*3.7. Cupping*

Cupping + Usual Conventional Therapy vs. Usual Conventional Therapy

The level of evidence and recommendations were derived based on five RCTs [167–171] that observed the combined effect of cupping and conventional treatment for LHIVD in terms of pain, function, and overall symptom improvement.

As a result of the meta-analysis, the combination of cupping and conventional treatment had a significant effect on the overall symptom improvement (RR: 1.43, 95% CI: 1.27–1.62, *p* < 0.001) compared to conventional therapy without cupping. However, there was no significant difference in pain improvement (MD, −1.08, 95% CI: −2.24–0.08, *p* = 0.07); therefore, the level of evidence was evaluated as very low due to the high imprecision.

In conclusion, cupping treatment should be considered in combination with conventional treatment for improving the overall symptoms of LHIVD (B/Moderate).
