Pulsatile dry cupping in patients with osteoarthritis of the knee – a randomized controlled exploratory trial

Abstract

IntroductionCupping is used in various traditional medicine forms to relieve pain in musculoskeletal diseases. The aim of this study was to investigate the effectiveness of cupping in relieving the symptoms of knee osteoarthritis (OA).MethodsIn a two-group, randomized controlled exploratory pilot study patients with a clinically and radiological confirmed knee OA (Kellgren-Lawrence Grading Scale: 2-4) and a pain intensity > 40 mm on a 100 mm visual analogue scale (VAS) were included. 40 Patients were randomized to either 8 sessions of pulsatile dry cupping within 4 weeks or no intervention (control). Paracetamol was allowed on demand for both groups. Outcomes were the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score, the pain intensity on a VAS (0 mm = no pain to 100 mm = maximum intensity) and Quality of Life (SF-36) 4 and 12 weeks after randomization. Use of Paracetamol was documented within the 4-week treatment period. Analyses were performed by analysis of covariance adjusting for the baseline value for each outcome.Results21 patients were allocated to the cupping group (5 male; mean age 68 ± SD 7.2) and 19 to the control group (8 male; 69 ± 6.8). After 4 weeks the WOMAC global score improved significantly more in the cupping group with a mean of 27.7 (95% confidence interval 22.1; 33.3) compared to 42.2 (36.3; 48.1) in the control group (p = 0.001). After 12 weeks the WOMAC global score were still significantly different in favor for cupping (31.0 (24.9; 37.2) vs. 40.8 (34.4; 47.3) p = 0.032), however the WOMAC subscores for pain and stiffness were not significant anymore. Significantly better outcomes in the cupping group were also observed for pain intensity on VAS and for the SF-36 Physical Component Scale compared to the control group after 4 and 12 weeks. No significant difference was observed for the SF-36 Mental Component Scale and the total number of consumed Paracetamol tablets between both groups (mean 9.1, SD ± 20.0 vs. 11.5 ± 15.9).ConclusionIn this exploratory study dry cupping with a pulsatile cupping device relieved symptoms of knee OA compared to no intervention. Further studies comparing cupping with active treatments are needed.Trial registrationClinicaltrials.gov Identifier: NCT01057043

Traditional Dry Cupping Therapy Versus Medroxyprogesterone Acetate in the Treatment of Idiopathic Menorrhagia: A Randomized Controlled Trial

“…However, there is no documented study in this area. Due to the limitations and side effects of the drugs used in the management of AUB on one hand, and the simplicity, speed of impact, lack of severe side effects, not interacting with other therapies of dry cupping on the other hand, it is necessary to conduct a study to demonstrate the effectiveness of this treatment as a novel method (9)(10)(11)(12). The aim of this study was to evaluate the usefulness of dry cupping on excessive menstrual blood loss in menorrhagia, with a well-validated menstrual pictogram compared to medroxyprogesterone acetate.…”

Cupping Therapy for Knee Osteoarthritis: A Synthesis of Evidence

“…The Western medicine administered to both groups included diclofenac, paracetamol glucosamine hydrochloride, and celecoxib; the duration of treatment was mostly 4 weeks. For the outcome measures, VAS and WOMAC values were observed in 2 studies [31,32]; LAI values were measured in 3 studies [33,34,35]. Details regarding the 5 RCTs [31,32,33,34,35] included in our meta-analysis are shown in table 1.…”

“…The 5 RCTs included a total of 535 patients with KOA. In addition, 2 trials compared a co-intervention of dry cupping therapy and Western medicine with a control of Western medicine alone [31,32]. In addition, wet cupping therapy combined with Western medicine was used in another 3 studies [33,34,35].…”

Therapeutic Benefits of Al-hijamah: in Light of Modern Medicine and Prophetic Medicine

“…Cupping therapy effectively treated musculoskeletal pain conditions as lumbar disc herniation, cervical spondylosis, [26] brachialgia paraesthetica nocturna, [27] persistent non-specific low back pain, [28] fibrositis, [29] firomyalgia, [30] chronic non-specific neck pain,31 chronic knee osteoarthritis [32] and other pain conditions e.g. pain of dysmenorrhea [33] and pain of acute gouty arthritis [34].…”