What exactly is cupping?

Robert H. Shmerling, MD
Robert H. Shmerling, MD, Faculty Editor, Harvard Health Publications

Follow me on Twitter @RobShmerling

The 2016 summer Olympics had its share of exciting performances, upsets, and photo finishes. But for days after Michael Phelps’s first appearance at the games, it seemed all anyone could talk about was “cupping.” It’s an ancient therapy that left multiple circular discolorations on his skin. During “dry cupping,” suction is applied to the skin for several minutes; sometimes it is combined with massage, acupuncture, or other alternative therapies. (“Wet cupping” is similar except that blood is removed by making small cuts in the skin.)

Cupping is supposed to draw fluid into the area; the discoloration is due to broken blood vessels just beneath the skin, much like a bruise. Cupping has been popular in Egyptian, Chinese, and Middle Eastern cultures going back thousands of years, but increasing numbers of people worldwide have been adopting it. Celebrities and athletes have popularized it in the U.S. in recent years.

What is cupping supposed to do?

According to its advocates, cupping is supposed to promote healing and has been used extensively for sore muscles. But that’s only the beginning. Cupping has also been used for

  • back and neck pain
  • skin diseases such as acne and hives
  • lowering cholesterol
  • migraines
  • knee arthritis
  • improving immune function.

And there are many others. If cupping does help with these problems, it’s worth asking: how? From a biological perspective, it’s not clear how the application of suction and drawing blood into an area under the skin would provide all these benefits. A recent review of the treatment describes cupping as a treatment that can strengthen the body’s resistance, restore balance between positive and negative forces, remove disease-causing factors, and promote blood circulation. But exactly how is unclear.

Does cupping work?

A number of studies have examined this question, but unfortunately don’t seem to have  convincingly answered it. In fact, a 2015 review of the evidence found that cupping might provide some relief for chronic neck or back pain, but that the quality of the evidence was too limited to draw firm conclusions.

One problem is that it’s tough to perform a high-quality study on cupping. The best studies are “blinded placebo-controlled trials” in which neither the patient nor the researcher knows which treatment (real or placebo) has been given to a study subject. When medications are studied, coming up with a placebo pill is not difficult; it can be much more difficult to create a convincing placebo comparator for cupping. In addition, pain can be a difficult thing to measure and the placebo effect — improvement related to an expectation of benefit — can be quite powerful.

Still, there have been studies comparing actual acupuncture with convincing but fake (or “sham”) acupuncture.  Similar studies of cupping could be possible. And if cupping truly helped, you may not care if it’s due to the placebo effect.

Are there risks involved with cupping?

Most experts agree that cupping is safe. As long as those treated don’t mind the circular discolorations (which fade over a number of days or weeks), side effects tend to be limited to the pinch experienced during skin suction. It’s quite unusual that cupping causes any serious problems (though, rarely, skin infections have been reported).

So, what’s next?

If you want convincing evidence of effectiveness before trying a treatment, you may want to pass on cupping for now. But if you’d like to try something that’s safe and might help with certain aches and pains (and possibly other ailments), the main downsides seem to be the temporary skin discoloration and the cost — I found estimates online of $30 to $80 per treatment. Some people have it only “as needed” but others may have it monthly or even more often. Future research could prove that cupping is as good as the claims say it is — but we’ll have to wait for the results of high-quality studies to know if it’s true.

Related Information: Harvard Health Letter

Comments:

  1. Pedro Alves - Food Scientist

    Harvard promoting an absurd superstition at Science’s expense?!
    Unbelievable! How many people were «cured» by that «ancestral technique» with «1000s of years», long before any kind of useful knowledge about the human body inner workings existed? 0?…
    How many were saved with vaccines provided by the Scientific Revolution of the last centuries? Billions!
    Scrap superstition for ever!

  2. Timothy

    Seen this before though had no idea what it is. Thanks for this informative article!

  3. Benjamin Dierauf, LAc

    As a Licensed Acupuncturist with over 20 years of experience, I have found cupping to be one of my favorite modalities to complement the effects of acupuncture. (And yes, I’ve successfully treated sciatica many times).

    The problem with the author’s approach to assessing the effectiveness of cupping (and acupuncture as well) stems from their use of “blinded placebo-controlled trials” instead of outcome studies. Blinded studies work for drugs, but they don’t work for procedures – patients know when they’ve been cupped or needled (or had surgery). Outcome studies that use standardized forms and assessment scales work much better for procedures.

    If we really wanted to understand the effects of cupping, we would be doing fundamental research on changes in anatomy and physiology that result from cupping, in addition to the outcome studies. Unfortunately there is no financial/patent incentive for this procedure (as there is with pharmaceutical research) so it’s going to take a lot longer to happen.

  4. Julia

    Cupping has been used for thousands of years and is a great way for health. I got two cupping sets and have used cupping a lot for the last several years and cured many problems the other ways can’t do. Believe in this ancient way of healing for your body’s discomfort and pain!

  5. Alison

    I tried methods similar to this for my Sciatica. I developed it when I was pregnant with our first child, although after spending years at my job hunched over a desk with bad posture I think that had a lot to do with it also then my pregnancy just tipped me over the edge.

    I felt like I was 100 years old hobbling around the house! Anyway I found a product reviewed online.

    I was skeptical at first as many people are with these kinds of things but I thought what the heck, what do I have to lose and gave it a shot and my only regret I have to say is that I didn’t find it sooner. I am just over 2 months pain and symptom free i’d say, around that amount of time anyway. Now my main task is doing the prevention method the product instructs to make sure my Sciatica never returns – hopefully!!!

  6. This is really happy story. I will translate this story and i will share it.
    Best regard to the writer.

  7. Royse

    I had sciatica for almost 2 years and was unable to sit and walk. Chiropractors, acupuncture didn’t help me at all. The situation was really bad. However, one day by searching google for alternative treatments I found an e-book that was created by former sciatica sufferer. He claimed that he cured his severe sciatica in one week at his home. I was skeptical about it, but I had nothing to lose, so I bought that e-book at:

    foryourhealth.ga/sciatica-sos-review/

    After receiving it, I didn’t believe that some specific stretches can help me to deal with sciatica, but I started following it and surprisingly after first session my pain was almost gone! It didn’t last long until my sciatica went away permanently. So from now on, I recommend everyone who have sciatica to practice specific stretches and hope for the best.

    • Jerry Panela

      Wow! I have the same problem for several years now. There are times that I can barely walk. Please advise on the stretching exercises. Thanks.

      • Alison

        Hi Jerry,

        I know the feeling, some days I feel like an ancient old woman! Stretches that helped me are ones like in this link here – spine-health.com/wellness/exercise/stretches-and-exercise-sciatic-pain-piriformis-syndrome

        Also I used this program to pretty much get rid of my Sciatica altogether over a period of around 4-5 weeks, maybe more – remediesreviewed.com/sciatica-sos-review/

        Hope this helps Jerry!