Effectiveness of Dry Cupping Therapy for Women with MS

Fatigue is one of the most common symptoms in patients with Multiple Sclerosis (MS). It can cause severe psychological problems and reduce their Quality of Life (QOL). Cupping therapy is known as a method of alternative medicine that can be used to treat or reduce patient symptoms. Thus, this randomized clinical trial was conducted to determine the effect of dry cupping therapy on the fatigue and QOL of women with MS.

It 60 patients (30 patients in each group) with MS referred to the Medical Center of Special Diseases in southeast Iran. Patients in the intervention group received eight sessions of dry cupping therapy (plus standard care) twice a week over 4 weeks, while the control group received just standard care. Data were collected before and after the intervention by using the demographic information questionnaire, the Fatigue Severity Scale, and the Multiple Sclerosis Quality of Life questionnaire. Data were analyzed using SPSS 18. The significance level was 0.05.

Thirty patients entered the study; none of them were excluded from the study, and 30 patients were finally analyzed. Before the intervention, there was no statistically significant difference between the two groups in terms of fatigue (intervention group: 47.67) 7.83); control group: 47.63) 8.76)) and QOL (intervention group: 48.85) 9.55); control group: 49.64) 9.90) (t = 0.018, p = 0.98 and t = 0.31, p = 0.75, respectively)). After performing cupping therapy in the intervention group, a significant decrease and increase were observed in the mean (SD) score of fatigue (intervention group: 34.48) 6.16); control group: 46.85 (8.95)) and QOL (intervention group: 60.14) 7.46); control group: 51.96) 9.45)), respectively (p < 0.001).

The authors concluded that cupping therapy significantly reduced the patients’ fatigue and increased their QOL. This method is recommended for reducing fatigue and improving QOL in patients with MS.

Oh dear, where to begin?

One is spoilt for choice when criticising this study, e.g.:

• A controlled trial is meant to compare the outcomes BETWEEN groups and not to calculated within-groups changes.
• The results of a single study should never be the basis for far-reaching recommendations.
• The study followed the infamous ‘A + B versus B’ design. This does not control for placebo effects and thus does not permit conclusions about a therapy per se. (For those new to the subject, I have previously dealt with this study design as nauseam. Please do a simple search of previous explanations)

In view of this, I think I ought to re-phrase the conclusions as follows:

Like most treatments, cupping therapy is associated with significant placebo effects which can significantly reduce the patients’ fatigue and increased their QOL. Studies that fail to control for placebo effects cannot tell us about the sepcific effects of medical interventions and therefore are prone to mislead the public.