Cupping therapy for fibromyalgia: A scoping review of proposed mechanisms

Fibromyalgia (FM) is a chronic condition characterized by widespread pain, fatigue, sleep disturbances, and other symptoms. Cupping therapy has emerged as a promising treatment for pain relief. Despite its increasing use, the mechanisms by which cupping therapy may alleviate FM symptoms are not fully understood.

This scoping review aims to summarize the proposed pain-attenuating mechanisms of cupping therapy in FM.

The review included original research studies published in English, involving participants aged ≥18 years with a clinical diagnosis of FM. Studies were included if they investigated the effects of cupping therapy alone on pain-related outcomes.

A systematic search was conducted in PsycINFO, Google Scholar, and MEDLINE from inception to March 2025 using the keywords "Fibromyalgia" and "cupping therapy".

Data extraction included publication details, intervention protocols, pain intensity outcomes, and postulated mechanisms of action.

From the 185 initial studies, five met the inclusion criteria: one randomized controlled trial, one single-arm clinical trial, one case-controlled trial, one partially randomized patient preference trial, and one case series. The types of cupping investigated included wet, dry, and medicinal cupping. Seven mechanisms for pain relief were identified, grouped as physiological and psychological.

This scoping review provides a summary of the proposed mechanisms for the pain-relieving effects of cupping therapy in FM. The findings highlight the potential for both physiological and psychological mechanisms contributing to pain reduction, but underscore the need for more rigorous research.