What are the effects of dry cupping therapy combined with the McKenzie method on clinical outcomes in chronic low back pain? A protocol for a randomized, sham-controlled trial.

If you suffer from chronic low back pain (CLBP), you know how much it can interfere with daily life — from bending down to pick something up to simply getting out of a chair. Researchers are now exploring whether combining two approaches, dry cupping therapy and a specific exercise program called the McKenzie Method, might offer better relief than exercise alone.

This study, published in BMC Complementary Medicine and Therapies, outlines a carefully designed clinical trial involving 88 adults aged 18 to 59 with non-specific chronic low back pain. Participants will be randomly placed into one of two groups: one group receives real dry cupping therapy applied along the lower spine (L1 to L5) combined with McKenzie Method exercises, while the other group receives a sham (fake) cupping treatment alongside the same exercises. Neither group knows which treatment they are truly receiving, making this a high-quality, controlled study.

Treatments will be given twice a week for eight weeks. Researchers will measure disability levels, how well participants move and function, pain intensity, spinal flexibility, and how patients personally feel about their progress — both immediately after the first session and at the four- and eight-week marks.

While cupping therapy has grown in popularity as a complementary treatment for back pain, the scientific evidence has been inconsistent. This trial is one of the first rigorous studies to test whether adding cupping to an active exercise program actually boosts outcomes beyond exercise alone.

The results aren't in yet — this article describes the study protocol — but the findings could help patients and healthcare providers make more informed decisions about combining passive therapies like cupping with active rehabilitation.

If you are considering cupping therapy for back pain, always consult a qualified, licensed practitioner to ensure safe and effective care.

This registered RCT (NCT05459376) investigates the additive clinical value of dry cupping therapy when combined with the McKenzie Method (MDT) for non-specific chronic low back pain (CLBP). Eighty-eight participants (ages 18–59) will be randomized into an active intervention arm (MDT plus dry cupping applied bilaterally at L1–L5) or a sham-controlled arm (MDT plus sham cupping). The intervention protocol runs twice weekly for eight weeks, with outcome assessments at baseline (T0), post-first session (T1), four weeks (T4), and eight weeks (T8). Primary outcome is disability via the Oswestry Disability Index. Secondary outcomes include the Timed Up and Go Test, Numeric Pain Rating Scale, Toe-touch Test for trunk ROM, and the Global Perceived Effect Scale. No effect size data are yet available, as this is a protocol publication. The key clinical question — whether dry cupping potentiates the effects of active exercise-based rehabilitation in CLBP — remains unanswered in high-quality literature, making this trial methodologically significant for evidence-based integrative practice.