What are the effects of dry cupping therapy combined with the McKenzie method on clinical outcomes in chronic low back pain? A protocol for a randomized, sham-controlled trial

Abstract Background Although exercise is a first-line approach to treating chronic low back pain (CLBP) in clinical practice, passive techniques such as dry cupping therapy are considered complementary to this condition. However, knowledge about the effects of combining dry cupping therapy with acti...

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Main Authors: Kimberly Moreira Pereira da Silva, Hugo Jario Almeida Silva, André Pontes-Silva, Josimari Melo DeSantana, Mariana Arias Avila, Germanna Medeiros Barbosa, Marcelo Cardoso de Souza
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Complementary Medicine and Therapies
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Online Access:https://doi.org/10.1186/s12906-025-04940-9
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author Kimberly Moreira Pereira da Silva
Hugo Jario Almeida Silva
André Pontes-Silva
Josimari Melo DeSantana
Mariana Arias Avila
Germanna Medeiros Barbosa
Marcelo Cardoso de Souza
author_facet Kimberly Moreira Pereira da Silva
Hugo Jario Almeida Silva
André Pontes-Silva
Josimari Melo DeSantana
Mariana Arias Avila
Germanna Medeiros Barbosa
Marcelo Cardoso de Souza
author_sort Kimberly Moreira Pereira da Silva
collection DOAJ
description Abstract Background Although exercise is a first-line approach to treating chronic low back pain (CLBP) in clinical practice, passive techniques such as dry cupping therapy are considered complementary to this condition. However, knowledge about the effects of combining dry cupping therapy with active exercises in people with non-specific CLBP is shallow. Objective To evaluate the effects of dry cupping therapy with the McKenzie method (MDT) on disability and functional outcomes in people with non-specific CLBP. Methods Eighty-eight people with non-specific CLBP aging 18 to 59 years will be recruited and evaluated for inclusion and exclusion criteria. Participants will be randomized into intervention (MDT and dry cupping therapy) or sham group (MDT and sham dry cupping therapy). Dry cupping therapy will be applied bilaterally to the vertebrae (L1 to L5). Interventions will be performed twice a week for eight weeks, and participants will be assessed before treatment (T0), immediately after the first intervention (T1), and at four (T4) and eight weeks of intervention (T8). Primary outcomes will be disability (Oswestry Disability Index). Secondary outcomes will be functionality (Timed Up and Go Test), pain (Numeric Pain Rating Scale), trunk range of motion (Toe-touch Test) and participant expectation and perception (Global Perceived Effect Scale). Discussion Despite recent research, there is no consensus in the literature regarding the effectiveness of dry cupping therapy in the treatment of people with non-specific CLBP. Also, no study with high methodological rigor has evaluated the combination of dry cupping therapy with active exercise in this population and whether this combination potentiates any clinical effect. Thus, this protocol may guide further research to support the prescription of exercise combined with dry cupping therapy in people with non-specific CLBP. The results of the study will be disseminated to participants through social networks and will be submitted to a peer-reviewed journal and scientific meetings. Trial registrations ClinicalTrials.gov, October, 2023 (report number: NCT05459376).
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spelling doaj-art-ee6e4b99e9a94427870059079877fb3d2025-08-20T03:03:23ZengBMCBMC Complementary Medicine and Therapies2662-76712025-07-0125111110.1186/s12906-025-04940-9What are the effects of dry cupping therapy combined with the McKenzie method on clinical outcomes in chronic low back pain? A protocol for a randomized, sham-controlled trialKimberly Moreira Pereira da Silva0Hugo Jario Almeida Silva1André Pontes-Silva2Josimari Melo DeSantana3Mariana Arias Avila4Germanna Medeiros Barbosa5Marcelo Cardoso de Souza6Faculty of Health Sciences of Trairi, Postgraduate Program in Rehabilitation Sciences, Federal University of Rio Grande do NortePostgraduate Program in Physical Therapy, Department of Physical Therapy, Federal University of São CarlosPostgraduate Program in Physical Therapy, Department of Physical Therapy, Federal University of São CarlosLaboratory of Research on Neuroscience (LAPENE), Physical Therapy Department, Federal University of SergipePostgraduate Program in Physical Therapy, Department of Physical Therapy, Federal University of São CarlosFaculty of Health Sciences of Trairi, Postgraduate Program in Rehabilitation Sciences, Federal University of Rio Grande do NorteDepartamento de Fisioterapia, Universidade Federal do Rio Grande do NorteAbstract Background Although exercise is a first-line approach to treating chronic low back pain (CLBP) in clinical practice, passive techniques such as dry cupping therapy are considered complementary to this condition. However, knowledge about the effects of combining dry cupping therapy with active exercises in people with non-specific CLBP is shallow. Objective To evaluate the effects of dry cupping therapy with the McKenzie method (MDT) on disability and functional outcomes in people with non-specific CLBP. Methods Eighty-eight people with non-specific CLBP aging 18 to 59 years will be recruited and evaluated for inclusion and exclusion criteria. Participants will be randomized into intervention (MDT and dry cupping therapy) or sham group (MDT and sham dry cupping therapy). Dry cupping therapy will be applied bilaterally to the vertebrae (L1 to L5). Interventions will be performed twice a week for eight weeks, and participants will be assessed before treatment (T0), immediately after the first intervention (T1), and at four (T4) and eight weeks of intervention (T8). Primary outcomes will be disability (Oswestry Disability Index). Secondary outcomes will be functionality (Timed Up and Go Test), pain (Numeric Pain Rating Scale), trunk range of motion (Toe-touch Test) and participant expectation and perception (Global Perceived Effect Scale). Discussion Despite recent research, there is no consensus in the literature regarding the effectiveness of dry cupping therapy in the treatment of people with non-specific CLBP. Also, no study with high methodological rigor has evaluated the combination of dry cupping therapy with active exercise in this population and whether this combination potentiates any clinical effect. Thus, this protocol may guide further research to support the prescription of exercise combined with dry cupping therapy in people with non-specific CLBP. The results of the study will be disseminated to participants through social networks and will be submitted to a peer-reviewed journal and scientific meetings. Trial registrations ClinicalTrials.gov, October, 2023 (report number: NCT05459376).https://doi.org/10.1186/s12906-025-04940-9Chronic painComplementary therapiesExercise therapy
spellingShingle Kimberly Moreira Pereira da Silva
Hugo Jario Almeida Silva
André Pontes-Silva
Josimari Melo DeSantana
Mariana Arias Avila
Germanna Medeiros Barbosa
Marcelo Cardoso de Souza
What are the effects of dry cupping therapy combined with the McKenzie method on clinical outcomes in chronic low back pain? A protocol for a randomized, sham-controlled trial
BMC Complementary Medicine and Therapies
Chronic pain
Complementary therapies
Exercise therapy
title What are the effects of dry cupping therapy combined with the McKenzie method on clinical outcomes in chronic low back pain? A protocol for a randomized, sham-controlled trial
title_full What are the effects of dry cupping therapy combined with the McKenzie method on clinical outcomes in chronic low back pain? A protocol for a randomized, sham-controlled trial
title_fullStr What are the effects of dry cupping therapy combined with the McKenzie method on clinical outcomes in chronic low back pain? A protocol for a randomized, sham-controlled trial
title_full_unstemmed What are the effects of dry cupping therapy combined with the McKenzie method on clinical outcomes in chronic low back pain? A protocol for a randomized, sham-controlled trial
title_short What are the effects of dry cupping therapy combined with the McKenzie method on clinical outcomes in chronic low back pain? A protocol for a randomized, sham-controlled trial
title_sort what are the effects of dry cupping therapy combined with the mckenzie method on clinical outcomes in chronic low back pain a protocol for a randomized sham controlled trial
topic Chronic pain
Complementary therapies
Exercise therapy
url https://doi.org/10.1186/s12906-025-04940-9
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