Medicine (Baltimore). 2026 Nov 13;105(46):e51486. doi: 10.1097/MD.0000000000051486.
ABSTRACT
BACKGROUND: Moving cupping is used to reduce pain and muscle tension in chronic low back pain (CLBP), but its effect on paraspinal muscle stiffness has not been compared with that of a sham procedure. We evaluated it using shear wave elastography (SWE).
METHODS: In this single-center, sham-controlled randomized trial, 68 adults with CLBP were assigned 1:1 by computer-generated simple randomization to moving cupping or sham cupping (four sessions over 2 weeks; 18-20 kPa vs 0 kPa). The 66 participants who received the allocated intervention had a mean age of 37.8 ± 9.0 years, and 71.2% were female. Assessors and the analyst were blinded. The primary endpoint was the change in multifidus shear modulus from baseline to the end of treatment; secondary outcomes included shear modulus at 1-week follow-up, pain intensity, Oswestry Disability Index (ODI), EQ-5D-5L, and Patient Global Assessment. Intention-to-treat analyses used linear mixed-effects models; a per-protocol mixed 2-way analysis of variance served as a sensitivity analysis.
RESULTS: A significant group × time interaction was observed for shear modulus (P < .001), as the decrease was greater with moving cupping (60.23 ± 14.83 to 10.84 ± 5.67 kPa) than with sham (57.54 ± 11.09 to 39.41 ± 9.84 kPa). At follow-up, shear modulus was 15.42 ± 7.41 vs 44.88 ± 14.22 kPa, and the change after treatment did not differ significantly between groups (P = .808). Pain also showed a significant group × time interaction (P < .001; moving cupping, 5.68 ± 1.41 to 2.44 ± 1.56; sham, 5.41 ± 1.18 to 3.41 ± 1.26), whereas ODI (P = .579) and EQ-5D-5L (P = .162) did not. No cupping-related adverse events occurred.
CONCLUSIONS: Two weeks of moving cupping reduced multifidus stiffness more than sham cupping, and the difference persisted 1 week after treatment. Pain decreased more with moving cupping, although the between-group difference was small, and there were no significant effects on disability or quality of life. Moving cupping may reduce paraspinal muscle stiffness but is not an established treatment for the broader symptom burden of CLBP.
PMID:43024291 | DOI:10.1097/MD.0000000000051486
