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The Effectiveness of Traditional Chinese Medicine Integrated with Self-Slump Stretching on Chronic Low Back Pain among Hill Tribe Farmers in Thailand: a pilot randomized controlled trial.

Journal of pharmacopuncture·September 2025·Raksuda Taniguchi, Sulukkana Noiprasert, Wachiraporn Padungkiettiwong et al.
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Key Finding

Acupuncture combined with cupping therapy produced significantly greater pain reduction in chronic low back pain patients compared to stretching exercises alone, with the combined approach showing the most improvement overall.

What This Means For You

Researchers in Thailand studied whether combining traditional Chinese medicine treatments with a specific stretching exercise could help hill tribe farmers suffering from chronic low back pain. The study involved 36 participants aged 18-65 who had experienced ongoing back pain. They were divided into three groups: one received acupuncture plus cupping therapy, another performed self-slump stretching exercises, and the third combined both approaches. Each group received weekly treatments for four consecutive weeks, with follow-up assessments continuing for another four weeks.

The results showed that participants who received acupuncture and cupping experienced significantly greater pain reduction compared to those who only did stretching exercises. Interestingly, the group that combined acupuncture, cupping, and stretching showed the most improvement overall, though the difference wasn't statistically significant compared to acupuncture and cupping alone. When measuring disability levels—how much back pain interfered with daily activities—the acupuncture and cupping group showed more improvement than the stretching-only group.

For patients considering treatment for chronic low back pain, this study suggests that acupuncture combined with cupping therapy may offer meaningful relief, both in terms of pain intensity and functional ability. Adding self-directed stretching exercises may provide additional benefits. These findings are particularly relevant for people whose work involves physical labor, as the study focused on farmers with physically demanding jobs. The treatments were well-tolerated, with weekly sessions over just four weeks producing noticeable improvements. If you're interested in trying acupuncture for chronic back pain, seek a licensed acupuncturist with experience in treating musculoskeletal conditions.

Clinical Notes for Practitioners

This pilot RCT (n=36) evaluated traditional Chinese medicine interventions for chronic low back pain in hill tribe farmers aged 18-65 in Thailand. Participants were randomized to three groups: acupuncture plus cupping (AC), self-slump stretching (SS), or combined treatment (AC+SS), receiving weekly sessions for four weeks with four-week follow-up. Primary outcomes included Visual Analog Scale (VAS) for pain and Roland-Morris Disability Questionnaire (RMDQ) for functional disability.

Results demonstrated statistically significant pain reduction in AC and AC+SS groups compared to SS alone (p<0.01). The combined AC+SS group showed greatest improvement, though not statistically superior to AC alone. For disability outcomes, the AC group showed significant improvement over SS group (p=0.03). The study establishes feasibility for larger-scale trials and suggests acupuncture-cupping protocols, with or without adjunctive stretching, provide clinically meaningful outcomes for chronic LBP in physically demanding occupations. Weekly treatment over four weeks appears sufficient for therapeutic effect.

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