Cupping Therapy

Written by: Dr. Mary Froeba, DAcOM LAc

I originally learned cupping therapy from my mother, who is also a Doctor of Acupuncture and Oriental Medicine. My first lesson was roughly twenty years ago and I loved it right away – the feel of the suction into the glass cup, the warmth of the fire, the joy and relaxation it gave whoever was being treated. 

Dr. Mary Froeba and older woman in graduation cap and gown
Mother and Daughter, Lesley Hamilton and Mary Froeba, Doctors of Acupuncture and Oriental Medicine

I carried that skill with me for years as I traveled the world. I remember shopping for glass fire cups in Sydney’s Chinatown when I was 18 years old. The old shop was dark and crowded with boxes full of overseas shipments, bags of dried herbs piled high with barely room to move. No one in the shop knew what I was asking for until an old woman who didn’t speak English (and I didn’t speak Chinese) came over. I mimicked the action of lighting a candle and placing an imaginary cup on my body. Her face brightened and she took me to a large cardboard box full of clear glass bowls – only one Australian dollar a piece! 

I didn’t think I had much more to learn about cupping therapy when I went to graduate school for my Masters in Acupuncture and Oriental Medicine, but I was wrong. I quickly understood the skill itself was but the tip of the iceberg. 

Throughout the four-year, year-round program, I learned how to “read” the color that came up from a cupping treatment and the feel of the tissue underneath. Did you know the cupping mark color tells you about the nature of a person’s pain and constitution? The story from the color and how a cup feels for a person is complex and can’t be justly written about in a single blog, something for another day. 

I was surprised to find how much more there was to learn – and I can tell you now, between cupping therapy, acupuncture, and herbology, I’ve chosen a medicine that I will be studying until my last day on Earth.

What Cupping Therapy Is

Put simply, cupping is the placement of a bowl or cup to a person’s body, attached by a vacuum. The vacuum may be created through heat or the pumped removal of air. Cupping therapy is typically used to treat pain but not exclusively.

cupping on person's back
Hard Plastic Cups with Suction Pump: Great for fine-control of suction strength.

A Brief History of Cupping Therapy

Cupping therapy has been practiced all over the world at various times in history – at least as far back as two thousand years ago. It has been practiced by the ancient Egyptians, Arabs, Native Americans, Chinese and Greeks (Hippocrates, the Father or Modern Medicine, was a practitioner!)

The earliest records of cupping therapy show the use of cattle horn for a cup and a small flame to create negative pressure within the cavity of the horn. Cupping therapy was likely used originally to help pull pus and blood from boils and wounds, but over time used for so much more; such as painful, tight muscles, diseases of the lungs, skin problems, and digestive difficulties.

Over the last two thousand years, cups have been made from a wide variety of materials: horns, wood, glass, and porcelain to name a few. Bamboo cups came into popularity a long time ago and are still used today in China, preferred for their light weight and low cost. Modern U.S. practitioners have the luxury of being particular, working with the materials and that best suit their own practices. Typically those are glass, plastic, or silicone.

cupping on woman's back
Ceramic Fire Cups that leave Heart Shaped Marks: “Love Cupping”

How Cupping Therapy Works

Cupping therapy is a suction of the surface body tissue, potentially strong enough to lift muscle tissue. It is this decompression action that allows the free flow of blood, lymphatic fluid, and other body fluids which may otherwise be impeded. Without obstruction, the body is able to operate at its full potential delivering nutrients and disposing of waste. 

Studies have also shown cupping therapy significantly reduces inflammation. Researchers measure blood inflammation markers (Erythrocyte Sedimentation Rate) before and after cupping therapy sessions – with anywhere from a 27% to 60% reduction. (Chirali)

Cupping can leave behind marks that people often call bruises, but they are not typical bruises and rarely are tender to the touch. The color of the marks, which vary from hot pink to dark purple, is an expression of what is happening underneath the tissue. The color may indicate inflammation, tension, anemia, or show signs of an old injury not fully healed, and so on.

Cupping Therapy in Action

Just as there are many different types of cups, there are many different ways to use them. 

Cups may be left in one place (stationary cupping therapy) or moved across an area of the body (moving cupping therapy.) Suction strengths may be very gentle or quite strong, depending on the practitioner’s goal and patient’s comfort level and constitution.

cupping on woman's face
Facial Cupping Therapy: For sinus pressure relief and facial rejuvenation

Facial cupping therapy, used for sinus pressure relief and facial rejuvenation, is very gentle and rarely produces cupping marks, as compared to the stronger suction typically done on the back. 

Some practitioners may employ something called “wet cupping” in which blood droplets are pulled from the body. This seems extreme but is typically painless and minimally executed. Before you judge this, remember even U.S. hospitals still use bleeding techniques today – with leeches too! 

It is important for patients to keep communication lines open during a treatment – if you don’t like what is happening, say so. The practitioner will either adjust or justify their actions. In the end though, you should be confident in the practice and if you don’t like what is happening, that matters.

With that said – most of the time, most folks are very happy with the way cupping therapy feels. Often it is a similar feeling to a massage, but with a sense of decompression rather than pressure. 

Research of Cupping Therapy Today

Studies that compare groups of people receiving cupping therapy versus other forms of therapy frequently show favorable outcomes. These studies have shown Cupping Therapy effective (or at least promising) for chronic low back pain, neck pain and tension, carpal tunnel syndrome, and brachialgia (arm pain), just to start! 

Cupping may not be effective, though, for treatment of hard tissue disorders such as bones spurs.  

Comparative studies between groups are common but it can be tricky when scientists start trying to create double blind studies or other studies that call to compare against a placebo. Why? Because you are either receiving cupping therapy or you aren’t. Some studies try to bypass this problem by applying the suction then immediately releasing it – calling it “sham cupping”. The problem is, a brief moment of suction is still therapeutic. It is called “flash cupping”. 

In the end, there is no placebo or fooling anyone when it comes to this therapy, making double blind studies unlikely to pass peer review. It is for this reason that some will always insist that the evidence for cupping therapy is insufficient. I say, if it does no harm, and people find it beneficial – then use it!

Dr. Froeba’s Cupping Therapy Practice

Here at Apex Sports Medicine in Leander, Texas, nearly all my patients receive cupping therapy in one form or another. Cupping is not only used as a therapeutic tool but also used as a diagnostic tool. For this reason I almost always employ it on a patient’s first visit. I’ll place and move cups along the individual’s back to see and feel what comes up. This information leads me to my next step – whether it is acupuncture, electrical stimulation, or more cupping therapy.

Dr. Mary Froeba holding cupping jar and flame
Dr. Mary Froeba, DAcOM LAc Fire Cupping

Additional resources not cited in text

1. Hijama or Cupping. Greek Medicine. [Online] 2007. http://www.greekmedicine.net/therapies/Hijama_or_Cupping.html.2. Chirali, Ilkay Zihni. Traditional Chinese Medicine: Cupping Therapy. 2. Philadelphia : Churchill Livingstone, 2007.

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