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21st Century, and We’re Still Cupping. Do You Know About This?

March 6, 2017

Wikipedia; WebMD Medical Reference Reviewed by David Kiefer, MD on August 10, 2016

A person receiving fire cupping therapy. Source: Alanna Ralph from Philadelphia, PA, USA – Cupping, CC BY 2.0,

You can buy a cupping set on, for about $39.95.

Cupping therapy is a form of alternative 1) ___ in which a local suction is created on the skin. Cupping has been characterized as pseudoscience. There is no good evidence it has any benefit on health and there are some concerns it may be harmful. Through suction, the skin is drawn into the cup by creating a vacuum in the cup placed on the skin over the targeted area. The vacuum can be created either by the heating and subsequent cooling of the air in the cup, or via a mechanical pump. The cup is usually left in place for somewhere between five and fifteen minutes. It is believed by some to help treat pain, deep scar tissues in the muscles and connective tissue, muscle knots, and swelling; however, the efficacy of this is unproven. Cupping is poorly supported by 2) ___ evidence. In their 2008 book Trick or Treatment, Simon Singh and Edzard Ernst write that no evidence exists of any beneficial effects of cupping for any medical conditIon. A 2011 review found tentative evidence for pain but nothing else. The way it works is unclear but might involve the placebo effect. Advocates claim that cupping is an alternative treatment for cancer. However, the American 3) ___ Society notes that "available scientific evidence does not support claims that cupping has any health benefits" and also that the treatment carries a small risk of burns.

Cupping is generally safe when applied by trained professionals on people who are otherwise healthy. It is not recommended for people with health problems, due to side effects from cupping. Cupping is not recommended as a replacement for typical treatments. Cupping may also result in bruising, burns, pain, and/or skin infection. Some research suggests that cupping is harmful, especially in people who are thin or obese: According to Jack Raso (1997), cupping results in capillary expansion, excessive fluid accumulation in tissues, and the rupture of 4) ___ vessels. Fire cupping can sometimes result in minor to severe burns, and may lead to hospitalization and may even require skin grafting to repair the injury. Also, other burns, due to carelessness with the flammable substances being used, such as spills and over application, can also occur.

Bamboo cups Source: Wikipedia

The dry cupping procedure commonly involves creating a small area of low air pressure next to the skin. However, there are varieties in the tools used, the methods of creating the low pressure, and the procedures followed during the treatment. The cups can be of 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 is 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 5) ___. 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. Skin markings are common after the cups are removed, varying from simple red rings that disappear relatively quickly, to discolorization from bruising, especially if the cups are dragged while suctioned from one place to another, ostensibly to break down muscle fiber.

One method of fire cupping involves soaking a cotton ball in almost pure alcohol. The cotton is clamped by a pair of forceps and lit via match or lighter, and, in one motion, placed into the cup and quickly removed, while the cup is placed on the skin. 6) ___ heats the inside of the cup and a small amount of suction is created by the air cooling down again and contracting. Other types of fire cupping include using other flammable substances such as herbs, or paper in another cup and setting it on fire. As the fire goes out, the therapist puts the other empty cup upside down on the area of skin to be treated. As the air inside the cup cools, it creates a vacuum. This causes your skin to rise and redden as your blood vessels expand. Massage oil may be applied to create a better seal as well as allow the cups to glide over various muscle groups in an act called “moving cupping“. Dark circles may appear where the cups were placed because of rupture of the capillaries just under the skin. There are documented cases of 7) ___ caused by fire cupping. Wet cupping is also known as Hijama or medicinal bleeding. Today, wet cupping is a popular remedy practiced in many parts of the Muslim world. 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 cattle horns with a valve mechanism in it to create a partial vacuum by sucking the air out. Cupping is still practiced in Finland as part of relaxing and/or health regiments.

People get cupping for many purposes, including to possibly help with pain, inflammation, blood flow, relaxation and well-being, and as a type of deep-tissue massage. The cups may be made of:

  • ‍Glass
  • Bamboo
  • Earthenware
  • Silicone

Cupping therapy might be trendy now, but it’s not new. It dates back to ancient Egyptian, Chinese, and Middle Eastern cultures. One of the oldest medical textbooks in the world, the Ebers Papyrus, describes how the ancient Egyptians used cupping therapy in 1,550 BCE. As mentioned above, there are different methods of cupping, including:

  • ‍Dry
  • Fire
  • Wet
  • Needle

A more modern version of cupping uses a rubber pump instead of fire to create the 8) __ inside the cup. Sometimes therapists use silicone cups, which they can move from place to place on your skin for a massage-like effect. Wet cupping creates a mild suction by leaving a cup in place for a few minutes. The therapist then removes the cup and uses a small scalpel to make light, tiny cuts on your skin. Next, he or she does a second suction to draw out a small quantity of blood. There may be 3-5 cups in a first session. However, it is rare to get more than 5-7 cups, the British Cupping Society notes. Afterward, one may use an antibiotic ointment and bandage to prevent infection. Skin should look normal again within 10 days.

Cupping therapy supporters believe that wet cupping removes harmful substances and toxins from the body to promote healing. But that’s not proven. Some people also get "needle cupping," in which the therapist first inserts acupuncture 9) ___ and then puts cups over them. There haven’t been many scientific studies on cupping; however, one report, published in 2015 in the Journal of Traditional and Complementary Medicine, notes that it could help with acne, herpes zoster, and pain management. That’s similar to the findings from a 2012 report, published in PLoS One. Australian and Chinese researchers reviewed 135 studies on cupping. They concluded that cupping therapy may be effective when people also get other treatments, like acupuncture or medications, for various diseases and conditions, such as Herpes zoster, Acne, Facial paralysis and Cervical spondylosis. However, many of the studies may be biased and better studies are needed.

The British Cupping Society says that cupping therapy is used to treat:

  • ‍Blood disorders such as anemia and hemophilia
  • Rheumatic diseases such as arthritis and fibromyalgia
  • Fertility and gynecological disorders
  • Skin problems such as eczema and acne
  • High blood pressure
  • Migraines
  • Anxiety and depression
  • Bronchial congestion caused by allergies and asthma
  • Varicose veins

Cupping is fairly safe, as long as one goes to a trained health professional. But you could have these side effects in the area where the cups touch your 10) ___:

  • ‍Mild discomfort
  • Burns
  • Bruises
  • Skin infection

Talk with a doctor before you start cupping or any other type of alternative or complementary medicine. And talk extensively with your cupping therapist, too, before you try it. Ask:

  • ‍What conditions do they use cupping for?
  • What is your training?
  • What is your experience in using it?
  • Am I already getting the standard treatments for my condition?
  • Are there reasons I should not get cupping?

ANSWERS: 1) medicine; 2) scientific; 3) Cancer; 4) blood; 5) cup; 6) Fire; 7) burns; 8) vacuum; 9) needles; 10) skin

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Wikipedia; WebMD Medical Reference Reviewed by David Kiefer, MD on August 10, 2016