Highlights
- •Interest in nonpharmacological pain treatment options such as cupping is growing.
- •Eighteen randomized trials have investigated effects of cupping on chronic pain.
- •Cupping has clinically meaningful short-term effects on pain and disability.
- •Cupping is relatively safe in chronic pain patients.
Abstract
There is a growing interest in nonpharmacological pain treatment options such as cupping.
This meta-analysis aimed to assess the effectiveness and safety of cupping in chronic
pain. PubMed, Cochrane Library, and Scopus were searched through November 2018 for
randomized controlled trials on effects of cupping on pain intensity and disability
in patients with chronic pain. Risk of bias was assessed using the Cochrane risk of
bias tool. Of the 18 included trials (n =1,172), most were limited by clinical heterogeneity
and risk of bias. Meta-analyses found large short-term effects of cupping on pain
intensity compared to no treatment (standardized mean difference [SMD] = −1.03; 95%
confidence interval [CI] = −1.41, −.65), but no significant effects compared to sham
cupping (SDM = −.27; 95% CI = −.58, .05) or other active treatment (SMD = −.24; 95%
CI = −.57, .09). For disability, there were medium-sized short-term effects of cupping
compared to no treatment (SMD = −.66; 95% CI = −.99, −.34), and compared to other
active treatments (SMD = −.52; 95% CI = −1.03, −.0028), but not compared to sham cupping
(SMD = −.26; 95% CI = −.57,.05). Adverse events were more frequent among patients
treated with cupping compared to no treatment; differences compared to sham cupping
or other active treatment were not statistically significant. Cupping might be a treatment
option for chronic pain, but the evidence is still limited by the clinical heterogeneity
and risk of bias.
Perspective: This article presents the results of a meta-analysis aimed to assess
the effectiveness and safety of cupping with chronic pain. The results suggest that
cupping might be a treatment option; however, the evidence is still limited due to
methodical limitations of the included trials. High-quality trials seem warranted.
Keywords
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Article info
Publication history
Published online: January 23, 2020
Footnotes
Disclosures: M.T. and B.B. declare that their Institute received funding for conducting two cupping trials from a cupping equipment manufacturer (HeVaTech, Germany). In addition, H.C., M.T., and B.B. were also authors of cupping studies included in this review. However, the ratings of these two studies were performed by raters, which did not participate in conducting these trials. All other authors declare that no conflicts of interest exist.
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© 2020 by United States Association for the Study of Pain, Inc.
