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Cupping Therapy

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Ryan Hughes

on 6 December 2013

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Transcript of Cupping Therapy

Cupping Therapy
Introduction
What is cupping?
Background & Significance
· Cupping therapy is sometimes referred to as
Myofascial decompression or Vacuum therapy.

· This intervention is derived from ancient
Chinese medicine.

· The first administration recorded dates back to
281 AD in an ancient pamphlet called “Handbook of Prescriptions for Emergencies” by Ge Hong.

· The treatment originally involved heating glass cups and then applying them to the affected area. Alcohol lined in the inside of the cups or had cotton balls soaked in alcohol, and by combining fire and alcohol a suction effect is created.

· Today clinicians use suction tubing attached to either glass or plastic cups. The suction effect created by the tubing is more efficient.

Recommendations on Best Practices
Great results on the majority of chronic injuries when reducing pain

Moderate results on chronic injuries when increasing function

Good results on reducing pain for acute muscular injuries such as Erector Spinae or Quadratus Lumborum pain

Not recommended for acute ligamentous injuries with swelling such as an ankle sprain
References
The Evidence
Reference Group 1
Kim T., Kang J., Kim K., Lee M., Kim J., Kim J., Lee S., Jung S., Kim A., Park H., Hong K. (July 23, 2012). Cupping for treating neck pain in video display terminal (VDT) users: A Randomized Controlled Pilot Trial. Journal of Occupational Health 2012; 54: p416-426.https://www.jstage.jst.go.jp/article/joh/54/6/54_12-0133-OA/_pdf

Citation: Lauche R., Cramer H., Hohmann, C., Choi K., Rampp T., Saha F., Dobos G., Musial F., Langhorst, J.(2011) The Effect of Traditional Cupping on Pain and Mechanical Thresholds in Patients with Chronic Nonspecific Neck Pain: A Randomised Controlled Pilot Study. Evidence-Based Complementary and Alternative Medicine. 2011, 20.http://www.biomedcentral.com/1472-6882/11/63
Reference Group 2
Teut M., Kaiser S., Ortiz M., Roll S., Binting S., Willich S., Brinkhaus B. (October 2012).Pulsatile dry cupping in patients with osteoarthritis of the knee – a randomized controlled exploratory trial. BMC complementary & Alternative Medicine. 2012; 12: 184http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3527288/

Huijuan Cao, Mei Han, Xun Li, Shangjuan Dong, Yongmei Shang, Qian Wang,
Shu Xu, Jianping Liu (2010) Clinical research evidence of cupping therapy in China: a
systematic literature review BMC Complementary & Alternative Medicine http://
www.biomedcentral.com/1472-6882/10/70

Reference Group 3
Michalsen A., Bock S., Ludtke R., Rampp T., Baecker M., Bachmann., Langhorst J., Musial F., Dobos G. (June 2009). Effects of traditional cupping therapy in patients with carpal tunnel syndrome: A randomized control trial. The journal of pain. Volume 10:6, pages 601-608


Level 2a - Example
- Cupping originates from China
- It's an ancient Chinese method that causes local congestion
- It resembles a vacuum that is created by cups placed on the skin
- The suction by heat or blood stasis draws blood into the underlying tissue causing localized healing to take place
- Cupping is also said to open the meridians of the body which allow energy to flow throughout the bodies organs and tissue

Benefits
Cupping Therapy can penetrate up to four inches into the tissue that causes:

- Tissues to release toxins
- Activates the lymphatic system
- Clear colon blockages
- Helps activate and clear veins, arteries and capillaries
- Activates the skin
- Helps clear stretch marks
- Improves varicose veins

But most importantly for the Athletic Training community:

- It helps reduce pain, increase function and increase blood flow for tissue healing.
More significance
· In modern medicine it has shown to penetrate the body up to four inches into the tissue.

· One treatment of cupping therapy ranges between 3-5 minutes, and according to research it shows a significant decrease in pain with patients dealing with acute or chronic injuries.

· Cupping also creates less stress on the hands of the clinician since most of the work is being done via the cups.

· Relating to athletic training this intervention is more time efficient and also produces clinically significant results.



Certification
Certification for this intervention is not as expensive as other soft treatment certifications. With a certification comes the case full of various size cups as well as the tubing. The main company that certifies professionals in cupping is cuptherapy.com in the San Francisco area.



There are 4 pieces of evidence that were selected


- 2 selections of level 2a (systematic review)

- 2 selections of level 2b (randomized control trial)



1. Jon-In-Kim (2011)

Systematic Review included 7 RCTs
· The inclusion criteria consisted of studies on cupping treating any form of pain of any origin. Studies using dry or wet cupping on any age or sex also included. Criteria for eligibility is simply being diagnosed with pain.

· The evidence reveals similar results from study to study. Wet cupping revealed in some studies to be more effective when compared to dry cupping. P values are all less than .065. Confidence intervals were calculated to be 95% using Cochrane Collaboration software.



Level 2b - Example
Lauche R. (2011)

· Randomized Control Trial designed to study the effect of traditional cupping therapy on chronic nonspecific neck pain and mechanical sensory thresholds.

· 45/50 individuals completed the study

· There was no blinding of patients or the clinician

· Results revealed after a single application of cupping, the treatment group showed a significant reduction in their symptoms. The pain measures (PR, PM, PaDi) revealed the significant difference between the treatment and control group

· The ANOVA model estimated the data collected and yielded a 95% CI.

· While there were many measurements of pain, there were no measurements of other aspects such as range of motion and the loss/gain of function of the neck.

· The study admits the need to create a sham treatment to administer to the control groups.

Citation: Lauche R., Cramer H., Hohmann, C., Choi K., Rampp T., Saha F., Dobos G., Musial F., Langhorst, J.(2011) The Effect of Traditional Cupping on Pain and Mechanical Thresholds in Patients with Chronic Nonspecific Neck Pain: A Randomised Controlled Pilot Study. Evidence-Based Complementary and Alternative Medicine. 2011, 20.http://www.biomedcentral.com/1472-6882/11/63
Citation:
Kim, J. , Lee, M. , Lee, D. , Boddy, K. , & Ernst, E. (2011). Cupping for treating pain: A systematic review. Evidence based Complementary and Alternative Medicine : ECAM, 2011, 467014-467017.
Video of Cupping
Courtesy of Pepperdine Athletic Training Clinic and Shane Besedick
Conclusion
- We have found by combining the evidence from systematic reviews & RTC's as well as tradition, experience and patient feedback that cupping can have a dramatic reduction in pain as well as an increase in function. We also find that cupping has great clinical significance in a variety of settings.
Precautions
- lubricant such as a massage cream should be used
- always sanitize between each use and patient
- It is normal for discoloration to appear on the skin where the cup was place, this will go away in a few days
- Do not use cupping on inflammed or cut skin
You should stop taking Aspirin (Ascard, Loprin etc.), warfarin, clopidogrel or any other blood thinning drug 24 hours before cupping.
- Cupping is not appropriate for patients with too high blood pressure, heart diseases, congestive heart failure and respiratory failure.
Priscilla Cabrera
Molly Herrera
Juan Hernandez
Ryan Hughes

PICO Question
"Is cupping therapy an effective treatment for improving function and decreasing pain in any patient with chronic pain compared to no treatment at all"
Full transcript