3. J Altern Complement Med. 2014 Apr;20(4):318-21. doi: 10.1089/acm.2013.0291. Epub 2014 Feb 12.
Wet cupping therapy restores sympathovagal imbalances in
cardiac rhythm.
Arslan M1
, Yeşilçam N, Aydin D, Yüksel R, Dane S.
Author information
1
Turgut Ozal University School of Nursing , Ankara, Turkey .
Abstract
OBJECTIVES:
A recent study showed that cupping had therapeutic effects in rats with myocardial infarction and
cardiac arrhythmias. The current studyaimed to investigate the possible useful effects
of cupping therapy on cardiac rhythm in terms of heart rate variability (HRV).
MATERIALS AND METHODS:
Forty healthy participants were included. Classic wet cupping therapy was applied on five points of the
back. Recording electrocardiography (to determine HRV) was applied 1 hour before and 1 hour
after cupping therapy.
RESULTS:
All HRV parameters increased after cupping therapy compared with before cupping therapy in healthy
persons.
CONCLUSIONS:
These results indicate for the first time in humans that cupping might be cardioprotective. In this
study, cupping therapy restored sympathovagal imbalances by stimulating the peripheral nervous
system.
PMID:24520978 [PubMed - in process]
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J Occup Health. 2012;54(6):416-26. Epub 2012 Sep 1.
Cupping for treating neck pain in video display terminal (VDT)
users: a randomized controlled pilot trial.
Kim TH1
, Kang JW, Kim KH, Lee MH, Kim JE, Kim JH, Lee S, Shin MS, Jung SY, Kim
AR, Park HJ, Hong KE.
Author information
1
Korea Institute of Oriental Medicine, South Korea. rockandmineral@gmail.com
Abstract
OBJECTIVES:
4. This was a randomized controlled pilot trial to evaluate the effectiveness of cupping therapy for neck
pain in video display terminal (VDT) workers.
METHODS:
Forty VDT workers with moderate to severe neck pain were recruited from May, 2011 to February,
2012. Participants were randomly allocated into one of the two interventions: 6 sessions of wet and
dry cupping or heating pad application. The participants were offered an exercise program to perform
during the participation period. A 0 to 100 numeric rating scale (NRS) for neck pain, measure yourself
medical outcome profile 2 score (MYMOP2 score), cervical spine range of motion (C-spine ROM),
neck disability index (NDI), the EuroQol health index (EQ-5D), short form stress response inventory
(SRI-SF) and fatigue severity scale (FSS) were assessed at several points during a 7-week period.
RESULTS:
Compared with a heating pad, cupping was more effective in improving pain (adjusted NRS difference:
-1.29 [95% CI -1.61, -0.97] at 3 weeks (p=0.025) and -1.16 [-1.48, -0.84] at 7 weeks (p=0.005)), neck
function (adjusted NDI difference: -0.79 [-1.11, -0.47] at 3 (p=0.0039) and 7 weeks (p<0.0001)) and
discomfort (adjusted MYMOP2 difference score: -0.72 [-1.04 to -0.40] at 3 weeks and -0.92 [-1.24, -
0.60] at 7 weeks). Significant improvement in EQ-5D was observed at 7 weeks (1.0 [0.88, 1.0]
with cupping and 0.91 [0.86, 0.91] with heating pad treatment, p=0.0054). Four participants reported
mild adverse events of cupping.
CONCLUSION:
Two weeks of cupping therapy and an exercise program may be effective in reducing pain and
improving neck function in VDT workers.
PMID:22971528 [PubMed - indexed for MEDLINE]
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PLoS One. 2012;7(2):e31793. doi: 10.1371/journal.pone.0031793. Epub 2012 Feb 28.
An updated review of the efficacy of cupping therapy.
Cao H1
, Li X, Liu J.
Author information
1
Centre for Complementary Medicine Research, University of Western Sydney, Penrith, Australia.
Abstract
BACKGROUND:
Since 1950, traditional Chinese medicine (TCM) cupping therapy has been applied as a formal
modality in hospitals throughout China and elsewhere in the world. Based on a previous systematic
literature review of clinical studies on cupping therapy, this study presents a thorough review of
randomized controlled trials (RCTs) to evaluate the therapeutic effect of cupping therapy.
METHOD:
Six databases were searched for articles published through 2010. RCTs on cupping therapy for
various diseases were included. Studies on cupping therapy combined with other TCM treatments
versus non-TCM therapies were excluded.
5. RESULTS:
135 RCTs published from 1992 through 2010 were identified. The studies were generally of low
methodological quality. Diseases for which cupping therapy was commonly applied were herpes
zoster, facial paralysis (Bell palsy), cough and dyspnea, acne, lumbar disc herniation, and cervical
spondylosis. Wet cupping was used in most trials, followed by retained cupping, moving cupping, and
flash cupping. Meta-analysis showed cupping therapy combined with other TCM treatments was
significantly superior to other treatments alone in increasing the number of cured patients with herpes
zoster, facial paralysis, acne, and cervical spondylosis. No serious adverse effects were reported in
the trials.
CONCLUSIONS:
Numerous RCTs on cupping therapy have been conducted and published during the past decades.
This review showed thatcupping has potential effect in the treatment of herpes zoster and other
specific conditions. However, further rigorously designed trials on its use for other conditions are
warranted.
PMID:22389674 [PubMed - indexed for MEDLINE] PMCID:PMC3289625
Free PMC Article
Trials. 2011 Jun 10;12:146. doi: 10.1186/1745-6215-12-146.
Evaluation of wet-cupping therapy for persistent non-specific
low back pain: a randomised, waiting-list controlled, open-
label, parallel-group pilot trial.
Kim JI1
, Kim TH, Lee MS, Kang JW, Kim KH, Choi JY, Kang KW, Kim AR, Shin MS, Jung
SY, Choi SM.
Author information
1
Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.
Abstract
BACKGROUND:
Persistent 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.
METHODS:
We 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 to 100 numerical rating scale (NRS) for pain,
6. the McGill Pain Questionnaire for pain intensity (PPI) and the Oswestry Disability Questionnaire
(ODQ), and we assessed acetaminophen use and safety issues.
RESULTS:
The 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.
CONCLUSION:
This 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.
PMID:21663617 [PubMed - indexed for MEDLINE] PMCID: PMC3141528
Free PMC Article
BMC Complement Altern Med. 2010 Nov 16;10:70. doi: 10.1186/1472-6882-10-70.
Clinical research evidence of cupping therapy in China: a
systematic literature review.
Cao H1
, Han M, Li X, Dong S, Shang Y, Wang Q, Xu S, Liu J.
Author information
1
Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
Abstract
BACKGROUND:
Though cupping therapy has been used in China for thousands of years, there has been no
systematic summary of clinical research on it.This review is to evaluate the therapeutic effect
of cupping therapy using evidence-based approach based on all available clinical studies.
METHODS:
We included all clinical studies on cupping therapy for all kinds of diseases. We searched six
electronic databases, all searches ended in December 2008. We extracted data on the type
of cupping and type of diseases treated.
RESULTS:
550 clinical studies were identified published between 1959 and 2008, including 73 randomized
controlled trials (RCTs), 22 clinical controlled trials, 373 case series, and 82 case reports. Number of
RCTs obviously increased during past decades, but the quality of the RCTs was generally poor
according to the risk of bias of the Cochrane standard for important outcome within each trials. The
diseases in which cupping was commonly employed included pain conditions, herpes zoster, cough or
7. asthma, etc. Wet cupping was used in majority studies, followed by retainedcupping, moving cupping,
medicinal cupping, etc. 38 studies used combination of two types of cupping therapies. No serious
adverse effects were reported in the studies.
CONCLUSIONS:
According to the above results, quality and quantity of RCTs on cupping therapy appears to be
improved during the past 50 years in China, and majority of studies show potential benefit on pain
conditions, herpes zoster and other diseases. However, further rigorous designed trials in relevant
conditions are warranted to support their use in practice.
PMID:21078197 [PubMed - indexed for MEDLINE] PMCID: PMC3000376
Free PMC Article
J Pain. 2009 Jun;10(6):601-8. doi: 10.1016/j.jpain.2008.12.013. Epub 2009 Apr 19.
Effects of traditional cupping therapy in patients with carpal
tunnel syndrome: a randomized controlled trial.
Michalsen A1
, Bock S, Lüdtke R, Rampp T, Baecker M, Bachmann J, Langhorst J, Musial
F, Dobos GJ.
Author information
1
Immanuel Hospital Berlin, Department of Internal and Complementary Medicine, Berlin, Germany.
a.michalsen@immanuel.de
Abstract
We investigated the effectiveness of cupping, a traditional method of treating musculoskeletal pain, in
patients with carpal tunnel syndrome (CTS) in an open randomized trial. n = 52 outpatients (58.5 +/-
8.0 years) with neurologically confirmed CTS were randomly assigned to either a verum (n = 26) or a
control group (n = 26). Verum patients were treated with a single application of wet cupping, and
control patients with a single local application of heat within the region overlying the trapezius muscle.
Patients were followed up on day 7 after treatment. The primary outcome, severity of CTS symptoms
(VAS), was reduced from 61.5 +/- 20.5 to 24.6 +/- 22.7 mm at day 7 in the cupping group and from
67.1 +/- 20.2 to 51.7 +/- 23.9 mm in the control group [group difference -24.5mm (95%CI -36.1; -2.9, P
< .001)]. Significant treatment effects were also found for the Levine CTS-score (-.6 pts: 95%CI -.9; -
.2, P = .002), neck pain (-12.6mm; 95%CI -18.8; -6.4, P < .001), functional disability (DASH-Score) (-
11.1 pts; 95%CI -17.1; -5.1, P < .001), and physical quality of life (.3; 95%CI .0; .3, P = .048). The
treatment was safe and well tolerated. We conclude thatcupping therapy may be effective in relieving
the pain and other symptoms related to CTS. The efficacy of cupping in the long-term management of
CTS and related mechanisms remains to be clarified.
PERSPECTIVE:
8. The results of a randomized trial on the clinical effects of traditional cupping therapy in patients with
carpal tunnel syndrome are presented. Cupping of segmentally related shoulder zones appears to
alleviate the symptoms of carpal tunnel syndrome.
Comment in
Testing traditional cupping therapy. [J Pain. 2009]
PMID:19380259 [PubMed - indexed for MEDLINE]
Complement Ther Med. 2009 Jan;17(1):9-15. doi: 10.1016/j.ctim.2008.05.003. Epub 2008 Jun 24.
The effectiveness of wet-cupping for nonspecific low back pain
in Iran: a randomized controlled trial.
Farhadi K1
, Schwebel DC, Saeb M, Choubsaz M, Mohammadi R, Ahmadi A.
Author information
1
Department of Anesthesiology, Critical Care and Pain Management, Pain research center,
Kermanshah University of Medical Sciences, Iran.
Abstract
OBJECTIVES:
To determine the efficacy of wet-cupping for treating persistent nonspecific low back pain.
BACKGROUND:
Wet-cupping therapy is one of the oldest known medical techniques. It is still used in several
contemporary societies. Very minimal empirical study has been conducted on its efficacy.
DESIGN:
Randomized controlled trial with two parallel groups. Patients in the experimental group were offered
the option of referral to the wet-cupping service; all accepted that option. The control group received
usual care.
SETTING:
Medical clinic in Kermanshah, Iran.
PARTICIPANTS:
In total, 98 patients aged 17-68 years with nonspecific low back pain; 48 were randomly assigned to
experimental group and 50 to the control group.
INTERVENTION:
Patients in the experimental group were prescribed a series of three staged wet-cupping treatments,
placed at 3 days intervals (i.e., 0, 3, and 6 days). Patients in the control group received usual care
from their general practitioner.
MAIN OUTCOME MEASURES:
Three outcomes assessed at baseline and again 3 months following intervention: the McGill Present
Pain Index, Oswestry Pain Disability Index, and the Medication Quantification Scale.
RESULTS:
9. Wet-cupping care was associated with clinically significant improvement at 3-month follow-up. The
experimental group who received wet-cupping care had significantly lower levels of pain intensity
([95% confidence interval (CI) 1.72-2.60] mean difference=2.17, p<0.01), pain-related disability (95%
CI=11.18-18.82, means difference=14.99, p<0.01), and medication use (95% CI=3.60-9.50, mean
difference=6.55, p<0.01) than the control group. The differences in all three measures were
maintained after controlling for age, gender, and duration of lower back pain in regression models
(p<0.01).
CONCLUSION:
This 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.
PMID:19114223 [PubMed - indexed for MEDLINE]
![ 1
Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical
Sciences, Shiraz, Iran.
Abstract
Cupping therapy (CT) is one of the oldest medical techniques available, and is still used in several
cultures instead of or as an adjunct or complement to 'western academic' medicine. Moreover, CT
(wet or dry) is claimed to have therapeutic effects in many types of disorders which do not fully
respond to conventional medicine or for which no effective treatment is available. However, no recent
reviews of the clinical practice ofcupping are available to the best of our knowledge. We describe the
applications of CT as used in Traditional Iranian Medicine (TIM). Several databases were searched for
relevant literature. In addition, we studied the main traditional treatises on TIM regarding the history
and practice of CT. Information about current practices was obtained from a systematic survey among
practitioners. Our results suggest that CT is currently prescribed for up to 120 diseases and disorders
that are difficult to treat, including cutaneous (21.7%), musculoskeletal (15%), and central nervous
system (13.3%) disorders. Moreover, TIM treatises note 25 specific sites on the body surface which
correspond to certain diseases, and on which wet-cupping therapy has therapeutic effects. Additional
clinical studies of CT may lead to findings on new therapeutic methods and may shed light on
mechanisms of disease and illness that are not fully understood in conventional medicine.
© 2014 S. Karger GmbH, Freiburg.
PMID:24603629 [PubMed - in process]
J Evid Based Complementary Altern Med. 2014 Apr;19(2):128-36. doi: 10.1177/2156587214524578.
Epub 2014 Feb 25.
Hijamat in traditional Persian medicine: risks and benefits.
Nimrouzi M1
, Mahbodi A, Jaladat AM, Sadeghfard A, Zarshenas MM.
Author information
Abstract
Traditional Persian medicine is based on humoral medical concepts. In the case of abundant blood in
the body, tabi'at (body nature) deals with this imbalance by elimination of the morbid substances via
some controlling mechanisms. If tabi'at could not react properly, the physician should prescribe an
intervention to let the extra blood out. This can be done through phlebotomy, wet cupping, and the use
of leech or scarification of the ears. Cupping with scarification may eliminate the morbid substance
through the scarified skin, and cupping without scarification evacuates the morbid materials from the
compromised organs. Wet cupping in health state is meant to be applied for preventing the blood
humor dominance in susceptible individuals. In disease condition, wet cupping is defined as a
treatment in which the patients confront the abundance of blood. Wetcupping may have harmful
complications in extremely thin or obese patients. Wet cupping should be postponed in patients
compromised by diseases especially in the thick phlegm abundance. In Asia, Iranian people, because
of religious beliefs, are very interested in cupping therapy. Many unsupervised cupping procedures are
performed in Iran, whereas benefits and risks of these procedures are undetermined by providers and
clients. In this study, the most important indications and contraindications of wet cupping have been
reviewed based on the traditional Persian medicine resources.
KEYWORDS:Hijamat; traditional medicine; wet cupping](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)