Suction Therapy on Neck Pain and Disability

INTERVENTION: This is a four‐arm, randomized, controlled clinical trial with participant and assessor blinding. Participants will be allocated to one of four groups according to different cupping therapy suction intensities applied using a hand pump: sham (no effective suction), 0.5 pump stroke, 1 pump stroke, and 2 pump strokes. A total of 100 participants with neck pain will be included, with 25 participants allocated to each group. Initially, all participants will receive a cupping therapy application using the sliding technique. First, 10 mL of grape seed oil will be applied to the skin, followed by the application of a size 3 cup with half suction. Sliding movements (upward, downward, left‐to‐right, and right‐to‐left) will then be performed over the dorsal region, covering the trapezius muscle, for 2 minutes. Following the sliding procedure, si Xcups will be applied to acupuncture points using a hand pump. The suction intensity will be set at zero (sham), 0.5 pump stroke, 1 full pump stroke, or 2 full pump strokes, according to group allocation. In the sham group, participants will receive si Xcups applied to acupuncture points using a hand pump with 1 full pump stroke. However, the cups will contain a small hole that prevents vacuum maintenance and will be attached to the skin using double‐sided adhesive tape, thereby simulating the active intervention. Each group will undergo five cupping therapy sessions performed twice per week. Before cup application, the treatment area will be cleaned with 70% alcohol and cotton. Four Dong Yang acrylic cups, size 3 (3.5 cm diameter), and two size 5 cups (2.3 cm diameter) will be applied bilaterally at the following acupuncture points: BL10 (Tianzhu), GB21 (Jianjing), and SI14 (Jianwaishu), remaining in place for 5 minutes. Suction will be applied using a Dong Yang hand pump, and the cups will be positioned so that the acupuncture point remains centered within the cup. Participants will be randomized using a random sequence generated by the Randomization.com website in blocks of 10 by a researcher not involved in the study. The allocation sequence will be stored in sequentially numbered, sealed, opaque envelopes to ensure allocation concealment. Outcome assessments and intervention delivery will be performed by different researchers. Participants and outcome assessors will be blinded to group allocation. Due to the nature of the intervention, the therapist responsible for administering the treatment cannot be blinded CONDITION: C05.651.538 Neck Pain ; Musculoskeletal Pain PRIMARY OUTCOME: A minimum average difference of 2 points in pain intensity, as measured by the Visual Analog Scale (VAS), is expected in the GV 2 pump group compared to the GV 1 pump, GV 0.5 pump, and sham groups. SECONDARY OUTCOME: An average reduction of at least 12.75 points in functional disability, as assessed by the Neck Disability Inde X(NDI), is anticipated in the GV 2 pump group compared to the GV 1 pump, GV 0.5 pump, and sham groups. INCLUSION CRITERIA: Be aged 18–59 years; be of either sex; have a score of 3 or higher on the Visual Analog Scale (VAS); have a score of 13 or higher on the Neck Disability Inde X(NDI)