Cupping therapy is a promising modality to be used as a complementary therapy for chronic diseases. It may improve the symptoms and quality of life of patients. There is a need for more studies regarding the efficacy and safety of cupping therapy in the treatment of chronic diseases to build a solid scientific evidence regarding this topic.

1. CUPPING THERAPY
FOR CHRONIC
DISEASES
Dr. Tamer S. AbouShanab

2. objectives
To give a brief illustration about:
• Cupping therapy types
• Cupping therapy effects
• Defining chronic diseases
• Cupping for asthma
• Cupping for chronic pain conditions
• Cupping for hypertension
• Cupping for diabetes
• Conclusion

3. Classification of cupping therapy types

4. Classification of cupping therapy effects

5. Chronic diseases
• Chronic diseases are defined by CDC broadly as conditions
that last 1 year or more and require ongoing medical attention
or limit activities of daily living or both. Chronic diseases such
as heart disease, cancer, and diabetes are the leading causes
of death and disability in the United States. They are also
leading drivers of the nation’s $3.3 trillion in annual health care
costs.
• Many chronic diseases are caused by a short list of risk
behaviors:
• Tobacco use and exposure to secondhand smoke.
• Poor nutrition, including diets low in fruits and vegetables and
high in sodium and saturated fats.
• Lack of physical activity.
• Excessive alcohol use.

6. Burden of chronic diseases
• The World Health Report 2002: “Reducing risks,
promoting healthy life, indicates that the mortality,
morbidity and disability attributed to the major chronic
diseases currently account for almost 60% of all deaths
and 43% of the global burden of disease. By 2020 their
contribution is expected to rise to 73% of all deaths and
60% of the global burden of disease. Moreover, 79% of
the deaths attributed to these diseases occur in the
developing countries.”

7. Cupping For Asthma
• Cupping therapy may
1. Improve airway permeability,
2. Improve pulmonary
hemodynamics,
3. Improve the functional state of
respiratory muscles. [1]
4. Anti-inflammatory effect. [2]
5. Immunomodulatory effect.[3]
1-Elena A.Shevchenko, adim Buevich, Elena E.Kalashnikova, Iraida G.Menshikova, Irina V.Skliar, and Marina Loevets.
Acupuncture In The Treatment Of Patients With Chronic Obstructive Bronchitis: A Randomized Controlled Trial. Medical
acupuncture Journal 16[3], 14-18. 2005.
2-Jun Tao Feng, Cheng Ping Hu, Xiao Zhao Li. Dorsal root ganglion: The target of acupuncture in the treatment of asthma.
Advances in Therapy journal, Volume 24, Issue 3, P 598-601. DOI - 10.1007/BF02848784
3-Stefanie Joos, Claus Schott, Hua Zou, Volker Daniel, Eike Martin. Immunomodulatory Effects of Acupuncture in the
Treatment of Allergic Asthma: A Randomized Controlled Study. The Journal of Alternative and Complementary Medicine.
December 2000, 6 [6]: 519-525. doi:10.1089/acm.2000.6.519.

8. Cupping For Asthma
• MY Thesis Title: The Role of Cupping Therapy As A
Complementary Therapy On The Pulmonary
Functions And Quality Of Life Of Asthmatic Children
• Aim: The aim of this study was to evaluate the
effectiveness of flash cupping therapy as a
complementary therapy for the treatment of asthmatic
children and adolescent in a randomized controlled trial.
Aboushanab TS. The role of cupping therapy as a complementary therapy on the pulmonary functions and quality of life of asthmatic
children (Doctoral dissertation, Master thesis. Egypt: Childhood Postgraduate Institute. Ain Shams University).

9. Cupping For Asthma
• Methods: Sixty out-patients [8-15 years] with confirmed
mild persistent asthma according to criteria of global
strategy for asthma management and prevention were
randomly assigned either to a treatment group [flash
cupping therapy + standard asthma medications] [n=30]
or a control group[standard asthma medications] [n=30].
Pediatric Quality of Life Questionnaire and Pulmonary
functions [FEV1, FVC, FEV1/FVC Ratio, FEF 25%-75%]
were measured before and after the treatment for both
groups.
Aboushanab TS. The role of cupping therapy as a complementary therapy on the pulmonary functions and quality of life of
asthmatic children (Doctoral dissertation, Master thesis. Egypt: Childhood Postgraduate Institute. Ain Shams University).

10. Cupping For Asthma
• Results:
Improvement in all
measured pulmonary
function tests [FEV1,
FVC, FEV1/FVC and
FEF 25%- 75%],
improvement in most
of clinical symptoms,
and improvement of
pediatric quality of
life questionnaire
were found to be
significantly higher in
treatment group than
in control group [p-
value < 0.05].
0
10
20
30
40
50
60
70
Cough Wheezes Noctornal
Symptoms
Use of Risk
Medication
Treatment Group
Control Group
Aboushanab TS. The role of cupping therapy as a complementary therapy on the pulmonary functions and quality of life of
asthmatic children (Doctoral dissertation, Master thesis. Egypt: Childhood Postgraduate Institute. Ain Shams University).

11. Cupping for Diabetes
• Cupping may:
1. Decrease serum glucose
(fasting and 2 hours
postprandial) and TG in
patient with diabetes (1,2)
2. Anti-Oxidant (1)
1-Ramazani M, Shariatzadeh SM, CHANGIZI AS, MALEKI RA, Akbari A, Shariatzadeh SM. Effect of cupping on blood factors and
oxidative stress in diabetes type II.
2-ALSHOWAFI FK. Effect of blood cupping on some biochemical parameter. The Medical Journal of Cairo University. 2010;78(2).

12. Cupping for hypertension
• Cupping may:
1. Reduce systolic and diastolic pressure,
2. Decrease in serum total cholesterol,
3. Decrease in serum triglycerides
4. Decrease in serum low density
lipoproteins. (1)
• In a recent systematic review by (Lu et al,
2018), included Seven randomized trials, most
not of high methodological quality.
• Conclusion: Although cupping is a safe
therapy, no firm conclusions can be drawn and
no clinical recommendations made.(2)
1-ALSHOWAFI FK. Effect of blood cupping on some biochemical parameter. The Medical Journal of Cairo
University. 2010;78(2).
2-Lu S, Du S, Fish A, Tang C, Lou Q, Zhang X. Wet cupping for hypertension: a systematic review and meta-
analysis. Clinical and Experimental Hypertension. 2018 Sep 5:1-7.

13. Cupping for chronic pain
• Cupping may:
• Chronic neck pain:
• Alleviate pain and to enhance function
and quality of life in patients suffering
from chronic neck pain.(1)
• Chronic back pain:
• In a systematic review about cupping
for chronic low back pain by (Moura et
al, 2018). (2)
• Conclusion: Cupping therapy is a
promising method for the treatment
and control of chronic back pain in
adults, since it significantly decreases
pain intensity scores when compared
to control groups.
1- Cramer H, Lauche R, Hohmann C, Choi KE, Rampp T, Musial F, Langhorst J, Dobos G. Randomized controlled trial of
pulsating cupping (pneumatic pulsation therapy) for chronic neck pain. Complementary Medicine Research.
2011;18(6):327-34.
2-Moura CD, Chaves ÉD, Cardoso AC, Nogueira DA, Corrêa HP, Chianca TC. Cupping therapy and chronic back pain:
systematic review and meta-analysis. Revista latino-americana de enfermagem. 2018;26.

14. Cupping for chronic pain
• Chronic back pain:
• In a systematic review about how current clinical practice
guidelines for low back pain reflect traditional medicine in east
Asian countries by (Cho et al, 2016).
• Conclusion: Acupuncture, cupping therapy, and manual therapy
were underestimated or not mentioned despite their current
evidence. The current evidence on acupuncture for chronic
LBP and evidence on cupping and manual therapy for both
(sub)acute and chronic LBP should be rigorously considered in
the process of developing or updating the clinical practice
guidelines system.
Cho HW, Hwang EH, Lim B, Heo KH, Liu JP, Tsutani K, Lee MS, Shin BC. How current clinical practice guidelines for
low back pain reflect traditional medicine in East Asian countries: a systematic review of clinical practice guidelines and
systematic reviews. PloS one. 2014 Feb 5;9(2):e88027.

15. Health Related Quality of life
• Cupping as a complementary medicine improves the
quality of life of asthmatic children. (1)
• Cupping improves the quality of life of chronic non-
specific neck pain patients.(2)
• Wet cupping improves HRQOL of patients with chronic
conditions.(3)
1- Aboushanab TS. The role of cupping therapy as a complementary therapy on the pulmonary functions and quality of life of
asthmatic children (Doctoral dissertation, Master thesis. Egypt: Childhood Postgraduate Institute. Ain Shams University).
2-Lauche R, Cramer H, Langhorst J, Dobos G. Cupping for chronic nonspecific neck pain: a 2-year follow-up. Complementary
Medicine Research. 2013;20(5):328-33.
3- Al Jaouni SK, El-Fiky EA, Mourad SA, Ibrahim NK, Kaki AM, Rohaiem SM, Qari MH, Tabsh LM, Aljawhari AA. The effect of
wet cupping on quality of life of adult patients with chronic medical conditions in King Abdulaziz University Hospital. Saudi
medical journal. 2017 Jan;38(1):53.

16. conclusion
• Cupping therapy is a promising treatment for chronic
diseases.
• Cupping may increase quality of life, and control
symptoms especially pain in chronic diseases.
• More large scale quality studies should be conducted to
confirm these results and raise the evidence.