Effects of ear acupuncture combined with cupping therapy on severity and threshold of chronic back pain and physical disability: A randomized clinical trial

Abstract

Background and aim: Chronic back pain causes physical, functional, and emotional disabilities. Traditional Chinese Medicine therapies have been shown as interventions to treat chronic back pain. The present study aimed to clinically evaluate the effects of ear acupuncture combined with cupping therapy on people with chronic back pain.

Experimental procedure: We conducted an open-label, randomized, parallel-group controlled clinical trial. Following the CONSORT statement recommendations, 198 participants were randomized into 'ear acupuncture' and 'ear acupuncture and cupping therapy' groups. Data were collected in three different points; before the first session (initial) with the patient, after the last session (final), and seven days after the end of the treatment (follow-up). The Brief Pain Inventory, a digital algometer, and the Rolland Morris Disability Questionnaire were used for data collection. Generalized Estimation Equation model was used to examine the association between the interventions and the primary outcome pain severity.

Results: Pain severity, pressure pain threshold, and physical disability improved over time in both groups. However, for the patients being treated with both ear acupuncture and cupping therapy, significant changes were seen in pain severity, pain relief, and physical disabilities between the initial and final sessions. For the 'ear acupuncture and cupping therapy' group, significant changes were also seen for pain relief and physical disability in the follow-up session.

Conclusion: Ear acupuncture combined with cupping therapy was shown to be more effective in the treatment of chronic back pain when compared to treatment using only ear acupuncture.

Keywords: Back pain; Chronic pain; Clinical trial; Cupping therapy; Ear acupuncture.

Graphical abstract

Fig. 1

Location of the acupoints for ear acupuncture therapy. Abbreviations: TF - Triangular fossa; AH – Antihelix; CO - Conchae; AT – Antitragus; TF₄ – Shenmen; CO₁₀ – Kidney; AH₆ – Sympathetic Nerve; AT₄ – Subcortex; CO₉ – Bladder; CO_I2 – Liver; AH₁₃ – Cervical Vertebrae; AH₁₁ – Thoracic Vertebrae; AH₉ – Lumbosacral Vertebrae. Authors' archive.

Fig. 2

Location of the acupoints for cupping therapy. (A) systemic acupoints – for all participants; (B) cervical region acupoints – if the pain was located in the cervical region; (C) thoracic region acupoints – if the pain was located in the thoracic region; (D) lumbar region acupoints – if the pain was located in the lumbar region. Abbreviations: LR – Liver; GB – Gall Bladder; BL – Bladder. Authors' archive.

Fig. 3

Flowchart illustrating the phases of the study, following the Consolidated Standards of Reporting Trials (CONSORT) recommendations for nonpharmacological interventions. Abbreviations: EA: ear acupuncture; C: cupping.