Cupping is a technique where a vacuum is created in a cup, drawing the skin up into the cup decompressing the layers of the epidermis and subcutaneous superficial fascia. Cupping has been practiced in most cultures in one form or another throughout history but the true origin of cupping therapy remains uncertain. Some may not realize the widespread use of the technique, in 1900 John Harvey Kellogg wrote about 'dry cupping' in The Home Handbook of Domestic Hygiene and Rational Medicine stating:
"Dry cupping is an excellent means of treating some affections, particularly lumbago. ... The application may be made by means of the regular apparatus, which consists of an air-pump with a properly constructed cup for application to the skin"
Cupping massage is a modern version of a traditional therapy, newer plastic materials allow flexible and softer cups without compromising the efficacy of the modality. Today, cupping is frequently carried out using plastic cups and a manual hand-pump to create the vacuum. The vacuum “draws” the soft tissue perpendicular to the skin, providing a tensile force, which can be left in one site for a prolonged period or moved along the tissue. The practitioner can control the intensity of the desired suction from 80 mmHg to 250 mmHg. The most common sites of application are the back, chest, abdomen and buttock. The cups are typically left in place for 5-15 minutes depending on the client’s reaction and sensitivity. To cover a wider area, lubricants can also be used to move the cup around once placed on the skin. Cupping massage uses varying amounts of suction along with a glide, stroke, torque, pull, vibration, all in a multi-planar nature.
Physiological Effects of Cupping
The biological mechanism and clinical effects of cupping are still not well researched, the skin, subcutaneous tissue and fascia are all embedded with mechanosensitive nerve fibers, so it is likely that cupping invokes a number of neurophysiological responses.
"The physiological effect of cupping expressed in the activation of the immune system by causing local inflammation and activation of the complement system, also affects the thymus and increases the lymph flow. Cupping also stimulates the mechanosensitive Aβ fibers which reduce nociceptive input. More intense stimulation activates the C and Aδ fibers in the affected areas, thereby raising the inhibitory receptive fields of cortically projecting and provoking diffuse noxious inhibitory controls. In addition, cupping probably strongly impacts relaxation and may serve as a social, comforting interaction. Further investigations of these mechanisms of action are necessary." (Rozenfeld 2016)
Is Cupping Safe?
Cupping is generally considered a safe therapy with minor side effects such as erythema, edema, and ecchymosis in a characteristic circular arrangement. The longer a cup is left on the skin and the higher tensile stress inside of the cup, the more of a circular mark is created this is due to capillary dilation. Cupping encourages blood flow to the cupped region (hyperemia), often the patient may feel warmer and/or hotter as a result of vasodilatation taking place, slight sweating may occur.
Cupping is a technique where a vacuum is created in a cup, drawing the skin and subcutaneous superficial fascia up into the cup. Cupping is believed to date back to as early as 3000 B.C.E., most associate cupping with Traditional Chinese Medicine, but the use of cupping was not limited to ancient China, cupping was also utilized in ancient Greece, ancient Egypt and used by Anglo-Saxons (Rubin 1974). Cupping has stood the test of time, but in the days of evidence based medicine, further investigations of the mechanisms of action and clinical efficacy are necessary.
Kellogg JH (1900). The Home Hand-Book of Domestic Hygiene and Rational Medicine.
Rozenfeld, E., & Kalichman, L. (2016). New is the well-forgotten old: The use of dry cupping in musculoskeletal medicine. Journal of Bodywork and Movement Therapies.
Rubin S. (1974) Medieval English Medicine. New York.
Wong, J. J., Shearer, H. M., Mior, S., Jacobs, C., Côté, P., Randhawa, K., . . . Taylor-Vaisey, A. (2015). Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? an update of the bone and joint decade task force on neck pain and its associated disorders by the optima collaboration. The Spine Journal