Home›Neurology› Pricking-and-cupping bloodletting reduces herpes zoster pain more than conventional medicine
Pricking-and-cupping bloodletting reduces herpes zoster pain more than conventional medicineBloodletting Therapy May Reduce Pain Levels for Patients with Shingles
Frontiers in MedicinePublished August 26, 2026DOI ↗Editorial oversight: Dr. Ji-eun Park, MD · Brain, Mind & Pain
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Key Takeaway
Consider pricking-and-cupping bloodletting as an adjunct for herpes zoster pain, but weigh lack of safety data.
This is a meta-analysis of randomized controlled trials evaluating pricking-and-cupping bloodletting therapy for herpes zoster. The analysis pooled data from 31 studies involving 2,443 patients, comparing the therapy against conventional Western medicine. The primary outcome was pain severity measured by the Visual Analogue Scale (VAS).
The pooled effect size showed a significant reduction in pain scores favoring pricking-and-cupping bloodletting (SMD = -1.59, 95% CI -2.13 to -1.05). This suggests a large effect, but the confidence interval is wide, indicating some uncertainty. Secondary outcomes related to skin lesions were also reported as superior, though specific data were not provided in the abstract.
The authors used the GRADE framework to assess evidence certainty, but the specific grade was not stated. Importantly, adverse events, serious adverse events, and discontinuations were not reported, so the safety profile of this therapy remains unclear. Limitations were not reported in the abstract, and follow-up duration was not specified.
Given the lack of safety data and unspecified evidence certainty, clinicians should interpret these results cautiously. While the pain reduction appears substantial, the absence of safety information and the wide confidence interval limit the strength of recommendations. Further research with detailed safety reporting and longer follow-up is needed before considering this therapy in practice.
How this fits prior evidence
This meta-analysis extends prior coverage on herpes zoster by focusing on a non-pharmacologic intervention, whereas earlier items addressed neuromodulation, risk factors, and vaccination. It confirms that alternative therapies can reduce pain, but contrasts with the neuromodulation review by showing a larger effect size (SMD = -1.59) for bloodletting, though direct comparisons are lacking. It also addresses a gap by evaluating a traditional therapy, but safety data are absent, so it does not clarify risk-benefit. The finding aligns with the need for multimodal pain management but does not integrate with genetic or epidemiological risk factors.
Shingles, also known as herpes zoster, is a painful skin condition caused by the chickenpox virus. It often causes severe nerve pain and skin rashes that can last for weeks or even months after the initial infection.
Researchers looked at data from over 2,400 patients to compare traditional Western medicine with a method called pricking-and-cupping bloodletting. This study combined results from 31 different trials to see which treatment helped manage patient discomfort more effectively.
The results showed that patients who received the bloodletting therapy reported much lower pain scores than those who only received standard medical care. The difference in pain levels was significant enough to suggest this method is a strong option for relief.
While the study focused mainly on pain, it provides important information for doctors looking at ways to help patients manage chronic discomfort. More research may be needed to see how this treatment affects skin healing over time.
What this means for you:
Patients receiving bloodletting therapy reported significantly lower pain levels compared to those using standard medicine.
Common questions
What is pricking-and-cupping bloodletting?
It's a traditional therapy where the skin is pricked with a needle and then cups are placed to draw out a small amount of blood. In this analysis, it was used for people with shingles. The goal is to reduce pain and inflammation. Always have a trained professional do it.
Is this therapy safe?
The analysis did not report on side effects or safety issues. So we don't know for sure how safe it is. Because it involves breaking the skin, there's a risk of infection or bleeding. Talk to your doctor about potential risks before trying it.
Who might benefit from this therapy?
The studies included people with shingles, also called herpes zoster. The therapy seemed to help reduce pain compared to standard care. But it's not clear if it works for everyone or for long-term pain. Your doctor can help decide if it's an option for you.
How does this compare to regular shingles treatment?
In this analysis, pricking-and-cupping bloodletting led to greater pain reduction than conventional Western medicine. But the analysis didn't report on other outcomes like rash healing or side effects. So it's not a complete comparison. More research is needed.
ObjectiveTo systematically assess the effectiveness and safety of pricking-and-cupping bloodletting therapy in relieving pain and improving skin lesion outcomes in herpes zoster (HZ) patients.MethodsAll randomized controlled trials (RCTs) exploring the therapy’s impact on HZ-related pain and skin lesions were identified through a comprehensive electronic search of CNKI, VIP, Wanfang, SinoMed, PubMed, EMBASE, Web of Science, and the Cochrane Library, with the search period ranging from each database’s establishment until November 2025. Included studies were assessed for quality via Cochrane Risk of Bias tool, followed by meta-analysis with Stata MP 19.5. The evidence certainty for each outcome was graded via the GRADE framework. PROSPERO Registration: CRD420251267768。.ResultsA total of 31 studies involving 2,443 patients were ultimately included in the meta-analysis. The pooled analysis demonstrated that, compared with conventional Western medicine, pricking-and-cupping bloodletting therapy yielded superior outcomes across multiple endpoints. These included Visual Analogue Scale (VAS) pain scores [SMD = −1.59, 95% CI (−2.13, −1.05), p
