Effect of Dry Cupping with & without Neural Glides on Pain, Sensory Functions and Functional Mobility in Individuals with diabetic Neuropathy. A Randomized Clinical Trial
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Background: Diabetic peripheral neuropathy is a common complication of type 2 diabetes mellitus and is associated with pain, sensory impairment, reduced walking capacity, and functional limitation. Non-pharmacological rehabilitation strategies such as dry cupping and neural gliding may help address neuropathic symptoms through local circulatory, mechanical, and neurodynamic mechanisms. Objective: To compare the effects of dry cupping with versus without neural glides on pain intensity, sensory function, functional mobility, and neuropathy severity in individuals with diabetic peripheral neuropathy. Methods: This randomized clinical trial included 30 participants aged 30–70 years with type 2 diabetes mellitus and mild to moderate diabetic peripheral neuropathy. Participants were allocated to dry cupping with neural glides or dry cupping without neural glides. Both groups received conventional physiotherapy and a home plan for four sessions per week over one month. Outcomes included the Visual Analogue Scale, Semmes–Weinstein Monofilament Test, 6-Minute Walk Test, and modified Toronto Clinical Neuropathy Score. Data were analyzed using Shapiro–Wilk, Wilcoxon signed-rank, and Mann–Whitney U tests. Results: Significant within-participant improvements were observed in pain, sensory testing, walking capacity, and neuropathy-related outcomes. Post-intervention between-group comparisons favored dry cupping with neural glides for VAS (p = 0.001), SWMT (p = 0.043), 6MWT (p < 0.001), and mTCNS (p < 0.001). Conclusion: Dry cupping combined with neural glides showed more favorable rank-based outcomes than dry cupping without neural glides, although larger trials with complete clinical outcome reporting are required.
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