Wet Cupping; Traditional Hijamah Technique versus Asian Cupping Technique in Chronic Low Back Pain Patients: Pilot Randomized Clinical Trial

Abstract Background Low back pain is a common complaint worldwide. Wet cupping (Al-Hijamah) therapy, which is one of the common traditional therapies in Saudi Arabia, Asia, and some European countries, is usually used to relieve low back pain. However, the majority of high-quality wet cupping trials were conducted in Asia and Europe, where they use a different cupping technique compared to our local wet cupping technique in Saudi Arabia. Objectives The objective of the study was to evaluate the feasibility of comparing the effect of the traditional Hijamah and the Asian wet cupping techniques in the management of patients with chronic low back pain. Design This is a randomized clinical trial comparing traditional versus Asian wet cupping techniques for CLBP. Setting The study setting was the outpatient clinics in two secondary care hospitals in Saudi Arabia. Patients Seventy eligible participants with CLBP for at least three months were randomly allocated to either traditional cupping group (34) or the Asian cupping group (36). Intervention Participants were randomized to receive one session of wet cupping using either the Asian technique or traditional Hijamah technique. Cupping was done at four sites of the bilateral Bladder Meridian (BL 23, BL24, and BL25). Outcome measures The Numeric Rating Scale, Present Pain Intensity, and Oswestry Disability Questionnaire scores were measured immediately after intervention, at seven days, and 14 days after intervention. Results In both groups, there was a significant decrease in Numeric Rating Scale, Present Pain Intensity, and Oswestry Disability Questionnaire, immediately after intervention and at seven days, and 14 days after the intervention. However, there was no significant difference between the two groups across all the outcome measures up to 14 days after intervention. Conclusions The study did not show a superiority of one technique compared to the other. Longer follow-up periods and more than one cupping session may be needed to evaluate the difference, if any, between both techniques. Trial registration NCT02012205 .