Evaluation of wet cupping therapy with medications versus standard treatment in the management of chronic cases of unspecified low back pain - A randomised controlled clinical trial

BACKGROUND: Unspecified chronic lowback pain (UCLBP) is the most common musculoskeletal condition associated with substantial health and socioeconomic problem. UCLBP does not have a known patho-anatomical origin, thus treatment focuses on minimizing pain and its consequences. Education and reassurance, medications, nonpharmacological therapy, and timely review are all part of the management strategy. OBJECTIVE: To evaluate the efficacy of Wet Cupping Therapy with Medications versus Standard treatment in the management of chronic cases of unspecified Low Back Pain. MATERIALS AND METHODS: 134 participants of either sex, aged between 20 and 70 years, diagnosed with UCLBP were recruited for the study. The participants were divided into trial and standard group by computer generated random number software method. Trial group received two sittings of wet-cupping therapy and medications for 14 days. Control group received TENS and HMP for 7 days, acetaminophen 500 mg twice daily and exercise therapy for 14 days. Assessments of primary and secondary outcome variables were done on day 7, day 14 and follow up was done on day 21 and day 28. Inflammatory biomarkers like TNF alpha and IL 6 were analysed using ELISA. Statistical analysis was done with Chi-square test, Mann Whitney U test, Friedman's ANOVA and Wilcoxon matched pair test to assess the significance between and within group results. RESULTS: Significant results were observed (p < 0.05) in all the assessed outcome variables like VAS, NPRS, VRS, Stambha (stiffness), Gourava (heaviness), Suptata (numbness) Range of motions, Modified Oswestry disability index, Roland-Morris disability questionnaire, TNF-alpha and IL6, Quality of life assessed by SF-36 questionnaire in within group results at various time points. Comparable results were seen in between group results, in all the assessed outcome variables. CONCLUSION: Wet Cupping therapy along with medications was effective in managing the UCLBP, improved quality of life, reduced disability and inflammatory biomarkers.