n Cupping Therapy as an Alternative Pain management Treatment for Chronic Pain

n Junus, A., & Mendoza-Aguilar, M. (2023, June 24–27) N9151 Scholarly Writing and Dissemination II [Conference presentation]. Target Conference: 2023 Annual Research Meeting, Seattle, WA. https:// academyhealth.confex.com/academyhealth/2023arm/cfp.cgi

Abstract

Chronic pain affects a large portion of the world’s population making it a leading cause of disability and disease worldwide. Research shows that neck pain affects up to 50% of individuals, back pain affects up to 67% of individuals, and that migraines are the second most burdensome neurologic disease. One alternative treatment is cupping therapy. The objective of this article is to complete a scoping review of the currently published research on the use of cupping therapy for analgesia, primarily with chronic pain. In order to find the appropriate studies, the search terms (“cupping” or “cupping therapy”) and (“pain” or “pain manage” or “pain treat” or “pain therapy” or “pain relief”) and “adult” were used across three major databases: CLIO, CINAHL, and PubMed. Ultimately, the results show cupping therapy is effective in reducing primarily musculoskeletal pain with some improved functional status. However, while there is low-to-moderate-quality evidence to support such claims, there is little moderate-to-high-quality evidence that supports the reduction of pain with cupping therapy as an alternative therapy. Additional research, including higher-quality randomized controlled trials (RCTs), must be done to positively correlate therapy with pain improvement to generalize results and recommend the implementation of cupping therapy into policies or practice as alternative therapy for patients with chronic pain in either the acute care or outpatient setting.

Background

There are many pharmacological advances that assist in the care of chronic pain patients, there is a growing interest in complementary and alternative treatments. Research shows that neck pain affects up to 50% of individuals, back pain affects up to 67% of individuals, and that migraines are the second most burdensome neurologic disease. Additionally, there is a growing interest in populations where pharmacological solution might be too expensive (Ma et al., 2018). Cupping therapy uses cups made from bamboo, glass, or plastic to create localized, vacuum pressure over a person’s skin theorizing a release of pressure thus a reduction in pain (Ma et al., 2018). To compile what research there is regarding cupping therapy and chronic pain. We also aimed to identify areas where there needs to be more research before we can safely and effectively implement potential complementary or alternative pain treatments.

Purpose

There is a two-fold purpose. First, to complete a scoping review of research regarding cupping therapy and pain management and present it in an easily digestible manner. Secondly, to identify areas where there needs to be more research before safely and effectively implementing cupping therapy as a complementary or alternative pain treatment.

Methods

We searched using three major databases: CLIO, CINAHL, and PubMed using the search terms (“cupping” or “cupping therapy”) and (“pain” or “pain manage” or “pain treat” or “pain therapy” or “pain relief”) and “adult.” We also looked at related articles that may have been referenced within systematic reviews and meta-analysis. We limited articles to the years 2017 to 2022 and only considered articles that had an English version available for reading. Out of 24 articles, we chose nine articles that had reliable statistical evidence of the effect of cupping on outcomes.

Discussion

There is low moderate-quality evidence that supports implementation of cupping therapy, most often dry cupping therapy, to reduce pain, primarily related to musculoskeletal pain in the neck, head, and back. However, there are many gaps. Some studies often didn’t have long periods of follow-up on patients, which is critical in studying chronic pain and adverse effects. Also, some studies were small in the number of included RCTs or a sample size, which can introduce a higher level of bias. Additionally, there is variability across different systematic analyses on what qualifies as effective cupping therapy. A lack of standardization of care in cupping therapy makes it difficult to determine if it was a specific type of cupping therapy or cupping therapy in general that we helpful in pain reduction. There are also gaps within this study due to the inability to research in other languages which, would be useful in researching complementary and alternative therapies.

Conclusion

While there is a consensus across studies that supports the efficacy of wet and dry cupping therapy in reducing primarily musculoskeletal pain, there is little moderate-to-high-quality evidence that supports the reduction of pain with alternative cupping therapy. There is too much variety in types of pain and too little research on long-term effects to generally recommend cupping therapy. Additionally, there is no standardization for cupping therapy, leading to the inability to control for variation in the quality and inability to provide reliable referrals for patients.

However, there is the possibility of cupping therapy reducing musculoskeletal pain in patients. Some pain treatments, even pharmacological, are supported by low-to-moderate-quality evidence that have anecdotally provided pain relief. Since pain is so individualized, it would be remiss to discount the potential benefits of cupping therapy, especially in chronic pain. To unlock the potential of cupping therapy as part of a multimodal analgesia plan, research into alternative and complementary therapies in medicine must continue. If complementary therapies such as acupuncture can take a rise in studies for pain relief, there is good reason to study cupping therapy as well.