Cupping Therapy: Types, Benefits, and Potential Risks

What does cupping therapy treat?

Cupping therapy is widely used for pain relief and treating musculoskeletal conditions, particularly neck pain, back pain, and joint discomfort. It is also used for:

• Improving blood circulation in stiff or injured areas.
• Reducing inflammation associated with arthritis and other chronic conditions.
• Easing muscle pain from sports injuries or overuse.
• Supporting recovery in patients with chronic pain conditions like fibromyalgia.
• Addressing respiratory issues, such as asthma or bronchitis, by stimulating blood flow in the chest.
• Managing skin infections and other dermatological concerns in some alternative treatments.

Who conducts cupping therapy?

Cupping therapy is performed by trained professionals in traditional and complementary medicine, including massage therapists, chiropractors, acupuncturists, and licensed cupping therapists. To enhance treatment outcomes, some healthcare practitioners integrate cupping with alternative medicine techniques, such as acupuncture or manual therapy.

Though generally safe when performed by a professional, cupping does have risks, including bruising, mild discomfort, and the potential for skin infections if proper hygiene is not maintained. Medical professionals should assess whether cupping suits each patient based on their health condition and medical history.

Types of cupping therapy methods

Cupping therapy has evolved into various methods, each designed to target specific conditions and enhance pain management. Rooted in traditional Chinese medicine, these techniques address issues like chronic back pain, knee pain, and shoulder pain (Al-Bedah et al., 2019). Each cupping session varies in approach, intensity, and expected pain outcomes, depending on the patient's needs.

Dry cupping

Dry cupping is one of the most common techniques in Chinese medicine (Pesut, 2021). It involves placing suction cups on the skin without making any incisions. This method helps improve blood flow and is commonly used for migraine headaches, chronic back pain, and local blood flow enhancement. After a session, cupping marks may appear but typically fade within a few days.

Wet cupping

Wet cupping involves small incisions on the skin before applying suction (Rahman et al., 2020). This technique, often used in traditional Chinese medicine, is believed to remove toxins by drawing blood. It treats blood disorders, diabetes mellitus, and skin conditions. A professional must conduct wet cupping under sterile conditions to prevent infections.

Hot cupping

Hot cupping, or fire cupping, uses heat to create suction. Practitioners briefly ignite an alcohol-soaked cotton ball inside the cup before placing it on the skin. The cooling air inside forms a vacuum, stimulating local blood flow. This technique helps with knee pain, shoulder pain, and muscle stiffness.

Potential benefits of cupping therapy

Cupping therapy is recognized in traditional medicine for its potential role in clinical practice as a low-risk therapy for various conditions. Many physical therapists integrate this ancient therapy into treatment plans for musculoskeletal pain, circulation issues, and recovery support. The mild suction created during cupping work expands blood vessels, increasing blood flow to targeted areas, which may aid in pain relief and tissue repair.

Moreover, professionals believe cupping influences pain signals, potentially reducing discomfort in patients with chronic pain conditions (Zhang et al., 2024). It is also linked to the immune system theory, which proposes that cupping may stimulate the body's natural defenses. Additionally, cupping may enhance the body’s antioxidant processes, supporting cellular repair and reducing inflammation.

Cupping therapy remains a widely used low-risk therapy in clinical practice. It offers an adjunct treatment for pain management, recovery, and circulation enhancement in physical therapy and traditional medicine settings.

Potential risks of cupping therapy

While cupping therapy is a traditional method used in Middle Eastern cultures and other healing practices, it carries potential risks that medical professionals should consider. The therapist puts special cups on the skin to create suction, which can cause bruising, skin irritation, and mild discomfort. In some cases, improper technique or excessive suction may affect large nerve fibers, leading to prolonged sensitivity or pain.

One concern is the potential for spreading infections, especially if disposable cups are not used or proper sanitation is lacking. Wet cupping involves drawing blood and may also introduce pathogens if sterile procedures are not followed. Cupping can impact lymphatic drainage, possibly affecting immune function, particularly in individuals with weakened immune systems.

Some practitioners might caution against its use in patients with organ failure or severe conditions. While it is often used to reduce pain, cupping may trigger inflammatory substances, leading to unintended side effects. Caution should also be taken when combining cupping with electrical stimulation in therapy to avoid excessive stress on the nervous system.

Who shouldn't undergo cupping therapy?

Certain individuals should avoid cupping due to potential risks and contraindications. Healthcare providers should assess a patient's medical history before recommending this therapy. People with bleeding disorders, blood clotting issues, or those taking anticoagulant medications may experience excessive bruising or prolonged healing.

Patients with skin infections, open wounds, or severe skin conditions should also avoid cupping, as the suction from glass cups may worsen irritation or lead to infections. Individuals with organ failure, severe cardiovascular conditions, or compromised immune systems may not respond well to cupping, which could strain the body more.

Psychiatric patients using mood enhancers or individuals with extreme sensitivity to pain should consult a professional before undergoing treatment. While cupping is often used to ease pain, it may not suit those with neurological disorders affecting pain perception. Proper screening by trained professionals is essential to ensure patient safety.

Main takeaways

Cupping therapy remains a widely used traditional and complementary medicine practice, offering potential benefits for pain relief, improved blood flow, and muscle recovery. While many healthcare providers integrate it into clinical practice, understanding the different cupping techniques, benefits, and risks is crucial for safe application.

Despite its effectiveness in managing chronic pain and musculoskeletal conditions, cupping therapy is not suitable for everyone. Healthcare providers must assess patient suitability, considering contraindications such as blood disorders, skin conditions, and organ failure. Proper hygiene is essential to prevent infections, especially with wet cupping therapy.

Cupping can be a valuable addition to pain management strategies when performed correctly. It can help patients with conditions like neck pain, migraine headaches, and muscle tension while minimizing potential risks.

References

Al-Bedah, A. M. N., Elsubai, I. S., Qureshi, N. A., Aboushanab, T. S., Ali, G. I. M., El-Olemy, A. T., Khalil, A. A. H., Khalil, M. K. M., & Alqaed, M. S. (2019). The medical perspective of cupping therapy: Effects and mechanisms of action. Journal of Traditional and Complementary Medicine, 9(2), 90–97. https://doi.org/10.1016/j.jtcme.2018.03.003

Furhad, S., & Bokhari, A. A. (2019, February 11). Cupping therapy. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538253/

Pesut, S. (2021, February 18). Dry cupping therapy: Does it really help? University Hospitals. https://www.uhhospitals.org/blog/articles/2021/02/dry-cupping-therapy-does-it-really-help

Rahman, H. S., Ahmad, G. A., Mustapha, B., Al-Rawi, H. A., Hussein, R. H., Amin, K., Othman, H. H., & Abdullah, R. (2020). Wet cupping therapy ameliorates pain in patients with hyperlipidemia, hypertension, and diabetes: A controlled clinical study. International Journal of Surgery Open, 26, 10–15. https://doi.org/10.1016/j.ijso.2020.07.003

Zhang, Z., Pasapula, M., Wang, Z. Q., Edwards, K. L., & Norris, A. (2024). The effectiveness of cupping therapy on low back pain: A systematic review and meta-analysis of randomized control trials. Complementary Therapies in Medicine, 76, Article 103013. https://doi.org/10.1016/j.ctim.2024.103013