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A revived ancient treatment method

- by Candice Ohrablo

Cupping is ingrained into many traditional cultures with the oldest records dating back to 1550BC in Egypt - remaining today as both a popular in-clinic, and at-home method of treatment. There is a multitude of research and other articles pertaining to the mechanism and efficacy of cupping; of which a few links are provided for additional insight into this modality. 

The following is my own opinion and utilization of cupping in my day-to-day practice.


What is cupping?

Where the majority of hands-on therapeutic techniques use positive pressure to push work through body tissues; cupping is a mechanism of creating negative pressure using a pocket of low pressure within the body of a cup to pull the tissue up into the cup body. A single cup can be left on one spot for a longer length of time and tends to affect a deeper depth of tissue as compared to hands-on methods. Multiple cups are used to address a large surface area of the body.


What do you use cupping for?

The simple action of cups has been useful to:

  1) Work on small areas that are difficult to palpate such as between the ribs

  2) Address multiple large areas simultaneously such as a low back spasm coupled with sciatica in the same session

  3) Handle systemic conditions underlying the skin such as edema and other conditions of poor circulation


What happens next?

As suction pulls the tissues up into the cup body the layers of the skin, muscle and connective tissue are subsequently broadened, interstitial fluids such as blood, etc. are drawn to this spot and pool by pressure differential. Practitioners can use this action to do a quick assessment; if the color under the cup becomes dark quickly the cup generally remains on the spot for a few minutes. A dark color means that there is a greater amount of low circulation within the spot circled by the cup – leaving the cup on may assist to soften that area to allow circulation though.  Cup suction can reach the full depth of tissue if placed in the appropriate location.

In certain cases, the cup can be moved along the length of muscle tissue to encourage fluid movement underneath the skin – this is called “gliding”. For some cases of edema, patients have found this modality soothing for their condition.


I heard cupping creates bruises?

Yes, cupping can create ecchymosis (the dark circle) and petechia (little red dots) as the blood leaves the capillaries and pools under the skin. Patients do report having little or no pain even though the marks are dark in color.

In discussion with colleagues in a technical sense the definition of a bruise is exactly: “An injury appearing as an area of discolored skin on the body, caused by a blow or impact rupturing underlying blood vessels.”

So, are the marks a bruise? By definition, no.

It is recommended to be aware of this effect of cupping – in the case of planned social gatherings where dark circles or red spots are not desirable in dress. Cupping marks average 3-5 days to subside (or more if you tend to heal slowly).


How often can I have cupping done?

Following a cupping session, it is best to wait for the cupping marks to disappear before proceeding with a subsequent visit of the same body area. In most cases a weekly program is common.


Have you heard of fire-cups?

Many patients come into my office with “Cupping stories” – a few of my favorites involve great grandmothers, old whiskey glasses, liquor and a flame… Traditionalists of fire-cups often describe the cups as speaking to the soul of the body as it imparts warmth. I love these stories – they have so much nostalgia and love attached to them.

Today, fire cups are not widely used due to imposed regulations and safety precautions by bodies that govern best clinical practices, so I am not able to practice fire-cupping in my office.


What about Blood-letting?

I have heard many happy stories about traditional blood-letting or Hajima from patients that have had it done. However, due to imposed regulations and safety precautions I am not able to perform Blood-letting in my practice.


For some more information - please have a look at the articles below:

"Cupping Therapy: An Overview from a Modern Medicine Perspective" Tamer S. Aboushanab, Saud AlSanad:

“An updated review of the efficacy of cupping therapy” Cao, H., Li, X., & Liu, J. (2012).. PloS one, 7(2), e31793.;

“Cupping Therapy – What Does the research show?”

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