Acupuncture Plus Cupping Relieve Pain and Reduce the Consumption of Analgesics in Patients with Advanced Knee...

Acupuncture is a nonpharmacological option described in the literature; however, its efficacy in the treatment of knee osteoarthritis (KOA) is still controversial. This randomized, sham-controlled trial evaluated before-and-after differences in pain relief visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index Pain Section (WOMAC-Pain) among advanced patients with KOA assigned to acupuncture, cupping, combined therapy, or sham controls.

A total of 120 patients waiting for total knee arthroplasty from the knee outpatient unit of the Institute of Orthopedics and Traumatology, "Hospital das Clínicas" of the University of São Paulo Medical School, were invited to participate in the project. Inclusion and exclusion criteria were applied, and those who accepted signed an informed consent form and were later randomly allocated (https://www.random.org) to the following groups: Group A-Sham Acupuncture + Sham Cupping; Group B-Sham Acupuncture + True Cupping; Group C-True Acupuncture + Sham Cupping; Group D-True Acupuncture + True Cupping. The VAS and WOMAC-Pain questionnaire were used to measure the intensity of pain, and the number of analgesics and/or anti-inflammatory drugs used during the research period was also recorded.

We found statistical differences in VAS and the amount of pain medication used by patients (p = 0.035). The post hoc test for VAS values revealed a statistically significant difference between groups A and C (p = 0.04) and between groups A and D (p = 0.001). No differences were found in WOMAC-Pain index (0.258).

The combination of acupuncture with cupping therapy demonstrated pain improvement by VAS and decreased the amount of pain medication used by patients, suggesting a complementary yet significant role in preoperative management.