Have you noticed the circular marks on the backs of certain athletes lately? If you’ve been following a few of them and noticed these strange bruises, most likely they’ve been to a cupping therapy session.1 This ancient therapeutic practice gained widespread attention when Olympian swimmer Michael Phelps, was spotted with cupping marks on his shoulder while competing in the 2016 Olympics.2
But what is cupping therapy? According to The Hearty Soul, it’s essentially a technique wherein cups are placed on your back or other parts of your body. Then, the air is vacuumed out from the cups, sucking your skin and fascia upward into the cup. This leaves the iconic circular marks behind, but they aren’t as painful as they look.3 In fact, it’s the suction that facilitates healing.
The Rich History of Cupping Therapy
The origins aren’t clear, but historians believe that cupping therapy originated from diverse locations in Asia and Africa. Records going back 5,500 years noted that Egyptians practiced it, and later introduced it to Greeks.4
Hippocrates, hailed as the father of modern medicine, was a noted proponent of cupping therapy. He was known to use two cups — the first had a narrow opening with a long handle, which was used for accumulated fluids. The second cup hade a wide opening, which was used for pain management.5
Cupping therapy also has a strong presence in Islamic cultures. Known as “hijama” in Arabic,6 it remains popular today due to its religious significance. According to Muslim teachings, the prophet Muhammad encouraged cupping due to its healing properties.7
In addition, cupping therapy has been associated with Traditional Chinese Medicine (TCM). Here’s an account of China’s history of cupping therapy, according to a study8 published in 2011:
“This ancient remedy has deep historical roots in Chinese civilization and has been an integral part of Traditional Chinese Medicine (TCM) for centuries. The earliest records of cupping in China are found in Bo Shu, a book written on silk, discovered in an ancient tomb of the Han Dynasty. A popular saying in China tells us: ‘Acupuncture and cupping, more than half of the ills cured.’”
Despite the differing histories, one thing is clear — Cupping has been used extensively to help patients get better.
Different Methods of Cupping
As cupping spread, more practitioners refined it, coming up with new variations to suit different applications. According to a study9 published in the Journal of Acupuncture & Meridian Studies, the earliest forms of cupping were only separated into two types — wet and dry cupping. But as more information became available, researchers learned that it applied in different ways. Here’s a breakdown of all known categories:
As you can see, the myriad categories make it quite daunting to familiarize yourself with all the cupping methods available. But for beginners, The Hearty Soul recommends sticking to the four main cupping methods:11
- Dry cupping — The basic form of cupping wherein a cup is placed on your skin for around 10 minutes, causing the blood vessels to expand and redden. Glass cups are usually used.
- Wet cupping — This is a second cupping session after your first dry cupping. Once a cupping mark develops, a scalpel (or needle) is used to make tiny incisions or piercings on the skin. Afterward, another round of cupping is administered to draw out blood from the incisions. The philosophy behind this is that toxins are expelled as they are drawn out.
- Fire cupping — A cotton ball is doused in an alcohol solution, and then held with forceps under a glass cup. As the cup heats up, a vacuum is created inside the cup. The cotton ball is withdrawn, and the cup rapidly placed on the skin. This is the riskiest method as accidental alcohol drips inside or on the rim can cause burns when placed on the skin. It should only be done by an experienced TCM practitioner.
- Moving cupping — First, oil is applied over your skin. Then, suction is created on a cup, which is then glided around the body, acting as a form of massage therapy. Typically, silicone cups are used to allow smoother movements over the skin.
How Cupping Therapy Can Help Enable Healing
Suction is the heart of cupping therapy, and is what promotes healing. According to a report from the South China Morning Post:12
“Cupping is believed to stimulate the flow of qi, the vital energy or ‘life force’ that, according to TCM, circulates through our bodies. TCM practitioners believe that when our qi is disrupted or disturbed, ‘blockages’ or imbalances can occur in the body. The purpose of cupping is to remove these blockages and restore the flow of this vital energy.”
Here’s a breakdown13 of the basic process, according to TCM practitioner Ruth Lee:
- A vacuum is created inside the cup, either by burning the oxygen inside a glass cup or by sucking the air out from the top of a plastic cup.
- The cup is then quickly placed on selected acupuncture points on the patient’s skin, and the vacuum draws the skin up to the cup.
- The low pressure inside the cup mobilizes the free flow of qi and blood around the body through channels known as meridians. This process facilitates the removal of toxins and ultimately restores balance to the body.
- The suction effect breaks the tiny blood vessels underneath the skin, resulting in slight discoloration of the area.
In TCM, it is believed that your body is designed to operate as one entire organism, a notion further reinforced through the concept of meridians. These pathways are spread throughout the body, connecting your organs, joints and extremities.14 Through cupping therapy, your body’s Yin-Yang (two opposing energies15) achieves balance, allowing qi to flow freely and better health can be achieved.
Where Can Cupping Therapy Be Used?
As mentioned earlier, the longevity and reputation of cupping therapy lies in its ability to help treat an array of conditions. By applying modern investigative methods, researchers have been able to observe how cupping can bring about healing to the following conditions:
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Anxiety — Cupping therapy has been used to help manage mental conditions that may lower quality of life. In a case report16 published in 2018, a 39-year-old man was suffering from a panic disorder for five years already, and had been taking medication for his condition. For the next 15 months, he took seven wet cupping therapy sessions. In just the first week, he had already noted a reduction of his symptoms of panic disorder. By the end of the study, he had already stopped using medication and had no attacks. The researchers concluded that cupping therapy may help with anxiety disorders. |
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Athletic recovery — With a resurgence attributed to athletes, cupping therapy has been studied, and findings suggest that their claims may have some merit. According to a 2022 study, it may “decrease muscle stiffness under appropriate cupping intensities that may improve sports performance and reduce muscle fatigue and soreness.”17 |
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Lower back pain — Chronic lower back pain is one of the most common medical complaints not just in America, but also around the world. According to a 2020 study, there are more than 500 million cases of low back pain present worldwide. By 2050, this number is projected to reach 800 million.18 If you’re experiencing lower back pain, you may consider trying cupping therapy for relief. In a 2018 study,19 researchers recruited 60 participants suffering from chronic lower back pain for more than three months and were administered a single cupping therapy session. After a week, the participants reported positive changes in pain intensity and disability, as well as better sleep quality. Another study,20 a meta-analysis published in Brazil, echoed similar findings. From a total of 26 published papers, cupping therapy was found to have a positive effect on chronic lower back pain. |
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Carpal tunnel syndrome (CTS) — An orthopedic condition caused by pressure on the meridian nerve in the wrist, CTS causes weakness in the hands, making you drop objects. Tingling and numbness may also develop.21 For those suffering from this condition, cupping therapy may be a viable treatment. In a study published in 2019, researchers selected 56 hands from people diagnosed with CTS, dividing it into two groups — the control group, which only received physiotherapy, and the test group, which received physiotherapy along with cupping therapy. Results indicated that the test group had significant improvement in symptoms, along with better distal sensory latency, which a test that determines the time it takes for your wrist to react after being stimulated, usually by an electrode.22 |
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Knee osteoarthritis — This degenerative disease usually occurs because of wear and tear of your cartilage. In other cases, the knee joint degrades due to factor such as accidents or rheumatoid arthritis. Either way, hallmark symptoms include pain in the knee joint, as well as stiffness and swelling.23 According to a meta-analysis24 published in Complementary Therapies in Clinical Practice, despite weak evidence, cupping therapy may still be a viable option for patients diagnosed with knee osteoarthritis. |
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Shingles — Also known as herpes zoster, this disease is caused by the reactivated varicella-zoster virus, which is also responsible for chickenpox. As such, you’re more likely to get it if you’ve had chickenpox before.25 Shingles causes blisters in a small area of your skin, but published evidence suggests that cupping therapy, specifically the wet approach, may provide relief. In a meta-analysis26 spanning eight randomized control trials with a total of 651 patients involved, wet cupping showed promising benefits for people diagnosed with shingles. To test the healing effects, the lesions were pricked beforehand with needles followed by a cupping session. The researchers conclude that wet cupping may be a better alternative compared to medication for treatment, as it helped manage pain and symptoms better than medications.27 |
Safety Reminders for Cupping Therapy
If you want to give cupping a try, you may be apprehensive having patches of your skin pulled upward, leaving circular marks.28 But don’t be discouraged, as studies29,30 confirm that cupping is generally safe for adults, as long as it is done properly.
There are also some safety reminders to take note of, however. According to TCM practitioner Dr. Troy Sing,31 the cups must not be applied on areas with damaged skin, over arteries, veins, lymph nodes, eyes, orifices or fractures. If done properly, the suction left behind will typically disappear within 24 hours. However, if you notice that you’re fainting, bruising, sweating or feeling dizzy, stop the session immediately.
Sing advises seeking a trained practitioner who specializes in the art of cupping. Furthermore, it’s best to refrain from doing cupping therapy if any of the following apply to you:32
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Pregnant |
Elderly |
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Diagnosed with hemophilia |
Currently taking blood-thinning medication |
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Blood disorders |
Edema, which is the buildup of fluid under your skin33 |
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Currently diagnosed with cancer |
Organ failure |
