title: Evaluation of wet-cupping therapy for persistent non-specific low back pain: a randomised, waiting-list controlled, open-label, parallel-group pilot trial.
abstract: BACKGROUND
  Persistent non-specific low back pain (PNSLBP) is one of the most frequently experienced types of back pain around the world. Wet-cupping is a common intervention for various pain conditions, especially in Korea. In this context, we conducted a pilot study to determine the effectiveness and safety of wet-cupping treatment for PNSLBP.
  
  
  METHODS
  We recruited 32 participants (21 in the wet-cupping group and 11 in the waiting-list group) who had been having PNSLBP for at least 3 months. The participants were recruited at the clinical research centre of the Korea Institute of Oriental Medicine, Korea. Eligible participants were randomly allocated to wet-cupping and waiting-list groups. Following the practice of traditional Korean medicine, the treatment group was provided with wet-cupping treatment at two acupuncture points among the BL23, BL24 and BL25 6 times within 2 weeks. Usual care, including providing brochures for exercise, general advice for PNSLBP and acetaminophen, was allowed in both groups. Separate assessors participated in the outcome assessment. We used the 0 to 100 numerical rating scale (NRS) for pain, the McGill Pain Questionnaire for pain intensity (PPI) and the Oswestry Disability Questionnaire (ODQ), and we assessed acetaminophen use and safety issues.
  
  
  RESULTS
  The results showed that the NRS score for pain decreased (-16.0 [95% CI: -24.4 to -7.7] in the wet-cupping group and -9.1 [-18.1 to -0.1] in the waiting-list group), but there was no statistical difference between the groups (p = 0.52). However, the PPI scores showed significant differences between the two groups (-1.2 [-1.6 to -0.8] for the wet-cupping group and -0.2 [-0.8 to 0.4] for the waiting-list group, p < 0.01). In addition, less acetaminophen was used in the wet-cupping group during 4 weeks (p = 0.09). The ODQ score did not show significant differences between the two groups (-5.60 [-8.90 to -2.30] in the wet-cupping group and -1.8 [-5.8 to 2.2] in the waiting-list group, p = 0.14). There was no report of adverse events due to wet-cupping.
  
  
  CONCLUSIONS
  This pilot study may provide preliminary data on the effectiveness and safety of wet-cupping treatments for PNSLBP. Future full-scale randomised controlled trials will be needed to provide firm evidence of the effectiveness of this intervention.
authors.affiliation: Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.
authors.forename: Jong-In
authors.initials: JI
authors.lastname: Kim
authors.forename: Tae-Hun
authors.initials: TH
authors.lastname: Kim
authors.forename: Myeong Soo
authors.initials: MS
authors.lastname: Lee
authors.forename: Jung Won
authors.initials: JW
authors.lastname: Kang
authors.forename: Kun Hyung
authors.initials: KH
authors.lastname: Kim
authors.forename: Jun-Yong
authors.initials: JY
authors.lastname: Choi
authors.forename: Kyung-Won
authors.initials: KW
authors.lastname: Kang
authors.forename: Ae-Ran
authors.initials: AR
authors.lastname: Kim
authors.forename: Mi-Suk
authors.initials: MS
authors.lastname: Shin
authors.forename: So-Young
authors.initials: SY
authors.lastname: Jung
authors.forename: Sun-mi
authors.initials: SM
authors.lastname: Choi
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D015669:Acupuncture Points; D015670:Acupuncture Therapy / Q000009:adverse effects; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010865:Pilot Projects; D056910:Republic of Korea; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen