Cupping Therapy and Its Benefits

Medically Reviewed by Shruthi N, MD on July 09, 2024
9 min read

Cupping therapy is an ancient form of alternative medicine where a therapist puts special cups on your skin for a few minutes to create suction. The idea is to draw blood to or away from parts of your body. People get it for many reasons, such as pain and inflammation relief, relaxation and well-being, and as a type of deep-tissue massage.

The cups may be made of:

  • Glass
  • Bamboo
  • Earthenware
  • Silicone
  • Plastic

History of cupping therapy

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 from 1550 B.C., describes how the ancient Egyptians used cupping therapy for treating fever, pain, vertigo, menstrual problems, and other ailments.

The Egyptians introduced cupping to the ancient Greeks who used it as a cure for almost every illness. In traditional Chinese medicine, it's closely linked to acupuncture. The Islamic Prophet Muhammad also recommended cupping in his writings, where he called it hijama

Originally, hollowed-out animal horns were used to treat boils and suck out venom from snake bites. Eventually, horns were replaced by bamboo and then by glass cups.

Cupping was used widely in Europe and America until the 1800s, when it fell out of favor as the practice of medicine became more scientific and focused on treating illnesses from the inside out. 

People in several countries still practice cupping. Many Americans first became aware of it after seeing purplish circles on the body of swimmer Michael Phelps during the 2016 Olympics.

The two main types of cupping are:

  • Dry
  • Wet

For either type, in the traditional method (fire cupping), your healer puts a flammable substance such as alcohol, herbs, or paper, inside a cup and sets it on fire. As the fire goes out, they put the cup upside down on your skin.

When the air inside the cup cools, it creates a vacuum. This causes your skin to rise and redden as your blood vessels expand. 

A modern version of cupping uses a rubber pump instead of fire to create a vacuum inside the cup. 

Dry cupping therapy

Dry cupping is simple and is the preferred method in the West because it's easy to do and doesn't involve blood. The therapist just applies the cups to your skin, compressing them with their hands, a pump, or a flame if using glass cups. (They may apply lotion first). They leave the cups in place for 5-10 minutes. You can have this therapy done as often as once or twice a week.

Dry cupping may be combined with a massage. This is called massage cupping or running cupping. Your therapist puts lotion or oil on your skin and moves silicone cups back and forth, up and down, or in circles on your skin for a massage-like effect.

Dry cupping is meant to increase blood flow while removing fluids and toxins from the area being treated. The fluids are said to have high levels of substances related to diseases.

Wet cupping therapy

In wet cupping, your therapist first creates a mild suction by leaving a cup on your back for about 3 minutes. They remove the cup and use a small scalpel to make light, tiny cuts on your skin. Next, they do a second suction to draw out a small quantity of blood. They might leave those cups in place for 10-15 minutes.

The idea is the cuts attract inflammatory cells and cause the release of natural pain relievers and mood enhancers called endogenous opioids. These help your body fight infections and maintain immunity.

You might get three to five cups in your first session. Or you might just try one to see how it goes. It’s rare to get more than five to seven cups, the British Cupping Society notes.

After treatment, you'll get an antibiotic ointment and bandage to prevent infection. Your skin should look normal again within 10 days. You can repeat wet cupping every 4-8 weeks.

Wet cupping can also be done in a two-step version where your therapist doesn't start with suction but first makes cuts in the skin and then applies the suction cups.

It's not exactly clear how cupping works to ease pain and cure diseases, though there are several theories. There haven’t been many scientific studies on cupping.

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. But the researchers said many of the studies they reviewed could have been biased and that better studies were needed.

Cupping therapy is used to treat:

The National Center for Complementary and Integrative Health says there's not enough high-quality research to determine whether cupping can be used for all these conditions.

Cupping for pain management

The "pain-gate" theory says that the touch and pressure from cupping stimulate large nerve fibers, which results in the blocking of pain signals to the brain sent by other nerves. The gate control system is in our spinal cords. So, activating these nerve fibers can block pain transmission.

Does it work? One 2023 review of existing studies found that cupping seemed effective for managing chronic pain, knee osteoarthritis, low back pain, neck pain, chronic back pain, and herpes zoster. But the studies were all of low to moderate quality. In general, experts see cupping as something that should complement conventional medicine rather than replace it.

Cupping for acne

In the immune system theory, cupping can reduce inflammatory substances and increase the production of substances to improve your immune system. Cupping may also boost your body's antioxidant processes. So, cupping might be able to help with skin conditions. One Iranian study compared two groups of people. One got acne medicine along with wet cupping, while the other got acne medicine and "sham cupping" (a device that felt like real cupping but had a tiny hole). The group that got the medicine and the wet cupping showed more improvement than the control group.

Cupping with acupuncture

Some people get "needle cupping," where the therapist first inserts acupuncture needles and then puts cups over them. The idea is that the cupping loosens muscles while the needles relieve the pain. One study showed that ear acupuncture combined with cupping therapy was more effective in treating chronic back pain than treatment using only ear acupuncture.

Cupping is fairly safe, as long as you go to a trained professional. But you could have the following side effects in the area(s) where the cups touch your skin:

  • Mild discomfort
  • Burns
  • Bruises
  • Skin infection

If the cups and equipment become contaminated with blood and aren't sterilized correctly between patients, bloodborne diseases such as hepatitis B and C can be spread.

Burns from cupping

Burns from fire cupping are a hazard but seem to be rare. Overheating the cup is usually the problem. An Australian study looked at 18,703 patients enrolled in the Burns Registry of Australia and New Zealand over a 7-year period and found just 20 had cupping-associated burn injuries. Sixteen of these occurred at home. Still, more people could have been burned but not badly enough to go to a hospital. There have been some other reports of people getting burned at cupping clinics.

Marks from cupping

Cupping marks are a common side effect of applying suction cups to your skin. They're usually circular and can range in color from light pink to dark purple, depending on your skin tone and how much pressure was used to apply the cups. These usually fade over time, in about 1-10 days.

If you have to go to your doctor before the bruises have healed, let them know that the marks aren't due to physical abuse.

Can cupping therapy cause blood clots?

There's no conclusive evidence, but some believe it's a risk. Experts warn to avoid cupping if your skin is scraped, oozing, or infected, as this can increase the chance of blood clotting. Also, if you're on a blood thinner or have heart disease, you shouldn't do cupping therapy.

You can have cupping on any part of your skin where suction cups can be applied. The most common areas are the:

  • Back
  • Chest
  • Stomach
  • Buttocks

These all have a lot of muscle. Less common areas include the chin, the crown of the head, thighs, neck, and shoulders.

Cupping therapy for shoulders

Cupping could be good for shoulder pain, as it increases circulation in the pain area (which encourages healing) and reduces muscle tension. But there aren't definitive studies that say cupping reduces shoulder pain.

Benefits of cupping therapy on back

Back pain is a popular reason why people seek out cupping. The theory is the same as for shoulder pain -- cupping increases blood circulation and reduces muscle tension. Some studies do show it can reduce back pain, but they aren't conclusive.

Benefits of cupping on knees

Cupping may reduce knee inflammation by increasing blood flow and flexibility. It also encourages tissue repair. One study said cupping for knee osteoarthritis was as effective as taking 650 milligrams of acetaminophen three times a day. But other studies showed weak evidence.

Many people may offer cupping therapy, including:

  • Massage therapists
  • Acupuncturists
  • Physical therapists
  • Chiropractors
  • Occupational Therapists
  • Doctors

You're most likely to get cupping from a massage therapist or an acupuncturist. They don't need to have special certification to offer cupping therapy, but they often have it. They usually need to be a licensed massage therapist or acupuncturist to offer any services. Requirements depend on the state you live in.

Make sure that your provider/therapist is cleaning and sterilizing the equipment they use between sessions, or using disposable cups and blades.

Cost of cupping therapy

Costs run about $30-$100 per session, depending on where you live and how long your session lasts. It could be as short as 15 minutes or as long as 1 hour. Also, wet cupping will cost more than the dry type. Some places offer a discount if you buy a package of appointments.

Cupping therapy at home

Yes, you can give yourself cupping therapy. Many kits are available containing plastic, silicone, or glass cups. Please do not buy glass cups, as these need to be heated to be applied and are too dangerous for beginners to use. Stick with plastic or silicone. Plastic ones usually come with a pump. Silicone cups are for doing massage cupping, which involves moving the cups around.

You can learn how to use cups by reading books, watching videos, or following instructions online. Let your doctor know you intend to try this therapy, as you might have a health problem that could make cupping a bad idea.

Talk with your doctor before you start cupping or any other type of complementary medicine. Talk extensively with your cupping therapist before you try it. Ask:

  • What conditions do you use cupping for?
  • What is your training?
  • What is your experience in using it?
  • Are there reasons I shouldn't get cupping?

You should probably avoid cupping if you have:

  • Cancer
  • Organ failure
  • Hemophilia or other blood clotting disease
  • A pacemaker
  • Cardiovascular disease
  • High cholesterol
  • An infection

You should also avoid cupping if you're pregnant, menstruating, elderly, under 18, or taking a blood thinner.

Cupping is an ancient therapy that's now back in style. It aims to increase blood flow, soften scar tissue, and decrease muscle pain by placing suction cups on your body and leaving them on for 10-15 minutes. Practitioners say it can help with back pain, arthritis, depression, migraines, acne, and many other conditions. Not many scientific studies support these claims, but some people who've had cupping therapy done swear by it.

Is cupping good or not?

Some studies say that cupping helps with pain relief, but most of the studies were not high-quality. Scientists aren't exactly sure how cupping works, so more research is needed. Cupping has minor side effects, so trying it usually won't hurt. Just let your doctor know you want to do it. And don't stop your normal treatment unless your doctor says it's OK.

What to expect after cupping?

After a cupping session, you'll probably see round red marks on your skin, which should fade in a week or two. Your therapist may advise you to drink lots of water (to flush out toxins), stay warm, and rest. You may feel a little tired as if you're fighting a minor illness. Therapists say this is normal, a side effect of your body getting rid of toxins.