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. 2023 Oct 26:14:1266712.
doi: 10.3389/fneur.2023.1266712. eCollection 2023.

Efficacy of cupping therapy on pain outcomes: an evidence-mapping study

Liaoyao Wang  1 , Ziling Cai  1 , Xuanlin Li  1 , Aisong Zhu  1   2   3
Affiliations

Efficacy of cupping therapy on pain outcomes: an evidence-mapping study

Liaoyao Wang et al. Front Neurol. .

Abstract

Objective: Cupping therapy is an ancient technique of healing used to treat a variety of ailments. An evidence-mapping study was conducted to summarize the existing evidence of cupping therapy for pain-related outcomes and indicate the effect and the quality of evidence to provide a comprehensive view of what is known.

Methods: PubMed, Cochrane Library, Embase, and Web of Science were searched to collect the meta-analyses investigating the association between cupping therapy and pain-related outcomes. The methodological quality was assessed by using the AMSTAR 2 tool. Significant outcomes (p < 0.05) were assessed using the GRADE system. The summary of evidence is presented by bubble plots and human evidence mapping.

Results: Fourteen meta-analyses covering five distinct pain-related conditions were identified and assessed for methodological quality using the AMSTAR 2, which categorized the quality as critically low (36%), low (50.0%), moderate (7%), and high (7%). In accordance with the GRADE system, no high-quality evidence was found that demonstrates the efficacy of cupping therapy for pain-related outcomes. Specifically, for neck pain, there were two moderate-quality, four low-quality, and two very low-quality evidence, while only one very low-quality evidence supports its efficacy in treating herpes zoster and one low-quality evidence for chronic back pain. Additionally, for low back pain, there were two moderate-quality, one low-quality, and four very low-quality evidence, and for knee osteoarthritis, three moderate-quality evidence suggest that cupping therapy may alleviate pain score.

Conclusion: The available evidence of very low-to-moderate quality suggests that cupping therapy is effective in managing chronic pain, knee osteoarthritis, low back pain, neck pain, chronic back pain, and herpes zoster. Moreover, it represents a promising, safe, and effective non-pharmacological therapy that warrants wider application and promotion.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021255879, identifier: CRD42021255879.

Keywords: cupping therapy; evidence mapping; meta-analysis; pain-related conditions; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the literature search and screening process.
Figure 2
Figure 2
AMSTAR 2 quality assessment.
Figure 3
Figure 3
Evidence mapping of cupping therapy. KOA, knee osteoarthritis; NP, neck pain; LBP, low back pain; VAS, visual analog scale. The size of the bubbles corresponds to the total population’s sample size for the effects of cupping, with bigger bubbles representing a larger sample size. The colors symbolize the different interventions of cupping and non-cupping groups.
Figure 4
Figure 4
Grade distribution of evidence of cupping therapy for pain-related conditions.
See this image and copyright information in PMC

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