{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T07:27:11Z","timestamp":1786519631956,"version":"build-2736575974"},"reference-count":52,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Ayurveda and Integrative Medicine"],"published-print":{"date-parts":[[2026,5]]},"DOI":"10.1016\/j.jaim.2026.101319","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T03:33:53Z","timestamp":1779420833000},"page":"101319","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["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"],"prefix":"10.1016","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2872-8031","authenticated-orcid":false,"given":"Ramesh Shivappa","family":"Killedar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9385-7748","authenticated-orcid":false,"given":"Pradeep Shahajirao","family":"Shindhe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Kage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rubeen","family":"Nadaf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahesh","family":"Sattigeri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jaim.2026.101319_bib1","doi-asserted-by":"crossref","DOI":"10.1155\/2013\/640690","article-title":"A Health- and resource-oriented perspective on NSLBP","volume":"2013","author":"Rolli Salath\u00e9","year":"2013","journal-title":"ISRN Pain"},{"issue":"Suppl 2","key":"10.1016\/j.jaim.2026.101319_bib2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/ner.12018","article-title":"Epidemiology of low back pain in adults","volume":"17","author":"Manchikanti","year":"2014","journal-title":"Neuromodulation"},{"key":"10.1016\/j.jaim.2026.101319_bib3","first-page":"1044","article-title":"Measuring the functional status of patients with low back pain","volume":"69","author":"Deyo","year":"1988","journal-title":"Arch Phys Med Rehabil"},{"issue":"4","key":"10.1016\/j.jaim.2026.101319_bib4","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.3390\/jcm12041685","article-title":"Chronic low back pain: a narrative review of recent international guidelines for diagnosis and conservative treatment","volume":"12","author":"Nicol","year":"2023","journal-title":"J Clin Med"},{"key":"10.1016\/j.jaim.2026.101319_bib5","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/S0140-6736(16)30970-9","article-title":"Non-specific low back pain","volume":"389","author":"Maher","year":"2017","journal-title":"Lancet"},{"key":"10.1016\/j.jaim.2026.101319_bib6","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1097\/AJP.0b013e3181b56db6","article-title":"Flexion-relaxation and clinical features associated with chronic low back pain","volume":"25","author":"Alschuler","year":"2009","journal-title":"Clin J Pain"},{"key":"10.1016\/j.jaim.2026.101319_bib7","doi-asserted-by":"crossref","first-page":"514","DOI":"10.7326\/M16-2367","article-title":"Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American college of physicians","volume":"166","author":"Qaseem","year":"2017","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.jaim.2026.101319_bib8","doi-asserted-by":"crossref","first-page":"A1","DOI":"10.2519\/jospt.2012.0301","article-title":"Patellofemoral pain: proximal, distal, and local factors, 2nd international research retreat","volume":"42","author":"Powers","year":"2012","journal-title":"J Orthop Sports Phys Ther"},{"issue":"2","key":"10.1016\/j.jaim.2026.101319_bib9","doi-asserted-by":"crossref","first-page":"79","DOI":"10.4103\/ayu.AYU_142_16","article-title":"Effect of Agnikarma (therapeutic heat burns) and Raktamokshana (therapeutic bloodletting) in the management of Kati Sandhigata Vata","volume":"40","author":"Joshi","year":"2019","journal-title":"Ayu"},{"issue":"4","key":"10.1016\/j.jaim.2026.101319_bib10","doi-asserted-by":"crossref","DOI":"10.1016\/j.jaim.2022.100665","article-title":"Protocol based pain management by Ayurveda parasurgical procedures W.S.R to musculoskeletal pain and its critical appraisal - an open labeled clinical trial","volume":"13","author":"Mishra","year":"2022","journal-title":"J Ayurveda Integr Med"},{"key":"10.1016\/j.jaim.2026.101319_bib11","series-title":"Chapter 18, Taila yoga prakarnam, shloka 51","first-page":"496","author":"Rao","year":"2016"},{"key":"10.1016\/j.jaim.2026.101319_bib12","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1007\/s00586-010-1356-3","article-title":"A systematic review on the effectiveness of complementary and alternative medicine for chronic non-specific low-back pain","volume":"19","author":"Rubinstein","year":"2010","journal-title":"Eur Spine J"},{"key":"10.1016\/j.jaim.2026.101319_bib13","doi-asserted-by":"crossref","DOI":"10.1016\/j.eujim.2024.102413","article-title":"Ayurveda interventions for non-specific chronic low back pain\u2014 protocol for a systematic review and network meta-analysis","volume":"72","author":"Kumari","year":"2024","journal-title":"European Journal of Integrative Medicine"},{"issue":"11","key":"10.1016\/j.jaim.2026.101319_bib14","doi-asserted-by":"crossref","first-page":"2791","DOI":"10.1007\/s00586-018-5673-2","article-title":"Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview","volume":"27","author":"Oliveira","year":"2018","journal-title":"Eur Spine J"},{"key":"10.1016\/j.jaim.2026.101319_bib15","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1186\/1745-6215-12-146","article-title":"Evaluation of wet-cupping therapy for persistent non-specific low back pain: a randomised, waiting-list controlled, open-label, parallel-group pilot trial","volume":"12","author":"Kim","year":"2011","journal-title":"Trials"},{"key":"10.1016\/j.jaim.2026.101319_bib16","series-title":"Commentary Nibandhasangraha of Sri Dalhanacharya on Susrutasamhita of Susruta, sutrastana shonitavarnaniya adhyaya: chapter 14,Verse 17","first-page":"381","author":"Trikamji","year":"2012"},{"issue":"Suppl 2","key":"10.1016\/j.jaim.2026.101319_bib17","doi-asserted-by":"crossref","first-page":"s192","DOI":"10.1007\/s00586-006-1072-1","article-title":"For the COST B13 working group on guidelines for chronic low back pain. Chapter 4. European guidelines for the management of chronic nonspecific low back pain","volume":"15","author":"Airaksinen","year":"2006","journal-title":"Eur Spine J"},{"key":"10.1016\/j.jaim.2026.101319_bib18","series-title":"Ministry of health and family welfare, department of Indian systems of medicine and homeopathy","first-page":"34","author":"Anonymous","year":"1999"},{"key":"10.1016\/j.jaim.2026.101319_bib19","series-title":"Sharangadhara samhita of sharangadharacharya, Madhyama Khanda, Ch. 7, ver. 62","first-page":"203","author":"Tripathi","year":"2002"},{"key":"10.1016\/j.jaim.2026.101319_bib20","series-title":"The ayurveda formulary of India, Part-I, 8:22","first-page":"137","year":"2003"},{"issue":"1","key":"10.1016\/j.jaim.2026.101319_bib21","doi-asserted-by":"crossref","first-page":"52","DOI":"10.5606\/tftrd.2018.1238","article-title":"Effectiveness of physical therapy and exercise on pain and functional status in patients with chronic low back pain: a randomized-controlled trial","volume":"64","author":"\u015eahin","year":"2017","journal-title":"Turk J Phys Med Rehabil"},{"issue":"3","key":"10.1016\/j.jaim.2026.101319_bib22","article-title":"Validation of digital visual analog scale pain scoring with a traditional paper-based visual analog scale in adults","volume":"2","author":"Delgado","year":"2018","journal-title":"J Am Acad Orthop Surg Glob Res Rev"},{"issue":"Suppl 1","key":"10.1016\/j.jaim.2026.101319_bib23","doi-asserted-by":"crossref","first-page":"S17","DOI":"10.1007\/s00586-005-1044-x","article-title":"Pain assessment","volume":"15","author":"Haefeli","year":"2006","journal-title":"Eur Spine J"},{"issue":"6","key":"10.1016\/j.jaim.2026.101319_bib24","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.31616\/asj.2018.12.6.1106","article-title":"Development of a modified disability questionnaire for evaluating disability caused by backache in India and other developing countries","volume":"12","author":"Aithala","year":"2018","journal-title":"Asian Spine J"},{"issue":"3","key":"10.1016\/j.jaim.2026.101319_bib25","doi-asserted-by":"crossref","first-page":"270","DOI":"10.4103\/0974-8520.153743","article-title":"A comparative clinical study of Siravedha and Agnikarma in management of Gridhrasi (sciatica)","volume":"35","author":"Vaneet Kumar","year":"2014","journal-title":"Ayu"},{"issue":"1","key":"10.1016\/j.jaim.2026.101319_bib26","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1093\/ptj\/73.1.26","article-title":"Reliability of the modified-modified sch\u00f6ber and double inclinometer methods for measuring lumbar flexion and extension","volume":"73","author":"Williams","year":"1993","journal-title":"Phys Ther"},{"issue":"11","key":"10.1016\/j.jaim.2026.101319_bib27","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1053\/apmr.2001.26064","article-title":"Validity, reliability, and responsiveness of the fingertip-to-floor test","volume":"82","author":"Perret","year":"2001","journal-title":"Arch Phys Med Rehabil"},{"issue":"4","key":"10.1016\/j.jaim.2026.101319_bib28","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1590\/S1413-78522013000400004","article-title":"Assessment of the quality of life through the SF-36 questionnaire in patients with chronic nonspecific low back pain","volume":"21","author":"Adorno","year":"2013","journal-title":"Acta Ortop\u00e9dica Bras"},{"issue":"Suppl 1","key":"10.1016\/j.jaim.2026.101319_bib29","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1186\/s12889-020-09506-7","article-title":"Assessment of health-related quality of life and patient's knowledge in chronic non-specific low back pain","volume":"21","author":"J\u00e1romi","year":"2021","journal-title":"BMC Public Health"},{"key":"10.1016\/j.jaim.2026.101319_bib30","doi-asserted-by":"crossref","DOI":"10.7717\/peerj.10304","article-title":"Effectiveness of specific stabilization exercise compared with traditional trunk exercise in women with non-specific low back pain: a pilot randomized controlled trial","volume":"8","author":"Minobes-Molina","year":"2020","journal-title":"PeerJ"},{"issue":"2","key":"10.1016\/j.jaim.2026.101319_bib31","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.jtcme.2018.03.003","article-title":"The medical perspective of cupping therapy: effects and mechanisms of action","volume":"9","author":"Al-Bedah","year":"2018","journal-title":"J Tradit Complement Med"},{"issue":"2","key":"10.1016\/j.jaim.2026.101319_bib32","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.jams.2019.11.004","article-title":"Single cupping thearpy session improves pain, sleep, and disability in patients with nonspecific chronic low back pain","volume":"13","author":"Volpato","year":"2020","journal-title":"J Acupunct Meridian Stud"},{"key":"10.1016\/j.jaim.2026.101319_bib33","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/s12906-018-2187-8","article-title":"Pulsatile dry cupping in chronic low back pain \u2013 a randomized three-armed controlled clinical trial","volume":"18","author":"Teut","year":"2018","journal-title":"BMC Compl Alternative Med"},{"issue":"8","key":"10.1016\/j.jaim.2026.101319_bib34","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1089\/acm.2015.0065","article-title":"The use of wet cupping for persistent nonspecific low back pain: randomized controlled clinical trial","volume":"21","author":"AlBedah","year":"2015","journal-title":"J Alternative Compl Med"},{"issue":"6","key":"10.1016\/j.jaim.2026.101319_bib35","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jams.2019.04.005","article-title":"Wet cupping-traditional hijamah technique versus Asian cupping technique in chronic low back pain patients: a pilot randomized clinical trial","volume":"12","author":"Al-Eidi","year":"2019","journal-title":"J Acupunct Meridian Stud"},{"key":"10.1016\/j.jaim.2026.101319_bib36","first-page":"2796","article-title":"The effectiveness of dry cupping and hot pack in pain relief and reduce functional disability on non-specific low back pain","volume":"8","author":"Razali","year":"2021","journal-title":"European Journal of Translational and Clinical Medicine"},{"issue":"1","key":"10.1016\/j.jaim.2026.101319_bib37","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1186\/s12906-023-04061-1","article-title":"Effects of a back school-based intervention on non-specific low back pain in adults: a randomized controlled trial","volume":"23","author":"Hernandez-Lucas","year":"2023","journal-title":"BMC Complement Med Ther"},{"issue":"4","key":"10.1016\/j.jaim.2026.101319_bib38","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1590\/S1516-31802011000400003","article-title":"Effects of transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) in patients with nonspecific chronic low back pain: randomized clinical trial","volume":"129","author":"Facci","year":"2011","journal-title":"Sao Paulo Med J"},{"key":"10.1016\/j.jaim.2026.101319_bib39","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.jbmt.2023.04.075","article-title":"Application of hot medicated fomentation for pain alleviation in non-specific low back pain - a randomized controlled clinical trial","volume":"35","author":"Khan","year":"2023","journal-title":"J Bodyw Mov Ther"},{"issue":"2","key":"10.1016\/j.jaim.2026.101319_bib40","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.berh.2010.01.002","article-title":"Exercise therapy for chronic nonspecific low-back pain","volume":"24","author":"Van Middelkoop","year":"2010","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"10.1016\/j.jaim.2026.101319_bib41","doi-asserted-by":"crossref","DOI":"10.1590\/1518-8345.2888.3094","article-title":"Cupping therapy and chronic back pain: systematic review and meta-analysis","volume":"26","author":"Moura","year":"2018","journal-title":"Rev Lat Am Enfermagem"},{"issue":"51","key":"10.1016\/j.jaim.2026.101319_bib42","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000032325","article-title":"Effectiveness of self-management of dry and wet cupping therapy for low back pain: a systematic review and meta-analysis","volume":"101","author":"Shen","year":"2022","journal-title":"Medicine (Baltim)"},{"key":"10.1016\/j.jaim.2026.101319_bib43","doi-asserted-by":"crossref","DOI":"10.1016\/j.ctim.2024.103013","article-title":"The effectiveness of cupping therapy on low back pain: a systematic review and meta-analysis of randomized control trials","volume":"80","author":"Zhang","year":"2024","journal-title":"Compl Ther Med"},{"key":"10.1016\/j.jaim.2026.101319_bib44","volume":"vol. 168","year":"2002"},{"issue":"1","key":"10.1016\/j.jaim.2026.101319_bib45","doi-asserted-by":"crossref","first-page":"49","DOI":"10.4103\/0974-8520.115447","article-title":"Multimodal Ayurvedic management for Sandhigatavata (Osteoarthritis of knee joints)","volume":"34","author":"Sharma","year":"2013","journal-title":"Ayu"},{"issue":"1","key":"10.1016\/j.jaim.2026.101319_bib46","doi-asserted-by":"crossref","DOI":"10.1016\/j.jaim.2021.07.002","article-title":"Ayurvedic management in limb girdle muscular dystrophy - a case report","volume":"13","author":"Rajoria","year":"2022","journal-title":"J Ayurveda Integr Med"},{"issue":"2","key":"10.1016\/j.jaim.2026.101319_bib47","doi-asserted-by":"crossref","first-page":"200","DOI":"10.4103\/0974-8520.119679","article-title":"Phytochemical evaluation of the wild and cultivated varieties of Eranda Mula (Roots of Ricinus communis Linn.)","volume":"34","author":"Doshi","year":"2013","journal-title":"Ayu"},{"issue":"Suppl 2","key":"10.1016\/j.jaim.2026.101319_bib48","doi-asserted-by":"crossref","first-page":"S1829","DOI":"10.4103\/jpbs.jpbs_14_24","article-title":"The GC-MS Study of the ayurvedic formulation \"Dhanwantharam Thailam\" used for rheumatism","volume":"16","author":"Brindha","year":"2024","journal-title":"J Pharm BioAllied Sci"},{"issue":"9","key":"10.1016\/j.jaim.2026.101319_bib49","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1080\/17512433.2020.1817738","article-title":"Paracetamol for low back pain: the state of the research field","volume":"13","author":"Koes","year":"2020","journal-title":"Expet Rev Clin Pharmacol"},{"issue":"9","key":"10.1016\/j.jaim.2026.101319_bib50","article-title":"Exercise therapy for chronic low back pain","volume":"9","author":"Hayden","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"issue":"8","key":"10.1016\/j.jaim.2026.101319_bib51","doi-asserted-by":"crossref","first-page":"780","DOI":"10.3390\/life11080780","article-title":"A role for superficial heat therapy in the management of non-specific, mild-to-moderate low back pain in current clinical practice: a narrative review","volume":"11","author":"Freiwald","year":"2021","journal-title":"Life"},{"issue":"3","key":"10.1016\/j.jaim.2026.101319_bib52","doi-asserted-by":"crossref","first-page":"197","DOI":"10.2217\/pmt.14.13","article-title":"Using TENS for pain control: the state of the evidence","volume":"4","author":"Vance","year":"2014","journal-title":"Pain Manag"}],"container-title":["Journal of Ayurveda and Integrative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0975947626000033?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0975947626000033?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T06:28:36Z","timestamp":1786516116000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0975947626000033"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":52,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["S0975947626000033"],"URL":"https:\/\/doi.org\/10.1016\/j.jaim.2026.101319","relation":{},"ISSN":["0975-9476"],"issn-type":[{"value":"0975-9476","type":"print"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"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","name":"articletitle","label":"Article Title"},{"value":"Journal of Ayurveda and Integrative Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jaim.2026.101319","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier B.V. on behalf of Institute of Transdisciplinary Health Science and Technology and World Ayurveda Foundation.","name":"copyright","label":"Copyright"}],"article-number":"101319"}}