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Cupping Therapy

What is cupping? Does it work? Will I look like I got into a fight with an octopus?!

All valid and wonderful questions when it comes to cupping therapy. I dont mind looking like I won a battle with a giant sea creature. For those of you who do, there are cupping techniques that have a very small chance of leaving marks; like fast cupping and flash cupping. If you are into showing off your self-care routines the deeper techniques like static cupping are available. Let's get into it!

What is cupping?

Cupping is an instrument-assisted soft tissue mobilization negative pressure therapy. That's a fancy way of saying cups use suction to lift the soft tissues of our bodies to create negative pressure or a lifting sensation to the affected areas. In comparison; massage is typically positive pressure therapy, pushing into tissues.

Does it work?

Well, considering cupping first comes into our known written history 1550 BC (3,500+ ago) in Egyptian text Papyrus Ebers, and has been widely used as a bodywork technique all over the world since, plus my personal experience as both the person giving and receiving, my opinion is yes.

However, our modern scientific standard community hasn't dedicated the resources to "properly study" the effects of cupping therapy. The consensus among this crew is that cupping its self lends to Randomized Controlled Trails or RTCs and are not rigorous enough, have too small of sample sizes, have a medium to high risk of bias, and lends to methodological error. Basically, you cant fit experience into a test tube. Good thing there is a long history, personal experiences, client testimonials, and those RTC's that do exist pointing to the conclusion being; "cupping having a therapeutic effect". Here are therapeutic effects that are suggested: lowers clients' perception of pain and disability at present and an increased range of motion.

While I do agree with those benefits I like to also look at the results of those RTC studies and have asked a few of my cupping clients for personal experiences to give a more experiential picture. See sighted resources (gathered from the American Massage Therapy Association course on cupping therapy) at the bottom of this post if you are interested.

The RTC's pointed to Low-Mid level evidence for cupping contributing to the following: creating a significant change in pain and disability perception in the client, increase in range of motion in areas of restriction, decrease in creatine kinase, decreasing inflammation. May help gain some relief from chronic fatigue syndrome, neck pain, myofascial pain, plantar heel pain, carpal tunnel syndrome, chronic low back pain, knee osteoarthritis, and ankylosing spondylitis.

I would now like to also provide two personal clients reviews regarding cupping.

Jacob M. Cupping Review

"Cupping therapy has been such a great addition to my massage therapy sessions. The cups relieve tension in my tightest muscles. I think it pulls deep into the tissues allowing you to work into the muscle even deeper breaking up tension and scar tissue. I feel more balanced in my body and my mind after a session. After Gretchen leaves the cups on for 10 minutes or so then disperse the energy thru slide cupping it feels divine. I haven't felt ill or weak since I've been seeing Gretchen. I believe the treatments help the body become more resilient to sickness and disease. I'm very grateful for these healing powers, thank you."

Lindsey P. Cupping Review

"I've had some experiences with cupping prior to seeing Gretchen, but the way Gretchen uses cups has been such a profound difference. She uses the cups when she feels a spot that is holding a lot of tension. She is always attentive and careful with the amount of suction and always asks if it feels okay. After leaving the cup for a little she then takes it off and I feel a huge difference in the tissue. It may still have some tension but it is more mobile and I can feel how much deeper it allows her to go (in massage). The cups are a special tool allowing the bodyworker to go deeper and reach more in the session. Highly recommend Gretchen's work to all! "

(Well, now im blushing :), thanks, guys!

I don't leave these here to inflate my ego. I want to provide some real client experience so that you can better decide if you would like to try cupping. Again these are their individual experiences and their beliefs.)

In my personal experience as a massage therapist, cupping has given me a tool to help relieve the body's tension it walks into my studio with. It's very rare for me to see someone whose body doesn't already have tension. Stress is just a part of our modern life and the body holds onto that in different ways. Once I have identified those areas in a client's body, cups help me continue to pay attention to those areas while I continue to manually work with the rest of the body or in tandem with the cups using a range of motion, slide cupping, fast cupping, or flash cupping. I've also used light suction slide cupping inside my manual lymphatic drainage facilitation sessions and believe that it is beneficial based on results reported and visually noted.

Overall there are many cupping techniques for different goals inside massage therapy. The vast majority of my clients express a great love for the cups but I do have a few who prefer not to use them. Massage and body care are personal and one should always feel they are in control of their sessions. It is ok if you dont like a specific therapy and should be verbal about this with your massage therapist. If they dont respect your boundary probably a good time to find another therapist.

"Will I look like I got into a fight with an octopus?!"

Ha! Probably my favorite question I've received regarding cupping.

It will depend on the modality used, the amount of suction, and the length of time the cup remains on the body. There are techniques like flash cupping and fast cupping that use light to medium suction for short lengths of time that are more likely not to leave marks. However, due to the nature of cupping (using suction on soft tissue), it causes the bodies fluids to move up next to the skin layer and can cause a raised surface of the skin, reddening of the skin (hyperemia), and when the cup is left on the skin for a longer period it can result in the visual effects of hematoma (bruising). If you are someone who doesn't want any visual indicators of body care, I would recommend starting with the Flash Cupping technique. This technique has the shortest retention time and can be used with light suction only. Just be aware that it could still cause reddening of the skin or a temporary change in skin texture. Even this lighter technique still increases fluid in tissues, softens skin and other soft underlying structures, has calming effects on our central nervous system, and is a great introduction to cupping.

However, if you are unconcerned and just want to experience cupping you can experience the deeper techniques like static cupping, blanket cupping, and Myofascial cupping. All of these techniques allow for a greater result in a range of motion increase and relief from current pain being experienced in the body due to perceived disability.

This is an example of a raised surface of the skin and reddening of the skin; hyperemia. A temporary effect of static cupping for this individual. Static cupping is a deeper technique that can also cause hematoma or bruising. Everybody is different and reacts in different ways.

Overall I highly recommend giving cupping therapy a try. In my experience, it has changed the overall quality of my work and results in my body care. Please feel free to reach out with any questions. Happy experiencing!

( I feel obligated to note that if you choose to try cupping on your own at home, without guidance or having experienced cupping with a therapist (not recommended). You purchase the soft silicone cups for personal use and not the plastic or hard acrylic cups meant for therapists. There are areas of the body that cupping is not meant to be used on as you have exposure to nerves and arteries and would not want to use a negative pressure technique as it may cause damage to these structures. Please seek guidance when using. )

Cited Works and References Provided By AMTA course on cupping therapy

1. Cao H, Li X, Liu J. An updated review of the efficacy of cupping therapy. PLoS One. 2012; 7(2):e31793. doi: 10.1371/journal.pone.0031793. Epub 2012 Feb 28. PMID: 22389674; PMCID: PMC3289625.

2. Bridgett R, Klose P, Duffield R, Mydock S, Lauche R. Effects of Cupping Therapy in Amateur and Professional Athletes: Systematic Review of Randomized Controlled Trials. J Altern Complement Med. 2018 Mar; 24(3):208-219. doi: 10.1089/acm.2017.0191. Epub 2017 Nov 29. PMID: 29185802.

3. Cramer H, Klose P, Teut M, Rotter G, Ortiz M, Anheyer D, Linde K, Brinkhaus B. Cupping for Patients With Chronic Pain: A Systematic Review and Meta-Analysis. J Pain. 2020 Sep-Oct; 21(9-10):943-956. doi: 10.1016/j.jpain.2020.01.002. Epub 2020 Jan 23. PMID: 31982686.

4. Moura CC, Chaves ÉCL, Cardoso ACLR, Nogueira DA, Corrêa HP, Chianca TCM. Cupping therapy and chronic back pain: systematic review and meta-analysis. Rev Lat Am Enfermagem. 2018 Nov 14; 26:e3094. doi: 10.1590/1518-8345.2888.3094. PMID: 30462793; PMCID: PMC6248735.

5, 6. Li JQ, Guo W, Sun ZG, Huang QS, Lee EY, Wang Y, Yao XD. Cupping therapy for treating knee osteoarthritis: The evidence from systematic review and meta-analysis. Complement Ther Clin Pract. 2017 Aug; 28:152-160. doi: 10.1016/j.ctcp.2017.06.003. Epub 2017 Jun 8. PMID: 28779923.

7. Kim S, Lee SH, Kim MR, Kim EJ, Hwang DS, Lee J, Shin JS, Ha IH, Lee YJ. Is cupping therapy effective in patients with neck pain? A systematic review and meta-analysis. BMJ Open. 2018 Nov 5; 8(11):e021070. doi: 10.1136/bmjopen-2017-021070. PMID: 30397006; PMCID: PMC6231582.

8. Ma SY, Wang Y, Xu JQ, Zheng L. Cupping therapy for treating ankylosing spondylitis: The evidence from systematic review and meta-analysis. Complement Ther Clin Pract. 2018 Aug; 32:187-194. doi: 10.1016/j.ctcp.2018.07.001. Epub 2018 Jul 6. PMID: 30057049.

9. Meng XD, Guo HR, Zhang QY, Li X, Chen Y, Li MY, Zhuo XM, Wang MJ, Shan K, Gong YN, Li NC, Chen B, Chen ZL, Guo Y. The effectiveness of cupping therapy on chronic fatigue syndrome: A single-blind randomized controlled trial. Complement Ther Clin Pract. 2020 Aug; 40:101210. doi: 10.1016/j.ctcp.2020.101210. Epub 2020 Jun 20. PMID: 32891286.

10. Nasb M, Qun X, Ruckmal Withanage C, Lingfeng X, Hong C. Dry Cupping, Ischemic Compression, or Their Combination for the Treatment of Trigger Points: A Pilot Randomized Trial. J Altern Complement Med. 2020 Jan; 26(1):44-50. doi: 10.1089/acm.2019.0231. Epub 2019 Oct 3. PMID: 31580695; PMCID: PMC6983744.

11. AlKhadhrawi N, Alshami A. Effects of myofascial trigger point dry cupping on pain and function in patients with plantar heel pain: A randomized controlled trial. J Bodyw Mov Ther. 2019 Jul; 23(3):532-538. doi: 10.1016/j.jbmt.2019.05.016. Epub 2019 May 23. PMID: 31563366.

12. Mohammadi S, Roostayi MM, Naimi SS, Baghban AA. The effects of cupping therapy as a new approach in the physiotherapeutic management of carpal tunnel syndrome. Physiother Res Int. 2019 Jul; 24(3):e1770. doi: 10.1002/pri.1770. Epub 2019 Jan 29. PMID: 30697914.

13. Teut M, Ullmann A, Ortiz M, Rotter G, Binting S, Cree M, Lotz F, Roll S, Brinkhaus B. Pulsatile dry cupping in chronic low back pain - a randomized three-armed controlled clinical trial. BMC Complement Altern Med. 2018 Apr 2; 18(1):115. doi: 10.1186/s12906-018-2187-8. PMID: 29609566; PMCID: PMC5879872.


Burnett AE, Mahan CE, Vazquez SR, et al. Guidance for the practical management of the direct oral anticoagulants (DOACs) in VTE treatment. J Thromb Thrombolysis. 2016; 41:206-232.

U.S Food & Drug Administration. FDA-Cleared Sterilants and High Level Disinfectants with General Claims for Processing Reusable Medical and Dental Devices. Website, Aug 25, 2019. Accessed Apr 6, 2021.

Vigotsky AD, Bruhns RP. The Role of Descending Modulation in Manual Therapy and Its Analgesic Implications: A Narrative Review [published correction appears in Pain Res Treat. 2017; 2017:1535473]. Pain Res Treat. 2015; 2015:292805. doi:10.1155/2015/292805.

Wang YL, An CM, Song S, Lei FL, Wang Y. Cupping Therapy for Knee Osteoarthritis: A Synthesis of Evidence. Complement Med Res. 2018; 25(4):249-255. doi: 10.1159/000488707. Epub 2018 Jul 16. PMID: 30007978.

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