Cupping is part of traditional Chinese medicine as well as Middle Eastern healing practices that date back thousands of years. Ancient Greek physician Herodotus was a fan circa 400 BCE, as was the Prophet Muhammad in the sixth century.
As more celebrities post social media pics of cupping marks there has been increased interest in this ancient healing technique. As a practitioner of Traditional Chinese Medicine I rejoice at all the attention being given to one of our therapies. However, a quick troll of the internet shows that many articles about cupping focus on the marks and don’t provide a lot of information to the uninitiated. Read on to learn more about this intriguing therapy.
What is Cupping Therapy
“Cupping is performed by applying cups to selected skin points and creating a subatmospheric pressure, either by heat or by suction.” (1)
In the past the cups were made of bamboo, horn and earthenware. Modern materials used for cupping include glass, plastic, and silicone. The method of creating a negative pressure inside the cup depends on the material it is made of. The air inside glass cups is typically heated with a flame. Plastic cups have a valve in the top to allow a pump to remove air creating the negative pressure. Silicone and rubber cups are compressible, so the therapist compresses the bell of the cup before applying it to the skin. As the bell resumes it’s natural shape it creates negative pressure.
In all types of cupping it is the negative pressure inside the cup that provides the therapeutic benefit.
Benefits of Cupping
Proponents of cupping claim to use it for health promotion and prevention as well as for its therapeutic effects. Many benefits have been attributed to cupping ranging from improved immune function and disease prevention to curing acne and even herpes zoster (shingles). Research is supporting the use of cupping therapy for pain conditions (low back pain, neck & shoulder pain, headaches) as well as internal conditions (hypertension, diabetes, rheumatoid arthritis, asthma).
Some of the effects of cupping include:
- stretching muscle and fascia
- drawing stagnant blood and metabolites out of the muscle
- increase in local blood flow which can improve healing time (3)
Types of Cupping
“Wet” cupping is a popular treatment in Arabic and Islamic cultures and traditional medicine. It involves puncturing the skin with a sterile lancet or scalpel. Often suction is applied to the clean skin for a short time, then the cups are removed and the skin is punctured or scored before re-applying the cups. The suction force of the cups draws blood out of the skin.
“Dry” cupping leaves the skin intact. In Traditional Chinese Medicine cupping can be stationary or gliding. In stationary cupping the cups are placed over specific acupuncture points and left in place for 10-15 minutes. The gliding style uses oil on the skin as a lubricant and the cups are moved along the meridians.
Traditional stationary cupping is all about improving blood flow and drawing metabolites and stagnant blood out of muscle tissue. Moving cupping has become popular in sports therapy where it has been modified into a technique called myofascial cupping which releases the fascia around muscles and helps achieve a type of stretch on the muscle tissue to release overly tense muscle fibers.
Questions about Cupping Therapy
As with all medical/therapeutic practices there is a risk involved. When properly performed, cupping therapy has very minimal risks. I would always advise you to have cupping, or any other therapy, done by a professional. Potential or perceived side effects are discussed below.
Is it painful?
Many people are under the impression that a therapy that leaves visible signs that you’ve had it must be painful. My patients describe cupping as a “reverse massage” and say it feels “like a good, deep tissue massage”. The suction should never be so intense that you feel pain. If it is, ask your therapist to reduce the amount of suction.
What are those marks?
By calling the marks that appear on the skin after cupping “welts” or “bruises” it is implied that harm being done. From Wikipedia we get the following definition of bruise:
bruise (bro͞oz/); noun: an injury appearing as an area of discolored skin on the body, caused by a blow or impact rupturing underlying blood vessels.
With cupping there has been no blow and no rupture of the underlying blood vessels. No actual harm is done. Overworked, injured or tight muscles contain extra-vascular blood. That is, blood that has leaked out of the vessels and is sitting in a “no-man’s land” within the tissue. By applying a gentle suction force to the skin and tissue this blood is drawn up toward the surface of the skin. It looks like a bruise, but there was no damage done to the blood vessels. With the blood now up at the surface it can be absorbed into the lymphatic vessels and returned to the heart. The redness will dissipate after a few days.
Will it get infected?
When performed by a professional there is very little risk of infection with “wet” cupping. The skin is first prepared by removing hair, and cleaned with an alcohol wipe. The incisions are made using sterile, single use lancets. After the procedure the skin is again thoroughly cleaned. Since “dry” cupping does not damage the skin there is no risk of infection.
You use fire?
Back in the ancient days before the invention of glass, cupping was done with hollowed out animal horns and segments of bamboo. At that time, we believe, the suction was created by the practitioner sucking the air out of the tube by mouth and then putting a stopper in the top opening.
With glass cups it is necessary to heat the air inside the cups with a small flame. The cups are then quickly applied to the skin. As the air in the cup cools off it creates the suction. Therapists are appropriately trained in the safe handling of the small flame and taught to keep the flame away from the patient’s skin. There is also a technique to getting the air inside the cup warm without heating the glass rim that will be against the patient’s skin.
If burns are a fear/concern of yours there are other options. Plastic cups have a valve in the top. A small pump is placed over the valve allowing air to be withdrawn from the cup. Silicone cups are also available. The cups are manually compressed before being applied to the skin. As the cup tries to return to it’s natural form it creates suction on the skin and underlying tissue.
Can anyone get cupping?
Much like massage, there are some health conditions that can be aggravated with cupping therapy. Cupping should only be performed over healthy, intact skin. People with the following health conditions should not get cupping:
- any organ failure (heart, kidney, liver)
- edema or ascites
- fever or dehydration
- hemophilia or anticoagulants
- severe chronic diseases
Again, discuss your concerns with your therapist and make sure your therapist has adequate training before you allow them to do any type of therapy on you. Cupping, when performed by a trained therapist, is safe and comfortable.
In modern times the scientific practice of “double-blind, randomized, controlled trials” are the gold standard. However, this method (where neither the therapist nor the patient is aware of who is getting treatment and who is not) applies best to drug studies, not to physical therapies. All physical therapies (including massage, acupuncture and cupping) share difficulties in performing standardized research. In physical therapies it is very difficult to administer a “sham” or fake treatment to compare to a true treatment.
As interest in cupping therapy grows more and better research is being done to identify exactly what changes are taking place and whether they are reproducible in a consistent fashion. Some of the articles listed below show promising results in helping us understand how cupping works and demonstrating that it is indeed a beneficial treatment method.
Interested in giving cupping a try for your sore, tired or injured muscles? Call us today to book an appointment or find out more about this helpful therapy.
- Tamer, S. Aboushanab, Saud AlSanad. “Cupping Therapy: An Overview from a Modern Medical Perspective”. Journal of Acupuncture and Meridian Studies, 2018, 11(3): 83-87.
- Ting Li, Yaoxian Li, Yu Lin, and Kai Li, “Significant and sustaining elevation of blood oxygen induced by Chinese cupping therapy as assessed by near-infrared spectroscopy,” Biomed. Opt. Express 8(1), 223-229 (2017)
- Al-Bedah et al. “The medical perspective of cupping therapy: Effects and mechanismsof action,” Journal of Traditional and Complementary Medicine, 2019, 9: 90-97