Pubmed Cupping Therapy

[Lakia Throssell]

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Background: Cupping therapy has been used to treat musculoskeletal impairments for about 4000 years. Recently, world athletes have provoked an interest in it, however, the evidence to support its use in managing musculoskeletal and sports conditions remains unknown.

Methods: 2214 studies were identified through a computerized search, of which 22 met the inclusion criteria. The search involved randomized and case series studies published between 1990 and 2019. The search involved five databases (Scopus, MEDLINE (PubMed), Web of Science, Academic Search Complete PLUS (EBSCO), and CrossRef) and contained studies written in the English language. Three analyses were included: the quality assessment using the PEDro scale, physical characteristic analysis, and evidence-based analysis.

Results: The results showed that most studies used dry cupping, except five which used wet cupping. Most studies compared cupping therapy to non-intervention, the remaining studies compared cupping to standard medical care, heat, routine physiotherapy, electrical stimulation, active range of motion and stretching, passive stretching, or acetaminophen. Treatment duration ranged from 1 day to 12 weeks. The evidence of cupping on increasing soft tissue flexibility is moderate, decreasing low back pain or cervical pain is low to moderate, and treating other musculoskeletal conditions is very low to low. The incidence of adverse events is very low.

Conclusion: This study provides the first attempt to analyze the evidence level of cupping therapy in musculoskeletal and sports rehabilitation. However, cupping therapy has low to moderate evidence in musculoskeletal and sports rehabilitation and might be used as a useful intervention because it decreases the pain level and improves blood flow to the affected area with low adverse effects.

Cupping therapy is a therapeutic technique that utilizes a vacuum force created beneath a small vessel applied onto the skin's surface. This approach focuses on blood and autologous healing substances in a specific area, stimulating metabolic activity, improving immune function, and stabilizing blood biochemistry.

Cupping therapy has been a traditional practice dating back to ancient times. This therapy was practiced by the Egyptians and Macedonians around 5500 years ago, and Egyptians later introduced this method to the Greeks. Cupping therapy was documented and endorsed in diverse civilizations, including China and Rome, as well as within the collective traditions (hadiths) of the Prophet Muhammad during the initial 6 centuries of the Common Era. Over time, cupping therapy extended to numerous parts of the world and has been consistently utilized, except in the United States, where it declined in popularity during the late 19th and early 20th centuries.

Cupping has traditionally carried folkloric, cultural, religious, and spiritual significance within various societies. Within certain traditional Muslim communities, adhering to specific ceremonial practices was believed to improve treatment outcomes, resulting in regulations restricting the anatomical regions where cupping could be administered. In traditional Eastern Medicine, cupping therapy was closely associated with acupuncture, whereas in Taoism, it was used to harmonize Qi by balancing Yin (negative energy) and Yang (positive energy). In India, Ayurvedic medicine also incorporates a blood detoxification technique known as Ghati yantra, which bears similarities to wet cupping. In certain less-dominant cultural and religious traditions, shamanic leaders utilized the cupping method to safeguard their communities from illnesses believed to be of demonic origin.

Wet cupping, a traditional procedure, continues to be practiced in various regions, including China, Korea, and parts of Eastern Europe. In regions of the Middle East and Northern Africa, this practice is called Al-Hijamah in Arabic, which can be loosely translated as "restoring the body to its natural state."

Conditions and area-specific: Cupping therapy can be customized to address particular conditions and target-specific areas, including cosmetic, sports-related, orthopedic, abdominal, facial, and gender-specific cupping therapies for females and males.

Although wet and dry cupping techniques remain relevant in contemporary medicine, a meta-analysis of cupping therapy's effectiveness in managing back pain indicated that most studies meeting inclusion criteria primarily focused on dry cupping. This preference is likely attributed to the noninvasive nature of dry cupping than wet cupping. The potential advantages of reduced invasiveness outweighed the additional physiological impact that wet cupping might offer.

By engaging in evidence-based discussions, analyzing case studies, and participating in practical demonstrations, learners review cupping therapy's potential effectiveness, safety considerations, and the methods for incorporating it as a complementary treatment option into their clinical practice. Healthcare professionals are equipped with the skills to enhance the competence required to make informed decisions about incorporating cupping therapy into patient care to improve patient outcomes and promote a holistic approach to healing.

Objectives:Differentiate between the various cupping techniques and their specific indications, ensuring the selection of the most suitable approach for individual patient needs.Implement cupping therapy safely and hygienically by following established sterilization protocols and maintaining infection control standards to ensure safe and successful treatment.Select appropriate cupping tools and materials, considering patient comfort and the specific treatment goals.Coordinate patient care effectively by documenting cupping therapy sessions in patient records, sharing relevant information with the patient's healthcare team, and ensuring continuity of care.Access free multiple choice questions on this topic.

Cupping therapy is a therapeutic technique that utilizes a vacuum force created beneath a small vessel applied onto the skin's surface. This approach focuses on blood and autologous healing substances in a specific area, stimulating metabolic activity, improving immune function, and stabilizing blood biochemistry.[1]

Cupping therapy has been a traditional practice dating back to ancient times. This therapy was practiced by the Egyptians and Macedonians around 5500 years ago, and Egyptians later introduced this method to the Greeks.[2] Cupping therapy was documented and endorsed in diverse civilizations, including China and Rome, as well as within the collective traditions (hadiths) of the Prophet Muhammad during the initial 6 centuries of the Common Era. Over time, cupping therapy extended to numerous parts of the world and has been consistently utilized, except in the United States, where it declined in popularity during the late 19th and early 20th centuries. [2]

Cupping has traditionally carried folkloric, cultural, religious, and spiritual significance within various societies. Within certain traditional Muslim communities, adhering to specific ceremonial practices was believed to improve treatment outcomes, resulting in regulations restricting the anatomical regions where cupping could be administered.[3] In traditional Eastern Medicine, cupping therapy was closely associated with acupuncture, whereas in Taoism, it was used to harmonize Qi by balancing Yin (negative energy) and Yang (positive energy).[1] In India, Ayurvedic medicine also incorporates a blood detoxification technique known as Ghati yantra, which bears similarities to wet cupping.[1] In certain less-dominant cultural and religious traditions, shamanic leaders utilized the cupping method to safeguard their communities from illnesses believed to be of demonic origin.[2]

Wet cupping, a traditional procedure, continues to be practiced in various regions, including China, Korea, and parts of Eastern Europe. In regions of the Middle East and Northern Africa, this practice is called Al-Hijamah in Arabic, which can be loosely translated as "restoring the body to its natural state."[1][4][5]

Although wet and dry cupping techniques remain relevant in contemporary medicine, a meta-analysis of cupping therapy's effectiveness in managing back pain indicated that most studies meeting inclusion criteria primarily focused on dry cupping. This preference is likely attributed to the noninvasive nature of dry cupping than wet cupping. The potential advantages of reduced invasiveness outweighed the additional physiological impact that wet cupping might offer.[6]

The specific mechanism through which cupping exerts its therapeutic effects remains unidentified. However, several theories have been proposed to elucidate its physiological benefits, as mentioned below.[7]

This theory proposes that the touch, pressure, and vibrational sensations generated during cupping therapy selectively stimulate large nerve fibers. This stimulation leads to the inhibition of pain signal transmission to the brain through the dorsal horn of the spinal cord. The increased stimulation of peripheral nociceptors caused by cupping results in the upregulation of receptor-fiber units, subsequently triggering the activation of large-fiber nerves. These large fiber nerves are responsive to stimuli, and the pumping mechanism used to create suction during cupping may contribute to pain relief.[7]

This theory proposes that pain in one part of the body can be suppressed or overshadowed by pain in a different area. More precisely, DNIC refers to the findings from animal studies that illustrate pain inhibition mediated by the lower brainstem. In humans, this phenomenon is called conditioned pain modulation (CPM). The effective utilization of CPM entails using conditioning to attain a reduced pain response. Cupping therapy has been used in the treatment of idiopathic pain syndromes. However, the precise mechanism through which DNIC operates in cupping therapy remains incompletely understood. Various hypotheses have been proposed, including the potential distraction caused by the sensation of cupping, the initiation of a DNIC response, or the induction of a deoxidation effect.[7]

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