Introduction to Cupping Therapy

Have you been looking for a new therapeutic treatment alternative that can help relieve tight muscles and tension throughout your body?  Therapeutic Cupping Therapy may just be the solution you were looking for.

In this article, we will explain what cupping therapy is, how it’s used, and how it works.  Hopefully, we will be able to answer some other questions you may have about cupping therapy as well.

In recent years, cupping therapy has been gaining popularity alongside acupuncture in the western hemisphere.  Michael Phelps, the famous swimmer of the US Olympic Swim Team, helped boost its popularity at the Rio Olympics.

His crop circle-like bruises really got people asking questions, doing research, and even going to their healthcare providers requesting the service themselves.

“If it’s good enough for an Olympic Gold Medalist, it wouldn’t hurt for my tendinitis”

What is cupping therapy?

This treatment is called cupping therapy (also known as Chinese cupping, cupping suction, dry cupping, etc.) and it involves using glass, plastic, or rubber cups over the skin and creating negative pressure by removing the oxygen inside.

These days, the negative pressure is created by a suction pump attached to the cup, but traditionally this treatment is done by lighting a flame under the cup and quickly placing it over the skin.

The negative pressure causes the soft tissue (skin, fascia, muscles) to raise and get sucked into the cup.

I’ve been using cupping for years in my practice since I was introduced to this treatment technique by a colleague.  Many of my clients have enjoyed this modality as a complement to our active rehabilitation.

Although cupping may sound like a new therapy, it has been performed for thousands of years by Traditional Chinese Medicine (TCM) practitioners.

How is cupping performed?

The treatment can be performed by leaving cups over tight or achy spots on affected muscles or by gliding the cups over muscles in a massage-like fashion.

Also, you can leave the cup in one area have the patient perform a movement or stretch. This is called tissue distraction with movement (TDM).

Massage lotion is definitely recommended to reduce the friction on the skin and to make the treatment more comfortable.

In addition, professional practitioners trained in acupuncture will place the cups over known acupuncture points to stimulate Qi (pronounced “chee”).  Since some cupping sets come with a firm metal projection that attaches within the inside of the cup, they can be used to provide acupressure.

The literature on cupping typically describes 10-minute applications.  However, I would recommend shorter treatments for the first few times.

How does cupping therapy work?

The negative pressure under the cups causes a localized area of reduced pressure beneath them.  Blood is drawn into this low-pressure zone.  Studies using near-infrared spectroscopy show that the blood underneath the cups has a higher concentration of oxygen as compared to surrounding areas.

“The treatment induced an oxygen elevation in the local tissue to accelerate the possible repair or function of the local tissue, subsequently giving rise to positive therapeutic effects.”

I often describe cupping by drawing a parallel to therapeutic massage.  Cupping helps release tight muscles by decreasing pressure over an affected area. Whereas, massage provides the same outcome by adding pressure.

Because of this, I like to use this treatment with people who experience significantly increased tenderness to the touch at the injured area. Rather than applying pressure like a massage, I use the cups to decrease pressure instead and still achieve the desired effect.

What is cupping therapy used for?

Literature on cupping has been shown to provide the following benefits:

1. Decrease pain
2. Reduce tenderness
3. Improve mobility
4. Tissue oxygenation
5. Assist with restoring better functional movement

(Keep reading for one more benefit)

“Cupping modulates pain and may contribute to reduced muscle guarding of superficial muscles and activation of inhibited postural muscles, which is the foundation for normal functional movement.”

“…maybe a low-risk, therapeutic treatment for the prompt reduction of symptoms associated with subacute and chronic low back pain. Cupping may allow patients to progress to functional movement training in a timely manner by promptly reducing pain and muscle tenderness and improving range of motion.” 

In my practice, I find cupping most beneficial for treating back, neck, shoulder, hip, and knee pain.  Cupping can be used to treat a variety of orthopedic impairments.

There is also research that suggests that cupping can be as effective as taking acetaminophen to treat osteoarthritis of the knee.

“The efficacy of treatment with cupping therapy in relieving signs and symptoms of knee osteoarthritis is comparable to that of acetaminophen 650 mg thrice a day orally, in terms of analgesia, anti-inflammatory and resolution of edema with minimal and temporary side-effects like ecchymosis…”

In addition to the benefits cited above, here we see we can add:

6. Reduce inflammation

Traditional Chinese Medicine practitioners may also use this to treat certain gastrointestinal and respiratory illnesses as well as pain.

Does cupping therapy hurt?

Cupping is typically a fairly comfortable treatment, but it can depend on how much suction is being used.  In addition, the size of the cup can have an impact in certain areas. Generally, the bigger the cups, the more comfortable the treatment. Conversely, smaller cups may feel more like pinching.  As a result, I would choose the biggest cup that fits the area you are treating to reduce the likelihood of discomfort.

Mild discomfort may be experienced with aggressive cupping over tight or sore muscles.  Comparatively, this is similar to the feeling of a deep tissue massage or release with a foam roller.

The residual markings left after treatment also make it appear as though it is painful.  However, unlike a bruise, these marks are not tender and only last a few days.

Can I do cupping at home?/ Where can I get a cupping set?

Cupping sets are relatively inexpensive and pretty simple to use.  Further, some sets come with a hose that goes from the cup to the pump, allowing for easier access to hard to reach areas.

Often the client will ask about purchasing a set for home.  This can certainly be considered a great investment that I, myself, have already made.

 

Note for Therapists

For the therapists out there, if you’re not using cupping therapy as part of your practice yet, you are missing out.  I’ve already convinced many therapists to integrate cupping into their practices and they all love it.

It serves as a great alternative to soft tissue release techniques that can be tough on your hands over time.  For your patients who are squeamish about needles, you can suggest cupping instead of acupuncture or dry needling.

Once you start using it and discover how much your patients love it, you will get sucked in as well!

Please like or share this article!

I would love to hear from you – Ask a Physio

References

Li T, Li Y, Lin Y, Li K. Significant and sustained elevation of blood oxygen induced by Chinese cupping therapy as assessed by near-infrared spectroscopy. Biomedical Optics Express. 2017;8(1):223-229. doi:10.1364/BOE.8.000223.

Alycia Markowski, Susan Sanford, Jenna Pikowski, Daniel Fauvell, David Cimino, and Scott Caplan. Pilot Study Analyzing the Effects of Chinese Cupping as an Adjunct Treatment for Patients with Subacute Low Back Pain on Relieving Pain, Improving Range of Motion, and Improving Function.The Journal of Alternative and Complementary Medicine. Volume 20, Number 2, 2014, pp. 113–117 ª  DOI: 10.1089/acm.2012.0769

Khan, A., Jahangir, U., & Urooj, S. (2013, October-December). Management of knee osteoarthritis with cupping therapy. Journal of Advanced Pharmaceutical Technology & Research, 4(4), 217.