Update evidence of effectiveness on pain relieving of cupping therapy: a systematic review and Meta-analysis of randomized controlled trials.

Abstract

Objective: To update the current best evidence on the effectiveness and safety of cupping therapy in pain management.

Methods: The protocol of this systematic review was registered at PROSPERO (CRD42021261308). An updated literature searching in 7 databases was conducted from January 2014 to January 2023. Two authors extracted data and assessed the risk of bias independently. Statistical analysis was performed using RevMan 5.4.1 software (Cochrane Collaboration, London, UK). Meta-analysis with a random effect model was conducted when there was no serious statistical heterogeneity among trials (I2≤75%). Grading of Recommendations Assessment, Development, and Evaluation was also conducted to assess the quality of evidence.

Results: Seventy-two trials with 5720 participants were included. All included trials were assessed as having high risk of bias. The majority of the included trials reported the benefit of cupping plus other therapy or cupping alone on improving cure rate (average risk ratio more than 1.15) and reducing visual analogue scale [average mean difference (MD) reduction 0.16 to 7.0 cm], improving quality of life, quality of sleep or other symptoms related to pain condition. And there was low/very low quality evidence that the incidence of adverse events in the cupping groups were lower than that in the control groups. Although the heterogeneity between studies and the methodological quality of the study itself lead to the low evidence strength of the current conclusions, the results of this study are a valuable supplement to the founding of previous review.

Conclusion: Cupping therapy alone or combined with other therapy was considered benefit in relieving pain, improving the quality of life, and increasing the cure rate of patients with pain conditions, though supported by the low quality of evidence. According to the limited evidence, cupping therapy seems to have less harm than drugs when treating pain conditions.