October 30, 2022

Article at itsafootcaptain.com

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Cupping For Plantar Fasciitis

We all have seen those photos of swimmers at the Olympics with bruises all over their bodies and wondered, “whaaaaaaaaaat?”.

It is an alleged therapeutic technique known as cupping where the therapist places special cups on your skin to create suction to supposedly help with with pain and inflammation and as a type of deep-tissue massage.

The overwhelming preponderance of all the evidence is that it does not work. The systematic reviews and the meta-analyses have been clear in finding no benefit. It does not work. It is no better than a placebo. It is pseudoscience.

If you have had it and think it helped, then think natural history, placebo, regression to the mean and the benefits of the theatrics around the clinical encounter or you got probably better for other reasons.

Over the last few years I have come across a couple of YouTube videos and published studies claiming that cupping does work for plantar fasciitis. A cursory look at those studies made it clear that it didn’t, so I thought nothing more of it. Needless to say I got a bit of a surprise a few weeks ago when a review was published claiming “There is moderate evidence to support the use of dry cupping to improve pain and function in patients with plantar fasciitis.” Whaaaaaaaaat? I was confused how they could reach that conclusion when the studies that I had read that they included in their review did not reach that conclusion.

The purpose of a review like that is to only include studies that meet certain quality criteria so only the good research without methodological flaws and without biases get included. So I dug deeper into the studies that they decided to include in the review, and sure enough they did not conclude what was claimed. They do not even have control groups to deal with things like the natural history, placebo and regression to the mean!, so no there is not “moderate” evidence that cupping works for plantar fasciitis. There is no evidence that it works. Shame on the Journal of Sports Rehabilitation for letting the authors reach that conclusion.

Do better.

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