Cupping therapy is an ancient Chinese form of alternative medicine in which a local suction is created on the skin; practitioners believe this mobilizes blood flow in order to promote healing. Suction is created using heat (fire) or mechanical devices (hand or electrical pumps).
A partial vacuum is created in cups placed on the skin either by means of heat or suction. It can leave temporary bruised marks on the skin and there is also a small risk of burns.
There is reason to believe the practice dates from as early as 3000 B.C.; the earliest record of cupping is in the Ebers Papyrus, one of the oldest medical textbooks in the world, describes in 1550 B.C. Egyptians used cupping. Archaeologists have found evidence in China of cupping dating back to 1000 B.C. In ancient Greece, Hippocrates (c. 400 B.C.) used cupping for internal disease and structural problems. This method in multiple forms spread into medicine throughout Asian and European civilizations.
Broadly speaking there are two types of cupping: dry cupping and bleeding or wet cupping (controlled bleeding) with wet cupping being more common. The British Cupping Society (BCS), an organisation promoting the practice, teaches both. As a general rule, wet cupping provides a more “curative-treatment approach” to patient management whereas dry cupping appeals more to a “therapeutic and relaxation approach”. Preference varies with practitioners and cultures.
The cupping procedure commonly involves creating a small area of low air pressure next to the skin. However, there is variety in the tools used, the method of creating the low pressure, and the procedures followed during the treatment.
The cups can be various shapes including balls or bells, and may range in size from 1 to 3 inches (25 to 76 mm) across the opening. Plastic and glass are the most common materials used today, replacing the horn, pottery, bronze and bamboo cups used in earlier times. The low air pressure required may be created by heating the cup or the air inside it with an open flame or a bath in hot scented oils, then placing it against the skin. As the air inside the cup cools, it contracts and draws the skin slightly inside. More recently, vacuum can be created with a mechanical suction pump acting through a valve located at the top of the cup. Rubber cups are also available that squeeze the air out and adapt to uneven or bony surfaces.
In practice, cups are normally used only on softer tissue that can form a good seal with the edge of the cup. They may be used singly or with many to cover a larger area. They may be used by themselves or placed over an acupuncture needle. Skin may be lubricated, allowing the cup to move across the skin slowly.
Depending on the specific treatment, skin marking is common after the cups are removed. This may be a simple red ring that disappears quickly, the discolouration left by the cups is normally from bruising especially if dragging the cups while suctioned from one place to another to break down muscle fiber. Usually treatments are not painful.
Fire cupping involves soaking a cotton ball in 95% alcohol. The cotton is then clamped by a pair of forceps and lit via match or lighter. The flaming cotton ball is then, in one fluid motion, placed into the cup, quickly removed, and placed on the skin. By adding fire to the inside of the cup, oxygen is removed and a small amount of suction is created. Massage oil may be applied to create a better seal as well as allow the cups to glide over muscle groups (e.g. trapezius, erectors, latisimus dorsi, etc.) in an act called “moving cupping”. Dark circles may appear where the cups were placed due to rupture of the capillaries just under the skin, but are not the same as a bruise caused by blunt-force trauma.
Wet cupping (Al-Hijamah or medicinal bleeding)
While the history of wet cupping may date back thousands of years, the first documented uses are found in the teachings of the Islamic prophet Muhammad. According to Muhammad al-Bukhari, Muslim ibn al-Hajjaj Nishapuri and Ahmad ibn Hanbal, Muhammad approved of the Hijama (cupping) treatment.
A number of hadith support its recommendation and use by Muhammad. As a result, the practice of cupping therapy has survived in Muslim countries. Today, wet cupping is a popular remedy practiced in many parts of the Muslim world.
Alternatively, mild suction is created using a cup and a pump (or heat suction) on the selected area and left for about three minutes. The cup is then removed and small superficial skin incisions are made using a cupping scalpel. A second suction is used to carefully draw out a small quantity of blood. The procedure was piloted and developed by Ullah et al 2005 and has been endorsed by the British Cupping Society which aims to promote, protect and develop professional standards in cupping therapy.
In Finland, wet cupping has been done at least since the 15th century, and it is done traditionally in saunas. The cupping cups were made of cow’s horns with a valve mechanism in it to create an underpressure on them by sucking the air out. Cupping is still used in Finland as an alternative medicine.
Traditional Chinese medicine cupping
According to traditional Chinese medicine (TCM) cupping is a method of creating a vacuum on the patient’s skin to dispel stagnation — stagnant blood and lymph, thereby improving qi flow — to treat respiratory diseases such as the common cold, pneumonia and bronchitis. Cupping also is used on back, neck, shoulder and other musculoskeletal conditions. Its advocates say it has other applications, as well. Cupping is not advised over skin ulcers or to the abdominal or sacral regions of pregnant women.
Limited bruising cupping massage
New silicone cupping therapy massage cups are available, an innovation for cupping therapy and its wider acceptance. “Medical silicone” cups are claimed to alleviate deep bruising associated with traditional cupping. The cups allow for added new massage techniques because they are simple to use and are pliable, unlike glass or plastic. It is also highly recommended to drink plenty of water after cupping to help move the blood and other fluids through the area affected; general massage can help reduce the blood bruising immediately after the cupping.
Cupping is claimed to treat a broad range of medical conditions such as blood disorders (anaemia, haemophilia), rheumatic diseases (arthritic joint and muscular conditions), fertility and gynaecological disorders, and skin problems (eczema, acne), and is claimed by proponents to help general physical and psychological well-being.
There is a description of cupping in George Orwell’s essay “How the Poor Die”, where he was surprised to find it practised in a Paris hospital.
Cupping is widely used as an alternative treatment for cancer. However, according to the American Cancer Society, “available scientific evidence does not support claims that cupping has any health benefits”.
Cupping as a fetish
Cupping, especially fire cupping, is a sexual fetish associated with sensation play and/or blood play. It is often part of BDSM, as the combination of sensation and bruising can be appealing to BDSM practitioners.