The purpose of this study is to determine whether pulsatile cupping with a cupping device is effective in the treatment of patients with chronic low back pain compared to no cupping or to minimal cupping.

Inclusion Criteria:

• Male and female, 18-65 years
• Chronic low back pain (disease duration > 3 months)
• Pain intensity on visual analogue scale at inclusion > 40 mm (0-100 mm scale)
• Only pharmacological treatment with NSAID or no treatment in the last 4 weeks
• Undersigned informed consent form

Exclusion Criteria:

• Use of anticoagulants (Phenprocoumon, Heparin)
• Coagulopathy
• Cupping in the last 6 weeks
• Other CAM therapies in the last 12 weeks (e.g. acupuncture)
• Physical therapy in the last 12 weeks (e.g. massage, osteopathy)
• participation in another study in the last 3 months
• Paracetamol allergy or intolerance
• Pathological neurological symptoms such as muscular paralysis or paraesthesia due to spinal disc herniation or other causes
• Known renal and / or hepatic diseases
• Intake of central nervous system-acting analgesics in the last 6 weeks
• Applying for early retirement due to low back pain
• Severe disease that does not allow participation
• No undersigned informed consent form