Effectiveness of Home-Based Cupping Massage Compared to Progressive Muscle Relaxation in Patients with Chronic Neck Pain—A Randomized Controlled Trial

Abstract

Chronic neck pain is a major public health problem with very few evidence-based complementary treatment options. This study aimed to test the efficacy of 12 weeks of a partner-delivered home-based cupping massage, compared to the same period of progressive muscle relaxation in patients with chronic non-specific neck pain. Patients were randomly assigned to self-directed cupping massage or progressive muscle relaxation. They were trained and asked to undertake the assigned treatment twice weekly for 12 weeks. Primary outcome measure was the current neck pain intensity (0–100 mm visual analog scale; VAS) after 12 weeks. Secondary outcome measures included pain on motion, affective pain perception, functional disability, psychological distress, wellbeing, health-related quality of life, pressure pain thresholds and adverse events. Sixty one patients (54.1±12.7 years; 73.8%female) were randomized to cupping massage (n = 30) or progressive muscle relaxation (n = 31). After treatment, both groups showed significantly less pain compared to baseline however without significant group differences. Significant effects in favor of cupping massage were only found for wellbeing and pressure pain thresholds. In conclusion, cupping massage is no more effective than progressive muscle relaxation in reducing chronic non-specific neck pain. Both therapies can be easily used at home and can reduce pain to a minimal clinically relevant extent. Cupping massage may however be better than PMR in improving well-being and decreasing pressure pain sensitivity but more studies with larger samples and longer follow-up periods are needed to confirm these results.Trial RegistrationClinicalTrials.gov NCT01500330

Relaxation and chronic pain: A critical review

“…Reduction of pain was found in three of the studies as a result of the relaxation intervention (Baird and Sands, 2004;Poole et al, 2007;Lauche et al, 2013), although the only one to show significant differences between study groups was Baird and Sands (2004). While all three applied the progressive muscle relaxation method, described by Jacobson (1938), the intervention delivered by Baird and Sands (2004) also included a personalised guided imagery relaxation script (Bowering et al, 2013).…”

The Effect of Cupping Therapy on Non-specific Neck Pain: A Systematic Review and Meta-Analysis

“…A total of 27 studies were excluded, as they did not have sufficient data for inclusion. Of these, 10 randomized trials were included in the systematic review and meta-analysis (23,(26)(27)(28)(29)(30)(31)(32)(33)(34). The search strategy and method of study selection is defined in Figure 1.…”

“…All studies adopted a two-armed parallel group design. Changes of VAS as the primary outcome of study were reported in 5 trials (26,(28)(29)(30)32). Six trials calculated the change in the Neck disability index (NDI) (23,26,28,(30)(31)(32).…”

“…The majority of patients were females with chronic nonspecific neck pain. Interventions included dry cupping (27,28,30,33,34), traditional cupping (26), massage cupping (29), and pulsating cupping (32). Two trials employed both dry and wet cupping in the intervention group (23,31).…”

“…One RCT (n = 40) compared cupping with heating pad application (23). Another RCT compared dry cupping with muscle relaxation in patients with non-specific neck pain (n = 40) (29). In 9 trails, the duration of treatment ranged from 2 to 3 13 weeks.…”