Cupping, patient benefits and new research

Cupping is rising to new awareness heights; now new research is showing additional benefits

Cupping and the fascination over the practice have brought the modality into the spotlight over the last few years, but in the health care realm, cupping has been popular for some time. There are approximately 25,000 healthcare professionals practicing cupping across the U.S. according to the National Center for Complementary and Integrative Health (NCCIH).

Cupping involves cups made of glass, ceramic, bamboo, or plastic, suctioned onto the skin where negative pressure is then created by removing the oxygen from the cup — generally achieved either by applying flame or by attaching a suction device. There are two types of cupping, wet and dry. With wet cupping, the skin is pierced to allow the patient’s blood to flow up and into the cup. Dry cupping involves no piercing at all.

Called Hijama in Arabic, cupping can be traced back to ancient times, appearing as a medical practice in both Egyptian and Chinese cultures.

Cupping goes mainstream

Cupping received international attention when U.S. swimmer Michael Phelps appeared at the 2016 Summer Olympics in Rio de Janiero with purple circles on his back from cupping to recover and heal muscles after competition.

“I’ve done it before meets, pretty much every meet I go to,” Phelps said during the Olympics. “So I asked for a little cupping yesterday because I was sore and the trainer hit me pretty hard and left a couple of bruises.”

Many athletes swear by the modality that draws blood to the affected area, reducing soreness and speeding muscle healing of overworked muscles.

Cupping research

After reviewing 135 randomized controlled trials published between 1992 and 2010 — the majority of which were published between 2008 and 2010 — researchers from the Beijing University of Chinese Medicine revealed that the mechanism behind cupping therapy is still somewhat cloudy.

However, these researchers also went on to say that some health and wellness experts feel that placing the cups on specific acupoints creates a therapeutic effect by either producing hyperemia (an excess of blood flow in a particular body part) or hemostasis (the stoppage of blood flow), sometimes resulting in harmless marks on the skin.

Another group of researchers indicate that there are many different potential theories as to how cupping works, a few of which include pain-gate theory, reflex zone theory, and activation of immune system theory. Though many still question how it works, research is continuing to find that it does, in fact, provide therapeutic benefits.

New research on cupping’s effectiveness

The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) reports that “cupping therapy is far from a placebo” as many studies have linked this practice to effective pain relief.

One 2017 study published in BMJ Open involved a systematic review and meta-analysis of 18 randomized controlled trials on patients with neck pain. After analyzing the data, the authors concluded that “cupping was found to reduce neck pain in patients compared with no intervention or active control groups, or as an add on treatment.”

Another study, this one published in Traditional Medicine Research in January 2019, noted that four sessions of hot cupping therapy performed every four days resulted in reduced pain intensity for individuals suffering with knee osteoarthritis. It also decreased their stiffness and disability.

Patient benefits

According to the NCCAOM, many elite athletes have used cupping as part of their training and treatment regimens. The Pacific College of Oriental Medicine (PCOM) adds that cupping therapy may offer benefits for athletes specifically, such as when they have muscle spasms since this practice improves blood flow while also removing toxins.

Individuals who are non-athletes can benefit from cupping as well. The PCOM indicates that among them are those struggling with asthma or those looking for congestion relief from the common cold. Cupping can also provide a variety of digestive reliefs, such as easing constipation and providing “stronger digestion.”

A 2012 review-based study published in PLoS One further states that cupping is commonly used in the treatment of conditions such as herpes zoster, Bell palsy, lumbar disc herniation, and cervical spondylosis. In most of trials conducted to ascertain the effectiveness of cupping, wet cupping was used. Other techniques utilized included:

• Retained cupping – an alcohol-soaked cotton swab is ignited inside the cup, creating a vacuum, then the burning swab is removed and the hot cup is placed on the skin;
• Moving cupping – massage oil or cream is placed on the skin prior to applying the cups so they can easily be slid to other regions of the body;
• Flash cupping – cups are applied very quickly before being popped off, a shortened application that is commonly used with children.

When not to cup

The NCCIH warns that cupping can create a few adverse side effects, one of the most notable the round marks left on the skin where the cups were applied. In some individuals this treatment can also result in skin discoloration, scars, and burns.

It’s also a potential that cupping can worsen skin conditions such as eczema or psoriasis says the NCCIH. And if the cups are applied to the scalp, it can create bleeding in the skull while repeated wet cupping sessions can result in anemia due to excessive blood loss. The NCAAOM stresses that individuals interested in this treatment option choose a properly-trained cupping practitioner.