Cupping therapy for migraine: A protocol for a systematic review of controlled trials

Introduction: Migraine is a common and disabling primary headache disorder. Cupping is a traditional medical treatment used in several societies in East Asia and it is frequently used for controlling pain including migraine. There have been no systematic reviews on the treatment effects of cupping on migraine. Furthermore, related studies have had many limitations, making it unclear whether cupping intervention is beneficial for migraine. We propose to conduct a systematic review and meta-analysis to consider the evidence related to the effect of cupping on migraine. Methods: We developed a protocol describing the essential reporting items based on the PRISMA for systematic review protocols 2015 (PRISMA-P 2015) (Registration number: CRD42017054979). We will search eight databases and include data from prospective randomized controlled clinical trials or quasi-randomized controlled trials that used cupping interventions for the treatment of migraine. The risk of bias will be assessed with the "Risk of bias" tool from the Cochrane Handbook. Using improved effectiveness and the change in headache pain intensity as graded on the visual analogue scale as the primary outcomes, we will compare these outcomes between the cupping intervention and control groups. Conclusion: There have been no systematic reviews of cupping therapy for migraine headaches to date. This systematic review will assess the effectiveness and safety of cupping therapy for migraine. This systematic review will inform and help healthcare practitioners to treat migraine and will be disseminated electronically and in print in a peer-reviewed journal.