 95 percent CI, –0.99 to –0.34; p=0.0002). Cupping was likewise significantly better for disability relative to other active treatments (SMD, –0.52, 95 percent CI, –1.03 to –0.0028; p=0.05), but no advantage over sham cupping was detected (SMD, –0.26, 95 percent CI, –0.57 to 0.05; p=0.10).

However, the researchers detected concerns regarding evidence quality. Heterogeneity, especially in the comparison between cupping and no treatment, was significant for both pain intensity and disability outcomes. The risk of bias was also high in most studies, particularly in terms of blinding of participants and personnel and of outcome assessments.