Cupping therapy, a historic form of alternative medicine with origins dating back over 2,000 years, has witnessed a recent resurgence in popularity due to its array of potential health benefits. Initially conceived within the realm of traditional Chinese medicine, cupping therapy encompasses the placement of specialized cups onto the skin to create suction, a mechanism believed to stimulate healing through increased blood flow (1).
The Mechanism of Cupping Therapy
Cupping therapy primarily employs cups made from glass, bamboo, or silicone. The therapist initiates the procedure by heating the inside of the cup and subsequently placing it on the skin, typically the back. The cooling air inside the cup induces a vacuum effect, prompting the skin and superficial muscle layer to be drawn into the cup - a method referred to as 'dry cupping'. Alternatively, 'wet cupping' involves a small incision on the skin after the cup is removed to extract a minor quantity of blood (1,2).
Proposed benefits
Recently, it has gained more attention in Western countries due to its potential benefits for pain relief, among other health benefits.
Increased Blood Flow: The primary theory behind how cupping might alleviate pain revolves around blood flow. The suction from the cups is thought to draw blood to the cupped region, promoting localized healing. This improved blood flow can help reduce muscle tension, promote cell repair, and aid in other regeneration processes.
Pain Gate Theory: Some believe cupping might work according to the "pain gate theory". This theory suggests that there's a neural "gate" that can only transmit a certain amount of sensory information to the brain at once. The theory suggests that by creating a different sensation (like the suction from the cups), cupping might "overload" these gates and prevent the transmission of pain signals to the brain.
Relaxation Effect: Cupping therapy often involves a degree of massage, as the practitioner moves the cups around on your skin. This can provide a relaxing, soothing experience, which can relieve stress and tension in the body. This relaxation effect can further reduce muscle tension and thereby relieve pain.
Inflammatory Response: Another proposed theory is that cupping creates a minor inflammatory response in the area where the cups are applied. This would then trigger an immune response, where the body sends more white blood cells to the area to repair the damage. The result might be reduced pain and increased recovery speed.
Release of Toxins: Some proponents also believe that cupping helps draw out toxins from deep within the muscles, reducing inflammation and promoting pain relief.
The Evidence
A study by Lee-Mei et al. included sixty subjects with self-perceived chronic neck and shoulder pain (NSP). The subjects were randomly allocated to two groups: the cupping group and the control group. The cupping group received cupping therapy (CT) at specific acupuncture points, while the control group received no intervention. Pain was assessed using skin surface temperature, visual analog scale, and blood pressure. The main results showed that one treatment of cupping therapy increased skin surface temperature and reduced the subjective experience of neck and shoulder pain in intensity.
The study has practical applications in the field of pain management, particularly for chronic neck and shoulder pain and suggests that cupping therapy can be an effective treatment option. However, further studies are required to improve the understanding and potential long-term effects of cupping therapy (3).
A systematic review by Kim et al. aimed to evaluate the effectiveness of cupping as a treatment for pain by analysing 7 randomized clinical trials. Results showed positive effects of cupping in low back pain, cancer pain, trigeminal neuralgia, and brachialgia, and the results from the reviewed trials suggest that cupping therapy may be a safe and effective adjunct to conventional drug treatment for pain; however more rigorous studies are needed to determine its overall effectiveness.
Remember, while these potential benefits sound promising, always consult with a healthcare professional before starting cupping therapy. The therapy should be performed by trained practitioners to ensure its safety and effectiveness
References:
Al-Bedah AMN, Elsubai IS, Qureshi NA, et al. The medical perspective of cupping therapy: Effects and mechanisms of action. J Tradit Complement Med. 2019;9(2):90-97. doi:10.1016/j.jtcme.2018.03.003
Rozenfeld E, Kalichman L. New is the well-forgotten old: The use of dry cupping in musculoskeletal medicine. J Bodyw Mov Ther. 2016;20(1):173-178. doi:10.1016/j.jbmt.2015.11.009
Lee-Mei, Chi., Li-Mei, Lin., Chien-Lin, Chen., Shu-Fang, Wang., Hui-Ling, Lai., Tai-Chu, Peng. (2016). The Effectiveness of Cupping Therapy on Relieving Chronic Neck and Shoulder Pain: A Randomized Controlled Trial. Evidence-based Complementary and Alternative Medicine, 2016:7358918-7358918. doi: 10.1155/2016/7358918
Kim JI, Lee MS, Lee DH, Boddy K, Ernst E. Cupping for treating pain: a systematic review. Evid Based Complement Alternat Med. 2011;2011:467014. doi:10.1093/ecam/nep035