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What Exactly Is Cupping?

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Cupping therapy is an ancient healing practice that originated in China over 2,000 years ago. The therapy involves placing glass, bamboo, or silicone suction cups on the skin and creating a vacuum to stimulate blood flow, loosen muscle tension, and promote healing. Cupping has gained popularity in recent years as an alternative therapy for various ailments.

Definition of Cupping

Cupping is a traditional healing technique that uses suction cups to create a negative pressure on the skin and underlying tissues. The suction cups are placed on specific points of the body to stimulate blood flow, loosen muscle tension, and promote healing.

Brief History of Cupping

Cupping therapy has been practiced in China as far back as 300 AD and was used to treat a variety of medical conditions such as respiratory diseases and musculoskeletal pain. Cupping therapy also has roots in Ancient Egyptian and Middle Eastern civilizations. In the East, cupping is often used in conjunction with acupuncture, while in the West it is used mainly as a standalone therapy.

How Cupping Works

Mechanism of Cupping

Cupping involves creating a vacuum sealed on the skin to promote blood flow and relaxation of tense muscles.

  • As the cup is placed on the skin, the surrounding air is removed by suction, creating a vacuum inside the cup.
  • The vacuum effect causes the muscles and tissue to be lifted and stretched, promoting increased blood flow to the area.
  • As blood flow is stimulated, damaged tissue is able to repair more quickly, resulting in reduced pain and swelling.

Types of Cupping

There are three main types of cupping therapy that differ based on the technique used to create suction:

  • Dry Cupping: In dry cupping, a suction cup is applied to the skin and left in place for several minutes. This form of cupping does not involve any incisions and is noninvasive. It is used to promote relaxation and blood flow to the area, and to relieve pain and tension.
  • Wet Cupping: Wet cupping involves the medical professional making tiny incisions in the skin during the cupping session to remove blood. It is believed that the removal of "bad" or "stagnant" blood from the area can promote healing. Wet cupping can be used to treat conditions such as skin disorders, blood disorders, high cholesterol, and rheumatism.
  • Fire Cupping: Fire cupping, also known as heated cupping, involves using heat to create suction. A flammable substance such as alcohol is placed in the cup and set on fire. The cup is then quickly placed on the skin, and as the air inside the cup cools, suction is created. Fire cupping can be used to treat respiratory illnesses, arthritis, and back pain.

Benefits of Cupping

Cupping therapy is used to provide relief from a wide range of ailments and is believed to provide multiple benefits to the body.

  • Promotes relaxation and stress reduction.
  • Helps with muscular pain relief, including back pain, neck pain, and stiff muscles.
  • Improves circulation and blood flow to promote healthy cell growth and tissue repair.
  • Boosts the immune system and helps to alleviate symptoms of common colds and respiratory infections.
  • Helps to decrease fatigue, asthma, and bronchitis.
  • Relieves migraines and anxiety.
  • Assists with digestive problems such as constipation, IBS, and stomachaches.
  • Treats skin problems such as acne, eczema, and cellulite.
  • May help to ease symptoms of chronic conditions such as multiple sclerosis and diabetes.

Indications for Cupping

Cupping therapy has been used for centuries as a form of alternative medicine for a wide range of conditions. Today, the therapy has gained significant popularity in the Western world as a natural way to promote healing and alleviate symptoms associated with various conditions. Here are some indications for cupping:

Pain Management

  • Cupping can help to relieve pain caused by musculoskeletal conditions such as back pain, neck pain, and joint pain. By promoting blood flow to the affected area, the therapy helps to reduce inflammation, promote healing and relieve pain.
  • Cupping also characterizes a form of myofascial release Methodology. It helps to loosen muscles and provide relief from tension. By placing cups on the affected area, cupping therapists are able to stretch the tissues and help to encourage blood flow to the area, dislodge adhesions, and provide pain relief.

Respiratory Disorders

  • Cupping therapy can help to relieve respiratory conditions such as asthma, COPD, and bronchitis.
  • The therapy helps increase blood flow and in turn oxygen to the affected areas, breaking up congestion, and reducing inflammation in the lungs. Inflammation reduction is highly beneficial in the shoulders, neck, and back area for patients with chronic respiratory conditions.
  • Fire Cupping, the most traditional form can be used on the upper back and neck area. This therapeutical approach can help to relax muscles, provide pain relief, stimulate breathing, and improve lung function.

Digestive Disorders

  • Cupping can be used to help relieve digestive disorders such as IBS, stomach ulcers, and constipation. The therapy helps to stimulate digestion by improving blood flow to the digestive organs, relaxing muscles, and reducing inflammation.
  • With stomach issues, wet cupping can be utilized, allowing the therapist to drain toxins by small incisions, which in turn helps relieve stomach pain and discomfort issues.

Skin Conditions

  • Cupping can be used to relieve skin conditions such as acne, eczema, and psoriasis, itchy skin, and cellulite. The therapy helps to stimulate blood flow and lymphatic drainage in the affected area, allowing the body to rid itself of toxins and dead cells. Additionally, cupping therapy provides relaxation which helps the body to re-establish homeostasis.

Other Conditions

  • Cupping therapy may help to alleviate symptoms associated with a wide range of conditions such as anxiety, stress, depression, and fatigue, and also may help patients to cope with side effects of cancer treatments during and after therapy treatments.
  • Additionally, cupping therapy can be used to treat conditions such as high blood pressure, varicose veins, and fertility issues related mainly to stress or stagnant blood flow.

Precautions for Cupping

Like any medical or alternative therapy, cupping carries some risks, and it is important to consult with your doctor before undergoing treatment. Here are some precautions to be aware of:


  • Pregnant women should avoid cupping on the abdomen and lower back to avoid disturbing circulation to the uterus. Cupping is considered safe if placed on the upper back and neck areas.
  • Patients with skin inflammation, deep vein thrombosis, organ failure, and hemophilia should avoid cupping altogether.
  • Cupping should not be performed on injured or broken skin or over moles and warts.

Risks and Complications

  • Cupping leaves temporary bruises or marks on the skin that usually disappear in 5-10 days. This should not be cause for concern
  • Rarely, patients may experience adverse reactions such as infection, skin irritation, burns, or an allergic reaction to the cups themselves. This is why it's critical to have a trained and certified cupping therapist, and patients should be advised to seek treatment at established clinics and centers.

Pre-Cupping Preparation

  • Patients undergoing cupping should wear loose-fitting and comfortable clothing, preferably made of natural fabrics such as cotton. Tight fitted clothes may obstruct blood and energy flow.
  • Patients should avoid applying lotions, creams, or oils to their skin on the day of their treatment, as they can interfere with the vacuum seal.
  • Patients should drink plenty of water before and after cupping therapy to help flush out toxins released during the therapy sessions.
  • Patients should inform their cupping therapist about any underlying medical conditions, allergies, or medications they are taking, to avoid any complications.

Post-Cupping Care

  • After the cupping session, patients should avoid taking hot shower or sauna for at least 4 hours since the body usually feels sensitive to extreme temperatures
  • If the cups are removed before the end of the therapy session, the therapist will cleanse the treated area with an antiseptic and apply clean dressings.
  • Patient should avoid exposing the treated area to direct sunlight for a few days as a precautionary measure, and patients should remain relaxed and cease all heavy physical activities for the remainder of the day/night if possible.
  • If there is any concern, or if the condition being treated does not improve, the patient should seek follow-up care with the cupping therapist or their doctor.

Cupping Treatment Procedure

The cupping procedure is usually performed by licensed practitioners or healthcare providers who have undergone specialized training. The therapy is relatively quick and painless, and it typically takes around 20 to 30 minutes, depending on the number of cups being used and the patient's individual condition. Here are the steps involved in the cupping treatment process:

Selection of Equipment

Before cupping therapy, the therapist selects the appropriate cups for each patient, depending on the area to be treated, the patient's age and medical conditions, and the type of cupping being performed. These cups can be made from glass, bamboo, silicone, plastic or ceramic. Glass cups are the traditional option. They create a stream of fire that is used to heat the cup, which then causes a vacuum that holds it in place.

Preparation of the Patient

The patient will be asked to lay down on a table or bed, depending on the type of cupping procedure being done. The therapist then applies oil or lotion to the skin to help the cups create a vacuum seal and glide effortlessly over the skin. During the process, the patient lies still and tries to relax.

Cupping Treatment Techniques

The therapist applies heated cups to specific points on the back, neck, shoulders or other parts of the body in a process called stationary cupping. In another form of the treatment, called sliding cupping or moving cupping, the therapist applies a lubricant to the skin and moves the cups continuously along the body's meridians to stimulate circulation and energy flow. In wet cupping, small incisions are made on the skin to let out some blood before the cups are placed on the body. The cups can be left on the body for 5-15 minutes.


Once the therapy is complete, the therapist removes the cups gently and covers the treated area with clean dressings to prevent infections. The patient may feel relaxed or uneasy after the treatment, depending on their individual response to the therapy. The therapist provides a post-treatment health advice such as advice on staying hydrated via water intake as cupping releases toxins and fluids from the body. The patient should also avoid taking a hot shower or bath for a few hours after the therapy to avoid irritation of the treated area. If there is any severe reaction such as a rash or blisters, the patient should inform their therapist immediately.


Cupping therapy is an ancient alternative medicine technique that has been used for thousands of years. It is a non-invasive procedure that is relatively safe and uses suction cups to promote healing and wellness. We have looked at the following main points regarding cupping:

  • Cupping therapy creates a vacuum effect that can stimulate circulation, reduce pain, and promote relaxation.
  • Types of cupping therapy include dry, wet, and fire cupping.
  • Cupping therapy is generally considered safe but should be avoided by pregnant women, people with bleeding disorders, or people taking blood thinners.
  • Cupping therapy can be beneficial in treating pain, respiratory issues, digestive disorders, skin conditions, and other ailments.

Future research avenues for cupping therapy involve further investigation into its molecular mechanisms of action and efficacy in treating specific conditions. There is no doubt that cupping therapy is an interesting field that deserves further study.

William H. McDaniel, MD

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School.

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