title: The Use of Wet Cupping for Persistent Nonspecific Low Back Pain: Randomized Controlled Clinical Trial.
abstract: OBJECTIVE
  To evaluate the effectiveness and safety of wet cupping therapy as a single treatment for persistent nonspecific low back pain (PNSLBP).
  
  
  METHODS
  Randomized controlled trial comparing wet cupping versus no treatment in PNSLBP.
  
  
  METHODS
  Outpatient clinic in three secondary care hospitals in Saudi Arabia.
  
  
  METHODS
  Eighty eligible participants with PNSLBP for at least 3 months were randomly allocated to an intervention group (n=40) or to a control group (n=40).
  
  
  METHODS
  Six wet cupping sessions within 2 weeks, each of which were done at two bladder meridian (BL) acupuncture points among BL23, BL24, and BL25. Only acetaminophen was allowed as a rescue treatment in both groups.
  
  
  METHODS
  The Numeric Rating Scale (NRS), McGill Present Pain Intensity (PPI), and Oswestry Disability Questionnaire (ODQ) were used as outcome measures. Numbers of acetaminophen tablets taken were compared at 4 weeks from baseline. Adverse events were recorded.
  
  
  RESULTS
  At the end of the intervention, statistically significant differences in the three outcome measures favoring the wet cupping group compared with the control group were seen: NRS score, 29.2 (95% confidence interval [CI], 24.6-33.8) versus 57.9 (95% CI, 53.3-62.6), respectively; PPI score, 1.17 (95% CI, 0.96-1.4) versus 2.3 (95% CI, 2.1- 2.7); and ODQ score, 19.6 (95% CI, 16.5-22.7) versus 35.4 (95% CI, 32.3-38.5) (p=0.0001). This improvement continued for another 2 weeks after the end of the intervention. Acetaminophen was used less in the wet cupping group, but this difference was not statistically significant. No adverse events were reported.
  
  
  CONCLUSIONS
  Wet cupping is potentially effective in reducing pain and improving disability associated with PNSLBP at least for 2 weeks after the end of the wet cupping period. Placebo-controlled trials are needed.
authors.affiliation: 1 National Center for Complementary and Alternative Medicine , Ministry of Health, Riyadh, Saudi Arabia .
authors.forename: Abdullah
authors.initials: A
authors.lastname: AlBedah
authors.affiliation: 1 National Center for Complementary and Alternative Medicine , Ministry of Health, Riyadh, Saudi Arabia .
authors.forename: Mohamed
authors.initials: M
authors.lastname: Khalil
authors.affiliation: 1 National Center for Complementary and Alternative Medicine , Ministry of Health, Riyadh, Saudi Arabia .|2 Faculty of Medicine, Tanta University , Tanta, Egypt .
authors.forename: Ahmed
authors.initials: A
authors.lastname: Elolemy
authors.affiliation: 1 National Center for Complementary and Alternative Medicine , Ministry of Health, Riyadh, Saudi Arabia .
authors.forename: Asim A
authors.initials: AA
authors.lastname: Hussein
authors.affiliation: 1 National Center for Complementary and Alternative Medicine , Ministry of Health, Riyadh, Saudi Arabia .
authors.forename: Meshari
authors.initials: M
authors.lastname: AlQaed
authors.affiliation: 1 National Center for Complementary and Alternative Medicine , Ministry of Health, Riyadh, Saudi Arabia .
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al Mudaiheem
authors.affiliation: 3 Orthopedic Surgery Department, King Fahad Hospital , Ministry of Health, Al Madina, Saudi Arabia .
authors.forename: Raid A
authors.initials: RA
authors.lastname: Abutalib
authors.affiliation: 4 Facharzt Orthopedy, King Fahad Hospital , Ministry of Health, Jeddah, Saudia Arabia.
authors.forename: Faisal Mohamed
authors.initials: FM
authors.lastname: Bazaid
authors.affiliation: 4 Facharzt Orthopedy, King Fahad Hospital , Ministry of Health, Jeddah, Saudia Arabia.
authors.forename: Ahmad Saeed
authors.initials: AS
authors.lastname: Bafail
authors.affiliation: 5 King Salman Hospital , Riyadh, Saudi Arabia .
authors.forename: AboBakr
authors.initials: A
authors.lastname: Essa
authors.affiliation: 4 Facharzt Orthopedy, King Fahad Hospital , Ministry of Health, Jeddah, Saudia Arabia.
authors.forename: Mohammed Yahia
authors.initials: MY
authors.lastname: Bakrain
mesh_terms: D015669:Acupuncture Points; D000328:Adult; D001815:Bloodletting / Q000379:methods*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012529:Saudi Arabia; D011795:Surveys and Questionnaires