Safety of Cupping Therapy in Studies Conducted in Twenty One Century: A Review of Literature

Background: Cupping therapy is a well-known traditional treatment modality, and has been used in various diseases around the world since ancient times. This method is reported to have a better clinical as well as adverse events (AEs) profile as found in various studies conducted around the world.

Aim: This study identifies, assesses, and classifies the adverse events profile of various types of cupping therapies in studies conducted in twenty one century.

Methods: Using electronic and hand searches, three databases including Pub Med, Google Scholar and Cochrane library were searched from the year 2000 to 2016. Studies were included in this review provided they reported adverse effects related to cupping therapy. Observational studies were assessed using the WHO-UMC causality scale. Randomized controlled trials were assessed in accordance to the quality of reporting for harm data.

Results: Nine hundred seventy nine (n=979) articles were identified. Based on exclusion and inclusion criteria and extensive review of all retrieved articles by two independent reviewers, only 25 studies that included six RCTs, sixteen single case reports and three case series were finally selected. The mostly observed adverse events of cupping therapy were scar formation reported in four studies that described fifty nine cases, and burns reported in two studies described sixteen cases, respectively. The adverse events of cupping therapy could be classified into local and systemic adverse events.

Conclusion: Cupping therapy adverse events were infrequently reported, but they were not rare. Most of adverse effects were mild to moderate in severity. Some of the cupping therapy adverse events were preventable by following the general infection control guidelines, hygienic techniques, safety protocols and rigorous training of cupping therapists. Cupping adverse events should be reported in all studies on cupping, and this therapy should be practiced only by qualified medical professionals.