Evaluating the Relative Effectiveness of Electrical Muscle Stimulation versus Dry Cupping on Female Patients with Fibromyalgia

Abstract

Background: Fibromyalgia syndrome (FMS) is a chronic musculoskeletal illness distinguished by widespread fatigue, pain, sleep disturbances, and reduced quality of life (QOL), with higher prevalence among females. Non-pharmacological interventions such as electrical muscle stimulation (EMS) and dry cupping have shown potential in managing fibromyalgia symptoms; however, their comparative effectiveness remains insufficiently investigated.

Aim: To find out the effects of electrical muscle stimulation compared to dry cupping on pain, quality of life and sleep quality in female patients with fibromyalgia.

Patients and methods: Sixty females aged 45-55 years with FMS (BMI 25-34 kg/m²) were randomized into three groups (n=20 each): Group A received weekly 20-min EMS session plus the Mediterranean diet for 6 weeks; Group B underwent twice-weekly dry cupping sessions on tender points plus Mediterranean diet; Group C followed the Mediterranean diet alone.

All patients continued taking their usual drugs as described by their rheumatology specialist and had an individual fixed visit. Fibromyalgia impact questionnaire (FIQ), Pittsburg sleep quality index (PSQI), pain pressure threshold (PPT) was measured.

Results: Both intervention groups showed significant improvements versus control (p<0.001), with Group B demonstrating superior gains: PPT increases (e.g., right tender point 1: MD=0.36 kg/cm²), FIQ reduction (MD=34.39 points), and PSQI improvement (MD=8.7 points) compared to Group A (p<0.05).

Conclusion: Dry cupping yielded greater enhancements in pain relief, QOL, and sleep quality than EMS, supporting its integration into FMS management alongside diet.