Effects of Chinese Cupping as an Adjunct Treatment for Patients with Subacute Low Back Pain on Relieving Pain, Improving Range of Motion, and Improving Function

Alycia Markowski, DPT, MPhySt, OCS,1 Susan Sanford, PT, LAc, MAc,2 Jenna Pikowski, DPT,1
Daniel Fauvell, DPT,1 David Cimino, DPT,1 and Scott Caplan, DPT1
Abstract
Background: Cupping, a classic Chinese medicine treatment, is a technique that applies suction cups over soft
tissue. Cupping is gaining popularity in physical medicine because of the simplicity in application, minimal
adverse effects, and reduction in pain and muscle tenderness. These factors also make it a cost-effective intervention.
For this study, cupping was used to treat low back pain (LBP).
Objective: To evaluate the effectiveness of Chinese cupping in acutely reducing pain, decreasing tenderness to
palpation, and improving range of motion for patients with subacute or chronic LBP.
Patients/Setting: Twenty-one patients who reported back pain for at least 8 weeks volunteered at a multidisciplinary
holistic outpatient clinic.
Intervention: After completion of a medical screening questionnaire and collection of baseline data, 4 glass cups
were applied and pressurized over the lower erector spinae muscles.
Outcome Measurements: Baseline data included demographic characteristics and the Oswestry Disability Questionnaire
score. Pre- and postintervention data included perceived pain on a visual analog scale (VAS), lumbar
spine range of motion, straight-leg raise test (SLR), and pain-pressure threshold (PPT) assessed with a digital force
gauge. The data were analyzed by using a Wilcoxon signed-rank test and Spearman rho correlations.
Results: Of the 17 patients who completed the study, there were significant post-treatment improvements in
VAS scores ( p = 0.0001), SLR motion on the left ( p = 0.043), and lumbar flexion range of motion ( p = 0.016) and
improvements in PPT at all 4 investigated points ( p < 0.007). Significant relationships were identified between
the improvement in low back flexion with the improvement in PPT at bilateral lumbar paraspinal muscles at the
L4 levels and at the left L2 level.
Conclusions: Chinese cupping may be a low-risk, therapeutic treatment for the prompt reduction of symptoms
associated with subacute and chronic low back pain. Cupping may allow patients to progress to functional
movement training in a timely manner by promptly reducing pain and muscle tenderness and improving range of motion.

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