The Optimal Treatment Time Of Dry Cupping Therapy To Induce Changes In Local Blood Flow At The Upper Trapezius


Context: Musculoskeletal neck and shoulder pain is a prevalent condition with nearly two-thirds of the population experiencing it sometime in their lifespan; factors may include activity level, sex, stress, and postural deficits. The treatment varies, but recent focus is on complementary and alternative medicine. Cupping therapy is a type of alternative medicine that involves a cup placed on the skin secured by suction for an unspecified amount of time. This therapy has been around for thousands of years, but there is much speculation around its true mechanisms on the human body; theories indicate that cupping therapy has an effect on blood flow, inflammation, and pain. Additionally, there has not been pre-defined parameters for the treatment of musculoskeletal pain conditions. Objective: The purpose of this study was to examine if different dry cupping treatment times altered changes in superficial and deep subcutaneous tissue hemodynamics. Design: Single-blinded, randomized crossover study Setting: Athletic Training Laboratory Participants: Thirty-two participants volunteered for this study. Participants were included if they were healthy individuals with non-specific neck pain. Participants were excluded if they had cupping therapy or any treatment performed within the past three months to the neck or shoulder area; history of head, neck, or shoulder injury within the past six months resulting in medical care; known blood clotting disorder; allergy to lubricant; or the following medical conditions: hypertension, diabetes, cancer, pregnancy, cardiac failure, renal failure, allergic purpura, hernia, psoriasis, eczema, rosacea, varicose veins, phlebitis, hepatocirrhosis, allergic dermatitis, sunburn, open wound, fever, or were taking anticoagulants. Interventions: Dry cupping therapy for 5, 7.5, and 10 minutes. Participants were randomly assigned to an intervention group using block randomization. Outcome Measures: Subcutaneous hemodynamics (superficial and deep oxygenated, deoxygenated, and total hemoglobin) were collected and exported using the Near Infrared Spectroscopy (NIRS) Portamon. Change scores were calculated between baseline and immediate post-intervention, immediate and 10 minutes post-intervention, and baseline and 10 minutes post-intervention measurements. Statistical analyses were completed using repeated measures ANOVAs to compare changes in subcutaneous hemodynamics following different treatment times (5, 7.5, and 10 minutes). Results: There was a main effect for superficial and deep oxygenated, deoxygenated, and total hemoglobin (p ≤ 0.001). Post hoc analyses revealed that all treatment times increased hemoglobin levels immediately after intervention and maintained this increase over the 10- minute period for oxygenated and total hemoglobin levels. Conclusions: Dry cupping therapy increases deep and superficial oxygenated, deoxygenated, and total hemoglobin levels at treatment times of 5, 7.5, and 10 minutes. This indicates that clinicians may be able to apply cupping therapy for a shorter period of time and maintain a significant increase in blood flow at the upper trapezius.