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Cupping may become a new treatment for knee arthritis

The ancient Chinese therapy of cupping is being tested as a new treatment for knee arthritis.

The traditional remedy, popular with celebrities such as Gwyneth Paltrow, is being put through the rigours of a clinical trial.

Some research suggests that cupping, which involves placing heated cups upside down on the skin, can result in significant reduction in lower back pain compared with painkillers. Other studies showed positive effects in trigeminal neuralgia - a condition that affects nerves in the face.

Now, in a new trial, researchers at Charite University, Berlin, are hoping to gain similar success with patients suffering from knee osteoarthritis.

Up to five million people have knee pain, and in most cases osteoarthritis is to blame. Wear and tear causes damage to the protective surface or cartilage that cushions the bones.

As it gradually wears away, it leads to the painful rubbing of bone on bone in the joints. It generally affects those over 50, and risk factors include age, being overweight, previous joint injury and a family history of the disease.

Treatments including painkillers, physiotherapy and steroids, but some will eventually need partial or total knee replacements - each year more than 40,000 knee replacements are carried out in Britain. It's hoped cupping will not only help reduce pain, but could also promote healing, delaying the need for a new joint.

Cupping has traditionally been used for a wide range of conditions, including high blood pressure, arthritis, sciatica, back pain, and in treating migraines. However, there is little evidence of its effectiveness.

The therapy involves direct heat being used to create a vacuum in the glass which is then quickly placed on any affected area.

The suction anchors the cup to the skin, which is drawn up a few millimetres into the cup. They are then left on the body for up to 15 minutes.

'It's thought the suction essentially 'injures' the skin, creating some inflammation,' says Dr Michael Teut, one of the leaders of the trial.

The body then responds by sending more blood, oxygen and nutrients to the area, which speeds recovery and lowers pain levels.' In the Berlin trial starting this month, patients with osteoarthritis of the knee aged from 40 to 80 will have treatment from a new cupping machine in eight treatment sessions.

The device uses silicone cups which are placed on the painful knee and the vacuum is created by a pump rather than direct heat.

Each patient will have eight sessions, lasting ten to 15 minutes, over four weeks.

Patients who have had the treatment say it does not hurt, but feels like someone pulling at the skin.

Afterwards patients might develop the characteristic redness or bruising where the cup had been.

A team from the same university has also had success in treating carpal tunnel syndrome - a pain or weakness in the forearm and hand caused by pressure on a nerve at the wrist - with cupping.

Around 50 patients were given a single session of cupping or placebo then re-examined seven days later.

Results show the severity of symptoms went down by around 60 per cent in the cupping group, and by about 25 per cent in the others.

Professor Philip Conaghan, from Arthritis Research UK, said: 'There are a large number of treatments for osteoarthritis that seem to have a small effect, but it's often hard to work out if they are better than placebo.

'Until further studies are carried out, we'll have to wait and see.'