A rare complication following combined dry needling and cupping therapy: Pneumothorax

AbstractIntroduction: Dry needling and cupping therapy are widely utilized for musculoskeletal pain. While generally safe, thoracic applications carry the risk of iatrogenic pneumothorax. We present a rare case of pneumothorax following the combined application of these therapies.Case Report: A 36-year-old female presented to the emergency department with sudden chest pain and dyspnea four hours after receiving combined dry needling and cupping therapy for back pain. Physical examination revealed decreased breath sounds on the right hemithorax. Chest X-ray and Computed Tomography confirmed a large right-sided pneumothorax. Tube thoracostomy was performed. The patient was discharged on the fourth day with full recovery.Conclusion: The combination of deep needling and the negative pressure of cupping may create a synergistic risk for pleural injury. Emergency physicians should utilize advanced imaging, such as CT or ultrasound, for early diagnosis in symptomatic patients.