Cupping Therapy

There is a growing body of research digging into how and why cupping may work.

A 2018 review of studies noted that cupping therapy has reported benefits for a variety of conditions that can be categorized as either localized or systematic diseases.

Cupping is thought to alleviate symptoms by promoting peripheral (close to the skin) blood circulation and improving immunity.

According to the 2018 review, the effects of cupping therapy include:

• promoting the skin’s blood flow
• changing the skin’s biomechanical properties
• increasing pain thresholds
• improving local anaerobic (without oxygen) metabolism
• reducing inflammation
• boosting cellular immunity

According to a 2017 study, the mechanical effect of cupping increases local blood flow and stretches underlying tissue.

Activation of Heme oxygenase-1, a gene that plays a critical role in the prevention of vascular inflammation, could account for many of cupping therapy’s claimed local and systemic health benefits.

A 2019 study noted that no single theory exists to explain the whole effects of cupping, but some theories include:

• altering pain signal processing
• using counter-irritation, or pain to reduce pain
• stimulating increased blood circulation through the release of nitric oxide
• stimulating the immune system with artificial local inflammation
• increasing the level of immune products, such as interferon and tumor necrotizing factor
• increasing the flow of lymph in the lymphatic system
• decreasing uric acid and both types of cholesterol
• changing the molecular structure and function of hemoglobin (Hb)

According to the research mentioned above, cupping may remove toxins by stimulating the immune response, both locally and systemically.

It may also eliminate uric acid, a natural waste product from the digestion of certain foods. Uric acid buildup can lead to high levels of acidity in the blood and urine.

Cupping may also have a positive effect on the lymphatic system, which is partially responsible for eliminating your body’s waste.

When the flow of lymph is interrupted, it can cause fluid buildup and prevent the body from properly eliminating toxins. Lymphatic drainage massage is one solution to this issue. Similarly, cupping may help increase the flow of lymph and prevent fluid buildup.

Cupping was likely first performed using animal horns. Later, cups were made from bamboo and then ceramic.

Suction was primarily created through the use of heat. Cups were originally heated with fire and then applied to the skin. As they cooled, the cups drew the skin inside.

Modern cupping is often performed using bell-shaped glass cups. They may also be made of plastic or silicone.

There are four main categories of cupping performed today:

• Dry cupping: a suction-only method
• Wet/bleeding cupping: may involve both suction and controlled medicinal bleeding
• Running cupping: involves moving suctioned cups around the body after applying oil to massage the desired area
• Flash cupping: involves quick, repeated suction and release of cups on an area of the body

Cupping may also involve the use of:

• acupuncture needles
• moxibustion, or the burning of mugwort leaves
• magnets
• laser therapy
• electrical stimulation
• water
• herbs

Subsets of cupping include:

• facial cupping
• sports cupping
• orthopedic cupping
• aquatic cupping

Your practitioner, your medical needs, and your preferences will help determine which method is used.

For best results, you may also want to fast or eat only light meals 2 to 3 hours before your cupping session.

During a cupping treatment, you can expect the following:

1. Your practitioner will ask you what symptoms you have been experiencing, likely taking a detailed health history if this is your first time visiting them.
2. The practitioner will place cups on your skin.
3. You will feel a sucking sensation and pressure as the cups are suctioned.
4. The practitioner may use heat or suction alone to place the cups.
5. Depending on the type of cupping, the practitioner may leave you to rest for a few minutes before they return to remove the cups.
6. Your skin may turn red and show light bruising after your session.

Be sure to confirm with your practitioner which type of cupping they are going to use before you start treatment. This may involve dry, wet/bleeding, running, facial cupping, and more.

Cups are most often applied to the:

• back
• chest
• abdomen
• buttocks
• legs

Generally, the back is the most common area for cups to be used. If you are receiving facial or cosmetic cupping, cups will be placed on your face.

The cup is often heated with fire using alcohol, herbs, or paper that is placed directly into the cup. The fire source is removed, and the heated cup is placed with the open side directly onto your skin.

When the hot cup is placed onto your skin, the air inside the cup cools and creates a vacuum that draws the skin and muscle up into the cup. Your skin may turn red as the blood vessels respond to the change in pressure.

Some modern cupping practitioners have shifted to using rubber pumps to create suction versus more traditional heat methods.

With dry cupping, the cup is kept in place for a set time, usually between 5 and 10 minutes.

Running cupping usually involves the application of oil before the use of suction. Then the cups are slowly moved around the area, creating a massage-like effect. Depending on the kind of service you are receiving, your session could last anywhere from 10 minutes to an hour or more.

When it comes to flash cupping, the cups are quickly suctioned and then released, usually in the same generalized area of the body. This is usually a 5 to 10 minute process as well.

While suction cups can cause more bruising and swelling on the surface of the skin, the procedure is relatively painless. The signs that appear after a therapy session can last from a few days to a few weeks. Bruising is not caused by any form of gross trauma. Therefore, they should not be painful. 

Cupping has been used to treat a wide variety of conditions. It may be particularly effective at easing conditions that create muscle aches and pains.

Since the cups can also be applied to major acupressure points, the practice is possibly effective at treating digestive issues, skin issues, and other conditions commonly treated with acupressure.

Cupping therapy may help with the following conditions, among others:

• lower back pain
• neck and shoulder pain
• headache and migraine
• knee pain
• shingles
• facial paralysis
• cough and dyspnea
• acne
• lumbar disc herniation
• cervical spondylosis
• brachialgia, the pain produced by a trapped nerve in the neck
• carpal tunnel syndrome
• hypertension
• diabetes mellitus
• rheumatoid arthritis
• asthma

There are not many side effects associated with cupping. The side effects you may experience typically occur during your treatment or immediately after, such as:

• circular marks where the cups have been
• discoloration
• dizziness

You may feel lightheaded or dizzy during your treatment. Rarely, you may also experience sweating or nausea.

After treatment, the skin around the rim of the cup may become irritated and marked in a circular pattern. Other risks include:

• hematoma (bruising)

If you experience any of these issues, consult your practitioner. They may offer remedies or steps you can take before your session in order to avoid any discomfort.

Cupping therapy is not recommended for everyone.

Do not use cupping if you use blood-thinning medication. Also avoid cupping if you have:

• a sunburn
• a wound
• a skin ulcer
• experienced recent trauma
• an internal organ disorder
• thinning skin

Cupping should not be done on:

• veins
• arteries
• nerves
• skin inflammation or lesions
• body orifices
• eyes
• lymph nodes
• varicose veins

Most medical professionals do not have training or a background in complementary and alternative medicine (CAM). Still, it is a good idea to let your doctor know if you choose to add cupping to your treatment plan.

This form of therapy should not be used by pregnant women and people with bone fractures or muscle spasms and the ones facing, or may be suspected of having, any form of cancer, such as metastatic cancer. 

Cupping is a long-practiced treatment that may help ease the symptoms of both temporary and chronic health conditions.

If you choose to try cupping, use it as a complement to your current doctor visits, not a substitute.

Here are some things to consider before beginning cupping therapy:

• What conditions does the cupping practitioner specialize in treating?
• Which method of cupping does the practitioner use?
• Is the facility clean? Does the practitioner implement safety measurements?
• Does the practitioner have any certifications?
• Do you have a condition that may benefit from cupping?

Before beginning any alternative therapy, let your doctor know that you are planning to incorporate it into your treatment plan.