Supplementary Material for: The Effects of Cupping Massage in Patients with Chronic Neck Pain - A Randomised Controlled Trial

Background: Chronic neck pain is a major public health burden with only limited evidence for the effectiveness of complementary therapies. This study aimed to test the efficacy of cupping massage in patients with neck pain. Patients and Methods: Patients with chronic non-specific neck pain were randomly assigned to cupping massage or a wait list control. The intervention group received 5 cupping massages on a twice-weekly basis while the control patients continued their usual treatments. The primary outcome measure was neck pain intensity (0–100 mm visual analogue scale (VAS)) after 3 weeks. Secondary outcomes included pain on movement, functional disability, health-related quality of life, mechanical detection and pain thresholds and adverse events. Results: 50 patients (52.6 ± 10.3 years, 92% female) were randomised to either cupping massage or a wait list (N = 25 each). Patients in the cupping group reported significantly less neck pain post intervention (difference per protocol –14.3 mm, 95% confidence interval (CI) –27.7 to –1.0, p = 0.037; difference intention-to-treat –10.8 mm, 95% CI –21.5 to –0.1, p = 0.047). Significant group differences in favour of the intervention were further found for pain on movement (p = 0.019) and functional disability (p < 0.001), the quality-of-life subscales pain (p = 0.002) and mental health (p = 0.003) and the mental component summary (p = 0.036). Changes were also found for pressure pain sensitivity at the site of maximal pain (p = 0.022). Five adverse events were reported. Conclusions: Cupping massage appears to be effective in reducing pain and increasing function and quality of life in patients with chronic non-specific neck pain. More rigorous studies are needed to confirm and extend these results.