Neurological Complications of Cupping Therapy: A Comprehensive Review.

Background: Cupping therapy, a traditional treatment method, has been shown to be effective in various studies. However, there have been reports of significant neurological complications following cupping therapy. This comprehensive review aimed to investigate the important and potentially severe neurological complications documented in the literature.

Summary: The review analyzed case reports and case studies published in three major databases (PubMed, Google Scholar, and Cochrane) up to June 2024. The search strategy involved a three-step process, where two traditional medicine experts independently searched for case reports and published case series, and then a 3-person committee consisting of two traditional medicine experts and a neurologist reviewed the selected articles. Out of 280 case reports and case series, 12 studies were included in the review, reporting 14 patients with neurological complications. The majority of cases (7/14) involved interventions combining cupping with other traditional medicine manual therapies. Complications reported included vascular and infectious complications, with subdural hemorrhage being the most common (4/14). Most patients (11/14) were free of underlying diseases, and all but three patients recovered from their complications with surgical and medical treatments.

Key messages: The study concludes that although rare, neurological complications of cupping therapy can be severe and potentially life-threatening. Therefore, it is essential for traditional medicine practitioners to be aware of these risks and take necessary precautions to prevent them. Adopting proper techniques and adhering to health guidelines can help mitigate the likelihood of complications. The creation of an international system to record and report the side effects of cupping therapy is also recommended.