Effectiveness of cupping therapy for low back pain: a systematic review.

Cupping therapy has been used for thousands of years in traditional Chinese medicine for the treatment of several chronic conditions, such as low back pain, chronic arthralgia, radiculopathy and respiratory disease. Dry and wet cupping (with controlled bleeding) are the two main types of cupping therapy. Other subtypes of the treatment are cupping with retention (keeping cups on the skin or acupuncture points for 10–15 min); movingcupping (sliding cups over the skin or acupuncture points with lubricants); shaking-cupping (moving cups up and down repeatedly on skin or acupuncture points); quickcupping (removing cups immediately when the skin is sucked in); and balance-cupping (composite manipulation, each dose including cupping with retention 6–8 min, movingcupping four times, shaking-cupping three times and quick-cupping three times). Nowadays, an increasing number of patients have shown an interest in using cupping therapy for the treatment of low back pain owing to their belief that it is more effective than Western therapeutics. Although cupping therapy is considered a safe, non-invasive procedure, the outcome does not always fulfil the expectation of therapists and patients. Moreover, complications of cupping therapy, such as anaemia and skin pigmentation, have also been reported. Since there is no consensus on the role of cupping therapy in the treatment of low back pain, we reviewed the medical literature in an attempt to test its effectiveness in low back pain and to further examine this method. The systematic research started with a thorough English and Chinese language literature search of PubMed from 1980 through 2013. The keyword search terms in combination were ‘cupping therapy’, ‘low back pain’, ‘lumbar sprain’, ‘lumbar myofascitis’ and ‘lumbosacral pain’. Articles with laboratory studies were excluded. Three reviewers took part in the study. One reviewer selected the titles and abstracts for inclusion, one extracted data from the full-text articles and the third reviewer confirmed the reference lists of potentially eligible studies. Identified studies were assigned a level of evidence according to the Oxford Centre for Evidence-Based Medicine 2011 levels of evidence.