Dry Cupping, Ischemic Compression, or Their Combination for the Treatment of Trigger Points: A Pilot Randomized Trial

Abstract

Background: Chronic neck pain (NP) attributed to myofascial pain syndrome is one of the particularly common skeletal muscle disorder associated with the hyperirritable zone in the taut band of muscle. Trigger points (TPs) are the physical interpretation of the myofascial pain syndrome. In the United States, 30%-85% of pain patients have been affected by myofascial TPs.Objectives: To reveal preliminary evidence on the clinical efficacy of ischemic compression therapy, dry cupping, and their combination on improving the TPs' pressure pain threshold (PPT), neck range of motion (NROM), and neck disability index (NDI) in patients with TPs and nonspecific NP. Besides, assess the feasibility of conducting a randomized clinical trial (RCT).Design: A randomized pilot study was conducted on 24 patients with TPs and nonspecific NP. Patients were randomly assigned to three groups: the cupping group, the ischemic compression group, and the combination therapy group. PPT, NROM, and NDI were assessed before and after 4 weeks of treatment.Results: The results showed a statistically significant improvement in NDI, PPT, and NROM compared with values before the treatment ( p < 0.05) in all groups. Although no significant difference was detected between ischemic compression (IC) and dry cupping, the combination approach showed significantly higher and faster improvement ( p < 0.05).Conclusions: It is feasible to conduct a main RCT. Both IC and dry cupping may hold promise in treating TPs; a combination of the two therapies may provide superior improving rate.

Efficacy of Combination Therapies on Neck Pain and Muscle Tenderness in Male Patients with Upper Trapezius Active Myofascial Trigger Points

“…e results of this study can be understood with the reports of previous studies declared by Kashyap et al [23], Iqbal et al [21,22], Hong et al [39], Martín-Pintado-Zugasti et al [9], Benito-de-Pedro et al [12], Nasb et al [41], Hanten et al [19], Chaitow [13], Fryer and Hodgson [3], Fernándezde-las-Peñas et al [36], Cagnie et al [16,20], Capo-Juan et al [17], and other researchers. e results achieved by these authors are similar to the results achieved in this study for the combination of two manual techniques (MET plus ICT) in the management of neck pain and muscle tenderness due to upper trapezius active MTrPs.…”

“…In addition, combination therapy including ICT has proven to be more effective than the ICT alone, which supports the result of our study. Nasb et al (2019) reported that the combination of ICT with dry cupping for 4 weeks has shown more effectiveness than either ICT or dry cupping alone in the improvement of PPT, NDI, and ROM scores significantly [41]. Hanten et al (2000) examined the efficacy of a home program containing ischemic compression followed by sustained stretching over active MTrPs.…”

Influence of quantified dry cupping on soft tissue compliance in athletes with myofascial pain syndrome

“…Several previous studies have confirmed that dry cupping can improve the symptoms of myofascial pain syndrome and restore activity [ 5 , 21 ], and our findings were consistent with those of these studies. However, the studies mostly used subjective clinical symptoms to evaluate the effect of cupping on improving myofascial pain, and our study was characterized by a combination of subjective questionnaires and quantitative assessments of objective soft tissue compliance.…”

“…The study was powered to detect an effect size of the primary outcome measure of 0.6, which was estimated based on the findings of a pilot study on dry cupping in myofascial pain syndrome [ 16 ]. To detect this effect with 80% power and a two-sided α of 0.05, a sample of eight patients was needed for each group.…”

An Overview of Cupping Treatment

“…İskemik grupla kupa grubu arasında NDI, PPT ve NROM açısından anlamlı farklılık tespit edilmemiştir. 84 Çin'de yapılan, kupa ve akupunktur kombinasyon tedavisinin lomber miyofasiyal ağrı sendromundaki etkinliğini inceleyen bir çalışmada, bu tedavinin VAS skorunu istatistiksel olarak anlamlı şekilde azalttığı rapor edilmiştir. 85…”