This study aimed to evaluate the comparative effectiveness of “fire cupping therapy” (FC) versus electroacupuncture for reducing pain and improving cervical spine range of motion in patients with neck pain due to cervical spondylosis. FC is essentially nothing else than the TCM version of cupping.
Eighty-two participants with neck pain caused by cervical spondylosis were randomly allocated in 1:1 ratio to either the fire cupping (FC) or the electroacupuncture (EA) group. Both groups received treatment at the EX-B2, A-shi, and GB21 acupuncture points. The two-week study assessed pain levels using the Visual Analog Scale (VAS) at 2 points in time post-intervention and evaluated adverse effects weekly.
After 2 weeks of intervention, VAS scores significantly decreased in both the FC group (from 6 (6–7) to 3 (2–3)) and the EA group (from 6 (6–7) to 2 (1–3)) (p<0.001). However, inter-group pain relief was not statistically significant (p = 0.5794, Cohen’s d = 21 0.12; 95% CI [-0.31–0.6]). Both groups showed statistically significant ROM improvement (p<0.001), though the EA group demonstrated better improvement in flexion, extension, and left/right lateral flexion (p<0.05). No adverse effects of FC were reported.
The authors concluded that FC appears to be an effective and safe therapy for neck pain due to cervical spondylosis, showing similar pain relief efficacy with no statistically significant difference compared to electroacupuncture despite a lower treatment dosage. However, due to methodological limitations, these findings should be interpreted with caution and warrant further validation in rigorously designed studies.
I do agree with the authors’ call for caution – but with little else of what they state. Here are some of my concerns:
- A trial comparing two supposedly active treatments is an ‘equivalence study’; and such investigations require much larger sample sizes that 80.
- Equivalence studies only make sense, if one of the two treatments has been shown beyond doubt to be effective; this is not the case for electroacupuncture nor for FC.
- As it stands, the study does not control for placebo effects; thus the findings are in accordance with both treatments being pure placebos.
- A study with 80 patients tells us as good as nothing about the safety of the iterventions; to draw conclusions about safety is thus unwarranted
My conclusion (yet again) is this:
If you design a nonsense study, you are asking for a nonsense result.
One Response to Cupping therapy for cervical spondylosis? No!
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Athletico, a U.S. physical therapy chain, announced 2 or 3 years ago that they were adding cupping to their PT modalities. See https://www.athletico.com/services/specialty-techniques/myofascial-decompression-cupping/
For quite some time, I’ve availed myself of their services & had always found them quite mainstream: no “doctors” of chiropractic, no acupuncturists… The announcement caused me to rethink my sense that they were immune to adding nonsense to their offerings. My guess is that the decision was made for reasons of financial gain.