Evaluation of wet-cupping therapy for persistent non-specific low back pain: a randomised, waiting-list controlled, open-label, parallel-group pilot trial

Abstract

BackgroundPersistent non-specific low back pain (PNSLBP) is one of the most frequently experienced types of back pain around the world. Wet-cupping is a common intervention for various pain conditions, especially in Korea. In this context, we conducted a pilot study to determine the effectiveness and safety of wet-cupping treatment for PNSLBP.MethodsWe recruited 32 participants (21 in the wet-cupping group and 11 in the waiting-list group) who had been having PNSLBP for at least 3 months. The participants were recruited at the clinical research centre of the Korea Institute of Oriental Medicine, Korea. Eligible participants were randomly allocated to wet-cupping and waiting-list groups. Following the practice of traditional Korean medicine, the treatment group was provided with wet-cupping treatment at two acupuncture points among the BL23, BL24 and BL25 6 times within 2 weeks. Usual care, including providing brochures for exercise, general advice for PNSLBP and acetaminophen, was allowed in both groups. Separate assessors participated in the outcome assessment. We used the 0 to100 numerical rating scale (NRS) for pain, the McGill Pain Questionnaire for pain intensity (PPI) and the Oswestry Disability Questionnaire (ODQ), and we assessed acetaminophen use and safety issues.ResultsThe results showed that the NRS score for pain decreased (-16.0 [95% CI: -24.4 to -7.7] in the wet-cupping group and -9.1 [-18.1 to -0.1] in the waiting-list group), but there was no statistical difference between the groups (p = 0.52). However, the PPI scores showed significant differences between the two groups (-1.2 [-1.6 to -0.8] for the wet-cupping group and -0.2 [-0.8 to 0.4] for the waiting-list group, p < 0.01). In addition, less acetaminophen was used in the wet-cupping group during 4 weeks (p = 0.09). The ODQ score did not show significant differences between the two groups (-5.60 [-8.90 to -2.30] in the wet-cupping group and -1.8 [-5.8 to 2.2] in the waiting-list group, p = 0.14). There was no report of adverse events due to wet-cupping.ConclusionThis pilot study may provide preliminary data on the effectiveness and safety of wet-cupping treatments for PNSLBP. Future full-scale randomised controlled trials will be needed to provide firm evidence of the effectiveness of this intervention.Trial RegistrationClinicalTrials.gov: (Identifier: NCT00925951)Date of trial registration: June 19th, 2009The date when the first patient was randomised: July 15th, 2009The date when the study was completed: November 27th, 2009

Cupping for Treating Neck Pain in Video Display Terminal (VDT) Users: A Randomized Controlled Pilot Trial

“…We allowed freedom for the selection of points and stimulation methods (wet or dry cupping) to reflect the real-world clinical situation. As it is a very difficult to separate individual factors affecting the specific effects of cupping, most clinical research does not adopt strict standardized treatment guidelines for the cupping procedure, including the size of cups, applied areas, volume of drained air, and retention time of cups 15,30,31,37) . To resolve this problem, two kinds of efforts should be made in the future.…”

“…Dry cupping without puncture of the skin was applied mainly, but wet cupping was also applied for up to 2 points in the case of lesions with blood-stasis symptoms, severe tenderness and prominent warmness. According to the predefined clean technique procedure 15) , cupping cups were attached after 3 to 5 cycles of pumping for negative pressure by cupping pump and retained for 5 to 10 minutes according to the patient's general condition and symptom severity. For wet cupping, the skin was punctured 6 times to a 2-mm depth around the cupping sites with 26-gauge disposable lancets (Tianjin Haing Lim Sou Won Medical Instrument Co., China).…”

“…VDT work has accompanied the sharp increase in the use of personal computers for work in the last several decades. According to a national survey of the Japan Ministry of Health, Labour and Welfare, Japanese laborers who engaged in VDT-related work comprised only 15.3% of all the working population in 1998, but after 10 years, that fraction increased to 79.2% 1) . German census data from 2004 suggested that twenty-one million people, comprising 59% of all hired workers, were engaged in computer-related work during daily life 2) .…”

Effects of Spiritual Care Cupping Reduce Pain in Patients with Knee Joint Pain

“…After binding to opioid receptors in the limbic system, the middle brain, and spinal cord, opioids reduce pain by preventing a variety of pain-producing neurotransmitters, so that reduced pain scale. Kim et al (2011) reported that the mu opioid receptors and delta opioid receptors bind strongly to the endorphins that come from POMC [9]. Endorphins and encephalin have an important role in endogenous pain reduction [10].…”

Evaluation of the Effect of Hijama Bi'l Shart in Waja-Ul-Mafasil (Knee Osteoarthritis): An Open Labelled Randomized Controlled Comparative Clinical Study

“…ADL and Sports/Recreation: Hijama Bi'l Shart might improve ADL and Sports/Recreation function through reduction of inflammation in tissues & cells 60,61 and boost the immune system by increasing the number of macrophages 45,47 .…”