Continue or Stop Applying Wet Cupping (Al-Hijamah) in Migraine
Condition: Migraine Disorders; Migraine With Aura; Migraine Without Aura
MeSH terms: Migraine Disorders; Migraine without Aura; Migraine with Aura
Study type: Interventional

Summary: 
      This study evaluates the short and long-term effects of application of Wet Cupping Therapy
      (WCT) in the treatment of migraine headaches in adults.Half of the participants will continue
      WCT application and the other half will not.
    

Detailed description: 
      In literature, Cupping therapy(CT) has been shown to be used mostly for pain control and the
      majority of RCT studies have shown that CT has potential benefits in pain conditions.
      Previous studies have reported the effect of pain mediator substance-P, endorphins,
      encephalins and dynorphins on pain(1) In addition to pain control, it is recommended for use
      as additional treatment in neurological diseases such as paralysis, Parkinson's disease and
      stroke Studies have shown successful results in the short term with the application of CT for
      migraine and tension-type headaches (2,3) Methodology Study design and Patient selection
      Patients with a history of migraine diagnosis who presented at the Research Polyclinic of
      Karabuk University Training and Research Hospital for wet-cupping therapy in the period May
      2016-January 2018 were included in the study. Patients were excluded if they had a history of
      head and neck surgery, a diagnosis of sinusitis, a diagnosis of fibromyalgia and inflammatory
      disease (rheumatism, infection etc.), were pregnant, had a diagnosis of cancer, bleeding
      disorder and widespread skin disease, malignant hypertension or any other disease which could
      cause headache. The diagnosis of migraine was confirmed by an experienced neurologist and the
      migraine type was determined. The medical treatments of the patients were reviewed and MIDAS
      was applied to determine the baseline score. In addition to the medical treatment, WCT was
      applied once a month, 3 times (Day 0, 30, 60). At the end of the 3rd month patients were
      allocated into two parallel arms. They were randomly assigned to the intervention group or
      control group in a double blind manner by the sealed opaque envelope technique. Intervention
      group continued WCT whereas patients in the control group discontinued the treatment. MIDAS
      was applied again at the end of the 6th and 12th months to both of the groups. Disability
      values in the 6th and 12th months were evaluated with MIDAS between those who continued
      treatment (Group 1) and those who did not (Group 2). Approval for the study was granted by
      Turgut Ozal University Ethics Committee, with number 99950669/236, dated 30.06.2014.Study
      design, application procedures and any possible side effects were explained to the study
      participants and informed consents obtained. All procedures performed in studies involving
      human participants were in accordance with the ethical standards of the institutional and/or
      national research committee and with the 1964 Helsinki declaration and its later amendments
      or comparable ethical standards.

      MIDAS The migraine disability score is a scale evaluating disability and loss associated with
      migraine. It consists of 7 questions, the 1st, 3rd and 5th of which evaluate the days lost
      from school, work, housework or leisure activities because of headaches in the last 3 months.
      The 2nd and 4th questions evaluate the number of additional days lost from work or housework
      in the last 3 months due to a reduction in productivity (defined as at least a 50% reduction
      in productivity). An additional two questions (MIDAS A and B) evaluate the frequency of
      headaches and the severity of the headaches using a visual analog scale (VAS), but these are
      not added to the total MIDAS score. The total MIDAS points are obtained from the total of the
      first 5 questions. Total points of 0-5 = 1st degree (very little or no restriction), 6-10
      points =2nd degree (mild or occasional restriction), 11-20 points = 3rd degree (moderate
      level of restriction), and 21 + points = 4th degree (severe restriction).
    

Intervention name(s): Wet Cupping
Intervention type(s): Procedure
Intervention description(s): cupping technique procedure was conducted in five phases:Primary suction,Area disinfection,Scarification,Bloodletting and secondary suction and Removing and dressing
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Wet cupping therapy; Migraine; MIDAS