Cupping therapy on low back pain. A systematic review
DOI:
https://doi.org/10.12775/QS.2025.41.59807Keywords
cupping therapy, low back pain, chronic back pain, pain relief, complementary and alternative medicineAbstract
Low back pain (LBP) encompasses a range of symptoms such as discomfort, muscle tension, tenderness, and stiffness in the area between the lower rib cage and the buttocks. The causes of LBP can be divided into two primary categories: specific low back pain, which has identifiable sources, and non-specific low back pain (NSLBP), which lacks a clear cause. Studies indicate that most patients will experience at least one recurrence of LBP within the span of a year. Additionally, around 5 to 10 percent of acute low back pain cases can progress to chronic low back pain (CLBP). Interestingly, around 90% of LBP instances are not associated with identifiable physical anomalies. This poses a significant challenge for healthcare systems, especially considering the persistent and often unclear nature of these pain conditions. To address lower back pain, three common approaches are used: medications, surgical procedures, and rehabilitation programs. In recent years, there has been a growing trend toward complementary and alternative medicine (CAM) in developed countries, largely due to the side effects associated with traditional treatment methods.
The aim of this article is to assess the effectiveness of treating low back pain through cupping.
A comprehensive analysis of research papers available on PubMed and Google Scholar was undertaken using the searchterms encompassing the following keywords: cupping therapy, low back pain (LBP), chronic back pain, complementary and alternative medicine (CAM).
In traditional medicine, treatment methods typically involve options like non-steroidal anti-inflammatory drugs, opioids, muscle relaxants, steroids, and in some cases, surgery. However, emerging research suggests that cupping therapy could be a promising alternative for managing these conditions. To fully understand how long cupping is effective for alleviating lower back pain (LBP), further studies and appropriate follow-ups are essential.
References
Savigny P, Watson P, Underwood M; Guideline Development Group. Early management of persistent non-specific low back pain: summary of NICE guidance. BMJ. 2009 Jun 4;338:b1805. https://doi.org/10.1136/bmj.b1805.
Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. BMJ. 2006 Jun 17;332(7555):1430-4.
https://.doi.org/10.1136/bmj.332.7555.1430
Trompeter K, Fett D, Platen P. Prevalence of Back Pain in Sports: A Systematic Review of the Literature. Sports Med. 2017 Jun;47(6):1183-1207. https://doi.org/10.1007/s40279-016-0645-3.
van den Hoogen HJ, Koes BW, van Eijk JT, Bouter LM, Devillé W. On the course of low back pain in general practice: a one year follow up study. Ann Rheum Dis. 1998 Jan;57(1):13-9. https://doi.org/10.1136/ard.57.1.13.
Suarez-Almazor ME, Belseck E, Russell AS, Mackel JV. Use of lumbar radiographs for the early diagnosis of low back pain. Proposed guidelines would increase utilization. JAMA. 1997 Jun 11;277(22):1782-6.
Croft PR, Macfarlane GJ, Papageorgiou AC, Thomas E, Silman AJ. Outcome of low back pain in general practice: a prospective study. BMJ. 1998 May 2;316(7141):1356-9. https://doi.org/10.1136/bmj.316.7141.1356.
Meucci RD, Fassa AG, Faria NM. Prevalence of chronic low back pain: systematic review. Rev Saude Publica. 2015;49:1. https://doi.org/ 10.1590/S0034-8910.2015049005874.
Wu A, March L, Zheng X, Huang J, Wang X, Zhao J, Blyth FM, Smith E, Buchbinder R, Hoy D. Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Ann Transl Med. 2020 Mar;8(6):299. https://doi.org/10.21037/atm.2020.02.175.
Ma K, Zhuang ZG, Wang L, Liu XG, Lu LJ, Yang XQ, Lu Y, Fu ZJ, Song T, Huang D, Liu H, Huang YQ, Peng BG, Liu YQ. The Chinese Association for the Study of Pain (CASP): Consensus on the Assessment and Management of Chronic Nonspecific Low Back Pain. Pain Res Manag. 2019 Aug 15;2019:8957847. https://doi.org/10.1155/2019/8957847.
Bindu S, Mazumder S, Bandyopadhyay U. Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: A current perspective. Biochem Pharmacol. 2020 Oct;180:114147.
https://doi.org/10.1016/j.bcp.2020.114147.
Park AL, Hwang EH, Hwang MS, Heo I, Park SY, Lee JH, Ha IH, Cho JH, Shin BC. Cost-Effectiveness of Chuna Manual Therapy and Usual Care, Compared with Usual Care Only for People with Neck Pain following Traffic Accidents: A Multicenter Randomized Controlled Trial. Int J Environ Res Public Health. 2021 Sep 23;18(19):9994. https://doi.org/10.3390/ijerph18199994.
Fairbank J, Frost H, Wilson-MacDonald J, Yu LM, Barker K, Collins R; Spine Stabilisation Trial Group. Randomised controlled trial to compare surgical stabilisation of the lumbar spine with an intensive rehabilitation programme for patients with chronic low back pain: the MRC spine stabilisation trial. BMJ. 2005 May 28;330(7502):1233. https://doi.org/10.1136/bmj.38441.620417.8F.
Foster NE, Anema JR, Cherkin D, Chou R, Cohen SP, Gross DP, Ferreira PH, Fritz JM, Koes BW, Peul W, Turner JA, Maher CG; Lancet Low Back Pain Series Working Group. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018 Jun 9;391(10137):2368-2383. https://doi.org/10.1016/S0140-6736(18)30489-6.
Baliga S, Treon K, Craig NJ. Low Back Pain: Current Surgical Approaches. Asian Spine J. 2015 Aug;9(4):645-57.
https://doi.org/10.4184/asj.2015.9.4.645.
Liu L, Tang Y, Baxter GD, Yin H, Tumilty S. Complementary and alternative medicine - practice, attitudes, and knowledge among healthcare professionals in New Zealand: an integrative review. BMC Complement Med Ther. 2021 Feb 13;21(1):63. https://doi.org/10.1186/s12906-021-03235-z.
Wu Z, Wang Y, Ye X, Chen Z, Zhou R, Ye Z, Huang J, Zhu Y, Chen G, Xu X. Myofascial Release for Chronic Low Back Pain: A Systematic Review and Meta-Analysis. Front Med (Lausanne). 2021 Jul 28;8:697986. https://doi.org/10.3389/fmed.2021.697986.
Rozenfeld E, Kalichman L. New is the well-forgotten old: The use of dry cupping in musculoskeletal medicine. J Bodyw Mov Ther. 2016 Jan;20(1):173-178. https://doi.org/10.1016/j.jbmt.2015.11.009.
Wang Y-T, Qi Y, Tang F-Y, et al. The effect of cupping therapy for low back pain: A meta-analysis based on existing randomized controlled trials. Journal of Back and Musculoskeletal Rehabilitation. 2017;30(6):1187-1195. https://doi.org/10.3233/BMR-169736
Al-Bedah AMN, Elsubai IS, Qureshi NA, Aboushanab TS, Ali GIM, El-Olemy AT, Khalil AAH, Khalil MKM, Alqaed MS. The medical perspective of cupping therapy: Effects and mechanisms of action. J Tradit Complement Med. 2018 Apr 30;9(2):90-97.
https://doi.org/ 10.1016/j.jtcme.2018.03.003.
Emerich M, Braeunig M, Clement HW, Lüdtke R, Huber R. Mode of action of cupping--local metabolism and pain thresholds in neck pain patients and healthy subjects. Complement Ther Med. 2014 Feb;22(1):148-58. https://doi.org/10.1016/j.ctim.2013.12.013.
Choi TY, Ang L, Ku B, Jun JH, Lee MS. Evidence Map of Cupping Therapy. J Clin Med. 2021 Apr 17;10(8):1750. https://doi.org/10.3390/jcm10081750.
Lee MS, Kim JI, Ernst E. Is cupping an effective treatment? An overview of systematic reviews. J Acupunct Meridian Stud. 2011 Mar;4(1):1-4. https://doi.org/ 10.1016/S2005-2901(11)60001-0.
Musumeci, G. Could Cupping Therapy Be Used to Improve Sports Performance? J. Funct. Morphol. Kinesiol. 2016, 1, 373-377. https://doi.org/10.3390/jfmk1040373
Zhang Z, Pasapula M, Wang Z, Edwards K, Norrish A. The effectiveness of cupping therapy on low back pain: A systematic review and meta-analysis of randomized control trials. Complement Ther Med. 2024 Mar;80:103013. https://doi.org/10.1016/j.ctim.2024.103013.
Almeida Silva HJ, Barbosa GM, Scattone Silva R, Saragiotto BT, Oliveira JMP, Pinheiro YT, Lins CAA, de Souza MC. Dry cupping therapy is not superior to sham cupping to improve clinical outcomes in people with non-specific chronic low back pain: a randomised trial. J Physiother. 2021 Apr;67(2):132-139. https://doi.org/10.1016/j.jphys.2021.02.013.
Kim JI, Kim TH, Lee MS, Kang JW, Kim KH, Choi JY, Kang KW, Kim AR, Shin MS, Jung SY, Choi SM. Evaluation of wet-cupping therapy for persistent non-specific low back pain: a randomised, waiting-list controlled, open-label, parallel-group pilot trial. Trials. 2011 Jun 10;12:146. https://doi.org/10.1186/1745-6215-12-146.
Mardani-Kivi M, Montazar R, Azizkhani M, Hashemi-Motlagh K. Wet-Cupping Is Effective on Persistent Nonspecific Low Back Pain: A Randomized Clinical Trial. Chin J Integr Med. 2019 Jul;25(7):502-506. https://doi.org/ 10.1007/s11655-018-2996-0.
Lee JW, Song JM, Park JP, Lee JW, Kang DH, Song JK. Long-term prognosis of isolated significant tricuspid regurgitation. Circ J. 2010 Feb;74(2):375-80. https://doi.org/ 10.1253/circj.cj-09-0679.
Teut M, Ullmann A, Ortiz M, Rotter G, Binting S, Cree M, Lotz F, Roll S, Brinkhaus B. Pulsatile dry cupping in chronic low back pain - a randomized three-armed controlled clinical trial. BMC Complement Altern Med. 2018 Apr 2;18(1):115. https://doi.org/10.1186/s12906-018-2187-8.
Hong, Y. & Wu, J. & Wang, B.. (2006). The effect of moving cupping therapy on nonspecific low back pain. Chinese Journal of Rehabilitation Medicine. 21. 340-343.
J.I. SalKim, T.H. Kim, M.S. Lee, J.W. Kang, K.H. Kim, J.Y. Choi, K.W. Kang, A.R. Kim, M.S. Shin, S.Y. Jung, S.M. Choi Evaluation of wet-cupping therapy for persistent non-specific low back pain: a randomised, waiting-list controlled, open-label, parallel-group pilot trial Trials, 12 (2011 Jun 10), p. 146, https://doi.org/10.1186/1745-6215-12-146.
AlBedah A, Khalil M, Elolemy A, Hussein AA, AlQaed M, Al Mudaiheem A, Abutalib RA, Bazaid FM, Bafail AS, Essa A, Bakrain MY. The Use of Wet Cupping for Persistent Nonspecific Low Back Pain: Randomized Controlled Clinical Trial. J Altern Complement Med. 2015 Aug;21(8):504-8. https://doi.org/10.1089/acm.2015.0065.
Harper B, Dudek A, Williamson J, Siyufy A, Smith JA. Combining Static and Dynamic Myofascial Dry Cupping Therapy to Improve Local and Regional Symptoms in Individuals with Low Back Pain: A Case Series. Int J Sports Phys Ther. 2024 Feb 2;19(2):227-237. https://doi.org/10.26603/001c.91653.
Wani, Khalid RB, Ulfat N, Afshana N, Mohd A, Abdul. (2024). Efficacy of wet cupping in the management of low back pain: a case series study. European Journal Pharmaceutical and Medical Research. 11. 609.
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