BACKGROUND: Cupping therapy is used to treat musculoskeletal conditions, including low back pain. OBJECTIVES: The study assessed the effects of dry cupping on pain and functional disability from persistent nonspecific low back pain. METHODS: This was a randomized controlled trial, where participants were allocated to a cupping therapy (n = 19) or sham (n = 18) group, for five 10-minute sessions of cupping therapy, twice a week, to stimulate the acupoints related to low back pain (GV4, BL23, BL24, BL25, and BL30, BL40 and BL58) and emotional aspects (HT3 and ST36). All participants were assessed at baseline, post-treatment and follow up (a finalization period of four weeks) using a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Groups were compared using the analysis of covariance (ANCOVA) and the effect size was calculated using Cohen ??s d. RESULTS: The cupping therapy group presented a lower mean VAS when compared to the sham, at post-treatment (mean difference -2.36; standard error (SE) 0.58; p < 0.001; "large" effect size -0.94) and follow up (mean difference -1.71; SE 0.81; p < 0.042; 'large' effect size -0.83). The cupping therapy group presented a lower mean ODI when compared to the sham post-treatment (mean difference -4.68; SE 1.85; p: 0.017; 'large' effect size -0.87), although in follow-up, there was no difference between the groups (mean difference 4.16; SE 2.97; p: 0.17; "medium" effect size -0.70). CONCLUSION: Dry cupping was more effective in improving pain and functional disability in people with persistent nonspecific low back pain when compared to the sham.

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