{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T05:12:40Z","timestamp":1768540360945,"version":"3.49.0"},"reference-count":46,"publisher":"Journal of Orthopaedic & Sports Physical Therapy (JOSPT)","issue":"1","content-domain":{"domain":["www.jospt.org"],"crossmark-restriction":true},"short-container-title":["JOSPT Open"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>OBJECTIVE: To compare the effects of dry cupping and placebo cupping in adults with musculoskeletal pain, in the short (1 week), medium (4 weeks), and long (6 months) term.<\/jats:p>\n                  <jats:p>DESIGN: Intervention systematic review with meta-analysis.<\/jats:p>\n                  <jats:p>LITERATURE SEARCH: Medline, EMBASE, CENTRAL, AMED, CINAHL, Physiotherapy Evidence Database, and Web of Science were searched until June 2025.<\/jats:p>\n                  <jats:p>STUDY SELECTION CRITERIA: The study design consisted of randomized clinical trials. Participants included people with musculoskeletal complaints. The intervention was dry cupping, and control was placebo cupping. The primary outcome was pain intensity.<\/jats:p>\n                  <jats:p>DATA SYNTHESIS: Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Pain scales were converted to a 0\u2013100 scale, with a meaningful difference threshold of 15 points. Random-effects meta-analyses were conducted. We judged the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation framework.<\/jats:p>\n                  <jats:p>RESULTS: A total of 3,330 records were screened; five trials ( n = 281) were included. There was very-low-certainty evidence that dry cupping was trivially harmful to meaningfully beneficial when compared to placebo cupping in the short term (mean difference [MD] = \u22129.9, 95% confidence interval [CI; \u221230.5, 10.7], four trials, n = 243) and long term (MD = \u22122.2, 95% CI [\u221211.8, 7.4], one trial, n = 52). There was very-low-certainty evidence that dry cupping was effective compared to placebo cupping in the medium term; the effect may be clinically meaningful (MD = \u221217.2, 95% CI [\u221233.0, \u22121.4], one trial). Four trials were at high overall risk of bias.<\/jats:p>\n                  <jats:p>CONCLUSION: The effects of dry cupping on pain were very uncertain at all timepoints. Treatment alternatives with higher-certainty evidence of effectiveness should be trialed before cupping.<\/jats:p>\n                  <jats:p>OPEN SCIENCE FRAMEWORK REGISTRATION: The study\u2019s registration is available at https:\/\/osf.io\/3fa9m\/ . 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