An interventional study of Paraffin Wax Therapy and Dry cupping in Rheumatic Arthritis, sponsored by University of Baghdad. Not yet recruiting at 1 site in Iraq. Open to participants aged 20 Years to 60 Years. Per ClinicalTrials.gov, last updated 2026-11-02.
Sponsored by University of Baghdad · Not applicable, Interventional, and Treatment
Rheumatoid arthritis is a chronic inflammatory disease that can cause pain, stiffness, and reduced functional performance in the wrist and hand joints. These problems may make daily activities, such as gripping objects and performing self-care tasks, more difficult.
The purpose of this study is to evaluate the effects of paraffin wax therapy and dry cupping on pain intensity and wrist joint functional performance among patients with rheumatoid arthritis. The study will compare two groups: one receiving paraffin wax therapy and the other receiving dry cupping therapy
Pain intensity and wrist joint functional performance will be assessed before and after the interventions using standardized assessment tools. The findings may help determine whether these complementary therapies can reduce pain and improve wrist function in patients with rheumatoid arthritis.
Rheumatoid arthritis (RA) is a chronic inflammatory disease that can affect the joints of the hands and wrists. Pain, stiffness, and reduced joint function may interfere with daily activities. In addition to standard medical treatment, non-pharmacological interventions may help manage symptoms and support physical function.
This study compares paraffin wax therapy and dry cupping therapy in adults with rheumatoid arthritis. Both interventions are intended to address symptoms affecting the hands and wrists. The study uses a two-arm, parallel-group randomized design with assessments conducted before and after the intervention period.
A total of 48 participants are included in the study plan, with 24 participants allocated to each group. Random allocation is performed in a 1:1 ratio using computer-generated block randomization. Allocation assignments are placed in sealed, opaque envelopes and opened by a research assistant after the baseline assessment.
**Paraffin Wax Therapy Group**
Participants assigned to this group receive paraffin wax therapy using medical-grade paraffin maintained at 45 ± 1°C. The affected hand is dipped into the melted paraffin for approximately 2-3 seconds and then removed to allow the wax to solidify for approximately 5-10 seconds. This process is repeated eight times to form a coating around the hand. The hand is then covered with a plastic bag and an insulating wrap for 15 minutes. The procedure is applied to the opposite hand as appropriate.
Treatment is provided twice weekly for four weeks, for a total of eight sessions.
**Dry Cupping Therapy Group**
Participants assigned to this group receive dry cupping therapy using acrylic cups measuring approximately 5-6.5 cm in diameter and a portable DF-750 suction pump. The cups are applied to the selected treatment points LI4, LI5, and TE4. Negative pressure is maintained at approximately -300 to -400 mmHg, with adjustments of approximately 25 mmHg according to participant tolerance and skin response. The cups remain in place for approximately 10 minutes.
Treatment is provided twice weekly for four weeks, for a total of eight sessions.
**Study Setting and Procedures**
The study is conducted at the Rheumatology Clinic of Baghdad Teaching Hospital in Baghdad, Iraq. Participants receive the intervention assigned to their group according to the study protocol. Study assessments are conducted at baseline and after completion of the intervention period.
The sample size was estimated using G*Power version 3.1 for a two-sided independent-samples t-test, with a significance level of 0.05, statistical power of 80%, and an assumed standardized effect size of 0.8. The minimum estimated sample was 42 participants. The target sample was increased to 48 participants to allow for an anticipated 10% attrition rate.
The study follows the applicable ethical requirements. Participants are informed about the study procedures, and informed consent is obtained before participation. Participant information is handled confidentially.
65 studies on the registry are indexed under Rheumatic Fever; 22 are open to participants now.
This study's planned enrollment of 100 is above the median of 81 across 30 interventional studies indexed under Rheumatic Fever.
Browse Rheumatic Fever studies →University of Baghdad is the lead sponsor of 169 studies on the registry; 68 are open to participants now.
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The criteria were revised on the registry on Nov 2, 2026. See what changed
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Exclusion Criteria:
Participants assigned to this group will receive paraffin wax therapy for the wrist and hand joints at a temperature of 45 ± 1°C. The treatment will involve eight successive dips, followed by wrapping the treated area for 15 minutes. The intervention will be administered twice weekly for four weeks, for a total of eight sessions.
Procedure: Paraffin Wax Therapy
Participants assigned to this group will receive dry cupping therapy using suction cups applied to the designated treatment points around the wrist and hand. The procedure will be performed without skin incision or bloodletting. The treatment points, suction intensity, session duration, and frequency will follow the approved study protocol.
Procedure: Dry cupping
Paraffin wax therapy will be applied to the wrist and hand joints at a temperature of 45 ± 1°C. The treatment will involve eight successive dips, followed by wrapping the treated area for 15 minutes. Sessions will be conducted twice weekly for four weeks, for a total of eight sessions.
Dry cupping therapy will be administered using suction cups applied to designated treatment points around the wrist and hand, without skin incision or bloodletting. The treatment points, suction intensity, session duration, and frequency will follow the approved study protocol.
Change in Pain Intensity Measured by the Visual Analog Scale (VAS)
Pain intensity will be assessed using the Visual Analog Scale (VAS) before the first treatment session and after completion of the eight treatment sessions. Changes in pain intensity will be evaluated and compared between the paraffin wax therapy and dry cupping groups.
Time frame: From baseline (before the first treatment session) to completion of the 4-week intervention period (after the eighth treatment session).
Change in Wrist Joint Functional Performance Measured by the Health Assessment Questionnaire Disability Index (HAQ-DI)
Wrist Joint Functional Performance will be assessed using the Health Assessment Questionnaire Disability Index (HAQ-DI) before the first treatment session and after completion of the eight treatment sessions. Changes in HAQ-DI scores will be compared between the paraffin wax therapy and dry cupping groups. The HAQ-DI assesses functional limitations in daily activities among patients with rheumatoid arthritis and is not specific to wrist function.
Time frame: From baseline (before the first treatment session) to the end of the 4-week intervention period (after the eighth treatment session).
Plan to share: No — Individual participant data will not be shared with other researchers because no data-sharing plan has been established for this study. Study results may be disseminated through scientific publications and academic presentations without disclosing individual participants' personal information.
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