Cervicogenic headache refers to a group of syndromes characterized by chronic head pain caused by organic or functional injuries to the cervical vertebrae or soft tissues in the neck. It is common among middle-aged individuals, particularly women, with an incidence rate of 70% to 91% among headache sufferers. Current treatments include modern medical therapies such as medications, nerve blocks, injections, and percutaneous radiofrequency, as well as traditional Chinese medicine (TCM) therapies.
Technique Overview
Cupping, also known as tui guan (推罐法) or la guan (拉罐法), is one of the traditional Chinese medicine therapies widely used in the treatment and clinical research of cervicogenic headache. Cupping therapy involves the application of external force to stimulate the meridians and collaterals, regulate qi and blood flow, increase local tissue temperature, relieve adhesions, and promote cellular metabolism or relax spasmodic muscles, thereby achieving the principle of “where there is flow, there is no pain.” This makes it an effective method for treating cervicogenic headache.
Operational Steps
1. Preoperative Preparation
(1) Carefully examine the patient to confirm the clinical diagnosis and determine the cupping method based on the condition (avoid if contraindications are present).
(2) Check that the lubricants and equipment are complete and usable, and clean them one by one, arranging them in order.
(3) The patient must rest for half an hour before the procedure to eliminate fatigue and tension. Cupping should not be performed within half an hour after meals or when the patient is hungry. Smoking and drinking should be avoided within half an hour before the procedure to prevent fainting during cupping. Explain the procedure to the patient to alleviate their fears and enhance their confidence in treatment.
2. Patient Positioning
The patient should be in a prone or sitting position, fully exposing the neck, shoulders, and upper back.
3. Selection and Preparation of Cupping Tools
Select glass cups of size 2 or 3 based on the patient’s constitution and body shape.
Key Technical Steps
Apply lubricant evenly to the neck, shoulders, and upper back. After the cup adheres to the skin, hold the cup and move it on the skin (lifting the cup slightly at the front, applying pressure at the back, moving at a speed that can be fast or slow depending on the condition, patient tolerance, and treatment needs). First, move the cup along the arc connecting the mastoid to the shoulder, passing through Fengchi (风池) and Jianjing (肩井), 3 to 6 times. Then, move to Tianzhu (天柱) and along the midline of the neck, 3 to 6 times. Finally, move from Fengfu (风府) to Dazhui (大椎), 3 to 6 times, until red-purple or purple ecchymosis appears.
Treatment Duration and Course
Each treatment lasts 10 minutes, performed twice a week with a 3-day interval, totaling 10 sessions over 5 weeks.
Precautions
(1) When using fire cupping, care should be taken to avoid burning the skin. During cupping, ensure that the cotton ball soaked in ethanol is not too wet, and do not linger at the cup opening to prevent burns; thus, burn ointment should be prepared.
(2) Prepare medications and equipment for unexpected situations such as fainting: e.g., glucose water, blood pressure monitor.
(3) Prepare multiple cups for timely replacement when the cup opening is heated. In winter or during late autumn and early spring, when the weather is cold, preheat the cups to avoid cold sensations before cupping, but do not heat the opening to prevent burns. The warming time should be such that the cup is not cold and is at or slightly above skin temperature.
(4) Choose fire cups with smooth openings, free from damage or cracks.
(5) Prepare sanitary paper to wipe off lubricants.
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