Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
John Cavenagh, MBA, PhD, PA-C
Objective: The objective of this selective EBM review is to determine whether or not “Is wet cupping effective in decreasing persistent nonspecific low back pain in adults?”
Study Design: Review of 3 RCTs published between 2009- current, all in the English language.
Data Sources: Three RCTs analyzed the effectiveness of wet cupping on the reduction of persistent nonspecific low back pain (PNSLBP) compared to a control group using other various analgesic therapies. All studies were found on EBSCOhost and were selected based on relevance to the question and being a POEM.
Outcomes measured: All of the articles analyzed the effectiveness of wet cupping in decreasing persistent nonspecific low back pain. The Present Pain Intensity Scale (PPI), Medication Quantification Scale (MQS), Oswestry Disability Questionnaire/Index (ODQ/ODI), and Numeric Rating Scale (NRS). Statistical significance was measured using ANCOVA, Wilcoxon rank-sum test, independent t tests, and NNT.
Results: All 3 studies showed a statistically significant decrease in low back pain post intervention on at least one measured outcome. Farhadi et al1 found a statistically significant change (p<0.01) on all 3 scales at 3 months post intervention. Albedah et al3 also found that there was a statistically significant decrease in low back pain (p=0.0001) on all 3 scales at both primary end point and follow up. Kim et al2 showed that this decrease was not significant on the NRS scale, both at primary end point (p=0.37) and follow up (p=0.15), as well as the ODQ scale at both points of analysis (p>0.05). There was a significant decrease in low back pain on the PPI scale at both primary end point and follow up (p<0.01).
Conclusion: The RCTs discussed in this review suggest that wet cupping may be an effective treatment for PNSLBP. The inconclusive results in Kim et al complicate the ability to confirm or rebut the hypothesis. Further studies are also warranted to implement a placebo effect, determine the number of sessions for maximum length of analgesia, as well as utilize wet cupping as an additional treatment to other forms of therapeutic modalities.
Marshall, Emily C., "Is wet cupping effective in decreasing persistent nonspecific low back pain in adults?" (2018). PCOM Physician Assistant Studies Student Scholarship. 333.