Cupping therapy

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Cupping therapy
File:Fire Cupping.jpg
A patient receiving fire cupping therapy

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.[1] Suction is created using heat (fire) or mechanical devices (hand or electrical pumps). It is known in local languages as Meyboom,baguan/baguar, badkesh, banki, bahnkes, bekam, buhang, bentusa, kyukaku, gak hoi, Hijamah, kavaa (ކަވާ), mihceme,[2] and singhi among others.


A partial vacuum is created in cups placed on the skin either by means of heat or suction. According to the American Cancer Society, "[a]vailable scientific evidence does not support cupping as a cure for cancer or any other disease". It can leave temporary bruised painful marks on the skin and there is also a small risk of burns.[3]


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.[citation needed]


Broadly speaking there are two types of cupping: dry cupping and bleeding or wet cupping (controlled bleeding) with wet cupping being more common.[citation needed] 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.[citation needed]

Dry cupping[edit]

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.[4]

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.[citation needed]

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[edit]

File:Fire cupping in Haikou - 02.JPG
A woman receiving fire cupping at a roadside business in Haikou, Hainan, China.

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)[edit]

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.[5] According to Muhammad al-Bukhari, Muslim ibn al-Hajjaj Nishapuri and Ahmad ibn Hanbal, Muhammad approved of the Hijama (cupping) treatment.[6]

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 .[7]

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[1] 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[edit]

According to traditional Chinese medicine (TCM) cupping is a method of creating a vacuum on the patient's skin to dispel stagnation[citation needed] — stagnant blood and lymph, thereby improving qi flow[citation needed] — to treat respiratory diseases such as the common cold, pneumonia and bronchitis.[citation needed] Cupping also is used on back, neck, shoulder and other musculoskeletal conditions. Its advocates say it has other applications, as well.[8] Cupping is not advised over skin ulcers or to the abdominal or sacral regions of pregnant women.[9]

Limited bruising cupping massage[edit]

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.[citation needed] 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[citation needed].


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)[citation needed], and is claimed by proponents to help general physical and psychological well-being[citation needed].

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.


The Public Library of Science, or PLoS ONE, published in 2012 a review of 135 studies on the efficacy of cupping therapy. The review considered only studies that included randomized control trials, as many other studies were found to be less consistent with standard medical testing procedures. The review concluded that (a.) cupping therapy did not produce serious adverse side effects; and (b.) TCM patients who received cupping therapy as part of their treatment showed significant health benefits over those who did not receive cupping. Patients who particularly benefited from the inclusion of cupping included those afflicted with shingles, facial paralysis (e.g. Bell's Palsy), acne, and spondylosis (or osteoarthritis of the neck).

135 RCTs published from 1992 through 2010 were identified. The studies were generally of low methodological quality. Trials were appraised according to the risk of bias for each important outcome, including adequacy of generation of the random allocation sequence, allocation concealment, blinding, and outcome reporting. Quality of each trial was categorized into low/unclear/high risk of bias. Trials that met all criteria were categorized into low risk of bias, trials that met none of the criteria were categorized into high risk of bias. The main limitation of the analysis was that nearly all included trials were evaluated as high risk of bias[10]

Only one controlled trial of cupping has been conducted, and it did not demonstrate any effectiveness for pain relief. In their 2008 book Trick or Treatment, Simon Singh and Edzard Ernst claims that no evidence exists of any beneficial effects of cupping for any medical condition.[11]

Cupping as a fetish[edit]

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.[12]

See also[edit]


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  1. 1.0 1.1 "British Cupping Society". Retrieved 2008. Check date values in: |accessdate= (help)<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  2. Kaya SO, Karatepe M, Tok T, Onem G, Dursunoglu N, Goksin, I (2009). "Were pneumothorax and its management known in 15th-century anatolia?". Texas Heart Institute Journal. 36 (2): 152–153. PMID 19436812. Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  3. "ACS :: Cupping". 2007-05-23. Retrieved 2007-06-21. Unknown parameter |coauthors= ignored (|author= suggested) (help)<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  4. Cui Jin and Zhang Guangqi, "A survey of thirty years’ clinical application of cupping", Journal of Traditional Chinese Medicine 1989; 9(3): 151–154
  5. Andrew Rippin and Jan Knappert, Textual Sources for the Study of Islam, Manchester: Manchester University Press, 1986; Chicago: University of Chicago Press, 1990. 78.
  6. Sunan Abu Dawood, 11:2097, 28:3848, Sahih Muslim, 26:5467, 10:3830
  7. Observations of the popularity and religious significance of blood-cupping (al-ḥijāma) as an Islamic medicine, Ahmed El-Wakil, Contemporary Islamic Studies, Vol. 2011, 2
  8. State Administration of Traditional Chinese Medicine and Pharmacy, Advanced Textbook on Traditional Chinese Medicine and Pharmacology, Volume IV, 1997 New World Press, Beijing
  9. Chinese Acupuncture and Moxibustion (Revised Edition), Xingnong, Foreign Languages Press, Beijing, China, 1987, p370.
  11. Singh, Simon; Ernst, Edzard (2008). Trick or Treatment. Transworld Publishers. p. 368. ISBN 9780552157629.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  12. "Cupping - PeterMastersWiki". Retrieved 2013-08-31.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>

Further reading[edit]

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External links[edit]

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