Cupping is ancient, but is it effective?
If you haven't heard of cupping, the premise is simple – small cups are attached to the skin by creating a vacuum underneath them.
This sucks the skin upward into the cup. It's as simple as that.
You might have seen evidence of cupping on the backs of celebrities and sportspeople. The marks are essentially huge hickeys; it looks like they've been getting jiggy with a giant squid. And, it looks a bit sore.
This is the second in a series of articles where I try out unusual treatments and report back. The first involved being frozen to -80°C with my boss. I hoped this wouldn't be quite as extreme.
What's cupping supposed to do?
Cupping is used to treat pain, ease scar tissue deep within muscles and connective tissues, and reduce swelling and muscle knots. Also, like many complementary treatments, cupping is supposed to minimize circulating toxins by drawing them into the skin where they are more easily removed.
Although this treatment has only recently risen to celebrity-fueled fame, it has an ancient pedigree stretching back through the mists of times. According to traditional Chinese medicine, cupping improves the flow of qi (your vital life force) and can help treat colds, bronchitis, and even pneumonia.
Cupping was practiced as part of ancient Persian medicine; according to a paper on traditional Persian medicine, cupping "evacuates the morbid materials from the compromised organs."
The Ebers papyrus, written more than 3,000 years ago, mentions that cupping was commonplace in Egypt at the time. In fact, cupping was even recommended by Muhammad.
However, it's important to remember that just because a practice has a long history doesn't mean it does what it is alleged to. I aimed to find out.
I've got a number of ongoing ailments I hoped to relieve: I've had a bad back for months, I've got a cold that I just can't shake, I'm fairly sure my qi is way out of whack, and I could certainly do with evacuating morbid material from my compromised organs.
I'm only having one session, though, so I can't expect to be entirely fixed; I'm predominantly interested in seeing how it feels.
The day arrives
For today's procedure, I was accompanied by one of our editors who brought her camera along to capture the drama. I'm a relatively nervous kind of guy and, I must admit, as I approached the clinic, my nerves were starting to get the better of me.
I was primarily concerned that yet another of my Medical News Today colleagues was going to see me half naked and in pain.
As we drew near, I noticed that the sign on the clinic door read "closed." My heart rose in my chest. But, as we pushed our faces to the glass, we were welcomed inside. There was no turning back.
My therapist was charming and well versed in cupping; she asked me what I hoped to gain from the experience. I informed her about my lower back beef, and she decided she would start with a deep tissue massage, followed by the cupping.
She explained that where she comes from (the Czech Republic), cupping is not such a strange idea. Whenever she had a cold, her grandmother would use a similar technique involving jam jars that "pulled the phlegm out of her lungs."
I reminded myself that the practice has been widespread throughout much of the world for thousands of years, and attempted to relax into the experience.
Left alone in the darkened therapy room, I stripped to my underwear and wondered what the next 60 minutes would bring.
The therapist came into the room and the deep tissue massage began. I've only ever had one massage in my life, and that was long ago. It turns out that I like massages. I think I needed some tension squeezing out of me. It was painful at times, yes, but I felt like I deserved it.
I did my research before embarking on this mission, and I learned that there are three main types of cupping: wet, fire, and dry.
In fire cupping, the vacuum that sticks the cup to the skin is created by... you've guessed it... fire; normally a flaming ball of cotton wool is used. In wet cupping, after a few minutes of cupping, small incisions are made in the skin, the cups are then replaced on the skin so that blood is drawn out. I opted for dry cupping, which involves neither fire nor bleeding.
The cupping commences
Then, it was time for the cupping. We started on a simple rubber cup; she pinched the rubber, and it was attached to my body. She drew it up and down my back, still tightly stuck to my skin. In places, particularly nearer my neck, there was some associated pain, but nothing too extreme. It was a good pain. It felt cathartic, as if it was doing something constructive below my skin.
An unexpected flame.
But, after the plastic cupping ended, the therapist moved on to glass cups and... flaming cotton wool. I had not expected fire.
I couldn't see the flame with my head buried in the massage board, but I could feel the heat. I winced and tensed.
I needn't have bothered; it was painless. I breathed a sigh of relief, but I still tensed each and every time I sensed the heat near my skin.
Each cup was first attached to my lower back before being dragged to its resting place further up – that was a little sore, but it was nothing like as bad as the marks it left behind. It was an odd sensation. As my skin was pulled tight under the cups, it kind of felt like being hugged by an angular, yet caring glass octopus.
Is there scientific support for cupping?
In two words – not really. It is widely acknowledged that most of the effects attributed to cupping are due to the placebo effect. However, a 2011 systematic review, published in the Journal of Acupuncture & Meridian Studies, offered a glimmer of hope. The researchers concluded:
It looks pretty sore, doesn't it?
"[T]he effectiveness of cupping has been demonstrated only as a treatment for pain, and even for this indication doubts remain."
Better still, a 2015 review of 75 randomized controlled trials, including 11,077 participants, gave more support. Published in PLOS One, the paper concludes that "cupping could be efficacious in treating the pain and disability associated with [chronic neck pain] or [chronic low back pain] in the immediate term."
A meta-analysis of 135 randomized controlled trials found potential benefits for a range of conditions, including herpes zoster, acne, facial paralysis, and cervical spondylosis (arthritis in the neck). However, the authors note that many of the studies included significant bias and that more research is needed.
Perhaps the least scientific of the claims behind cupping is its power to "detoxify." Detoxification is a term that has become wildly fashionable in the health and wellness realm, but it doesn't have a specific meaning. So, I asked one of our resident experts what she thought about the term in this context, she said:
"Maybe detox is the incorrect term. The vacuum produced from cupping causes a localized expansion of the tissue. This facilitates a profound vasodilation reaction to increase circulation/blood flow to painful constricted areas. Increased circulation improves oxygen supply and cell metabolism, which reduces inflammatory (or toxic) substances."
Raleigh Harrell, L.Ac.
Evidence aside, these treatments are as much about the experience, the attention from the clinician, and the rush of endorphins as they are about medical results. As the therapist explained, she doesn't claim to be carrying out medical interventions; they are just another way to approach physical ailments that might work for some people. And, if it's good enough for Jennifer Aniston, it's good enough for me.
The color of cupping
Cupping aficionados claim that the color of the welts left on the skin can tell you something about the state of your body and your injuries. This comes from a paper written by the respected acupuncturist, Susan Johnson, L.Ac.:
"[P]roblems relating to toxin buildup or muscle spasm will cause the skin under the cup to color, whereas issues dealing with nerve or bone will not color at all. [...] Light or moderate [energy] blockage will cause the skin under a cup to color pink or red, and it will take a day or two for this color to fade. Severe stagnation can cause the skin to color a deep scarlet, purple, or even black; it may take 7–10 days for the dark color to disperse."
Interestingly, by looking at the color of my flesh as it was sucked into the cups, the therapist was able to correctly identify that the left side of my neck and the lower-right side of my back were the worst affected areas.
Did it work for me?
Well, I still have a cold, but I'm not sure one session would cure that; I can't tell you what my qi is up to, and I don't even know how to go about checking for the evacuation of morbid materials.
However, my back does feel better, and I feel good about the experience. Whether it was the soothing words of the therapist, the massage, or the couple of hours away from my desk, we will never know, and, right now, I don't care too much. It is what it is.
Would I do it again? Maybe, actually. Although it surprises me to say it, I found the whole experience rather pleasant. Now, as I write this, a couple of hours after putting my clothes back on, I still feel upbeat and not in the least bit sore. I'll let you know how I feel tomorrow...
There's still no pain, to my surprise, but my back looks like I've been wrestling Cthulhu.