What Is Cupping? Uses, Benefits, Risks & More

If you’ve ever come across someone with reddish, sometimes purple, round marks on their back (almost like a bruise or sunburn), that’s from an ancient Chinese practice called cupping.

Cupping therapy is an ancient medical practice with renewed interest that consists of suctioning multiple, often sore parts of the skin using cups made out of glass, plastic, or bamboo.

This suctioning, which is often used by acupuncturists and other therapists, is most commonly known to promote blood flow3 in the skin and help ease pain you may be experiencing in that area. 

While this traditional health practice is deeply rooted in Chinese and Middle Eastern medicine, there is some evidence that it may have originated as far back as 1550 BC in ancient Egypt4.

Depending on your comfort level and recommendation by your health care provider, cups may be moved around or left in place.

They may also only be kept on your body briefly or for longer periods of time, depending on your healthcare goals, pain, and more.

One common area to be cupped is the back, although cups work well on other areas, too — particularly on fleshy sections of the body like the legs, buttocks, and facial area.

While cupping as an ancient healing practice dates back thousands of years, the published research to elucidate this historic technique is relatively young (i.e., over the past few decades), and thus emerging.

With that said, enough randomized controlled trials (RCTs) exist that systematic reviews and meta-analyses1 are now able to consolidate and inform the benefits of cupping therapy across a variety of health issues and needs.

Indeed, science to date shows that cupping can be beneficial for conditions such as low back pain, osteoarthritis, neck pain, and more3.

One randomized controlled study5 of 50 patients who suffered from neck pain and were assigned cupping as a treatment or were put on a waitlist (i.e., control group) found that the patients in the cupping group had significantly less neck pain post-treatment.

More research in this specific area of musculoskeletal pain will be valuable, however.

A 2016 systematic review1 of wet cupping indicates that the ancient therapy in modern use has efficacy (as demonstrated by RCTs) for neck pain, low back pain, and even carpal tunnel syndrome. 

Furthermore, a 2017 systematic review and meta-analysis2 found cupping to improve treatment effectiveness and physical function in patients with knee osteoarthritis, although the studies were noted to be low quality and thus the overall evidence would be strengthened by future, robustly designed clinical trials.

Perhaps made most famous by Michael Phelps in the 2016 Summer Olympics, athletes are a specific group reported to utilize cupping therapy.

While a 2018 research review of clinical trials in amateur and professional athletes indicates6 possible benefits from pain and range of motion, many of the studies lacked robust evidence.

While more research is needed in this area, several theories summarized in a 2019 research review7 include an increase in blood circulation, immune system activation, blood detoxification, and more.

While there are many methods of cupping therapy, the most common method is cups applied with the use of heat (also known as fire cupping). 

This is where pressure is created in the cup by applying a flame — typically using alcohol-soaked cotton that is set aflame and used to remove the oxygen.

The cup is then directly placed onto the skin, creating a vacuum-like suction.

There is also wet cupping8. Following a suction stage, small incisions are made in wet cupping by the therapist.

If you’re familiar with cupping, then you probably know that the aftereffects are, well, not pretty.

Cupping causes the skin to temporarily turn a reddish color under the area that was cupped and typically form bruise-like marks on the skin.

The skin discoloration can last anywhere from a few days to a couple of weeks. But, the good news? It's rarely painful.

While there aren’t many risks associated with cupping (scarring of the skin and temporary bruising are the most common), it’s also important to note that many cupping studies to date lack safety data6 (something future clinical trials should improve upon).

Cupping is not recommended for geriatric patients, pediatric patients, those with high cholesterol, bleeding concerns, or anemia, or women who are pregnant or are currently menstruating.

Cupping should also be avoided on sites with wounds or bone fractures, as well as over nerves, arteries, veins, veins, body orifices, lymph nodes, eyes, or areas with skin inflammation.

Cupping has been used for thousands of years for a variety of purposes such as pain relief, muscle relaxation, and improving circulation.

This type of therapy has been associated with an array of health benefits, although future clinical trials will be valuable to tease apart exact mechanisms of action and efficacy areas in a systematic way.