Cupping therapy has been one of the most buzzed-about alternative treatments in the wellness space for years now.
Even celebrities and athletes—from Jennifer Aniston, Gwyneth Paltrow and Victoria Beckham to Michael Phelps, Ian Kennedy, Steven Adams and Alexander Naddour—have vouched for the benefits of this integrative therapy.
But cupping has been around for long before Phelps made it "cool" back in 2016 during the Rio Summer Olympics.
"Cupping therapy is one of the most ancient and revered healing techniques," says Dr. Jessica Duncan Propes, Atlanta-based doctor of chiropractic specializing in sports injury management, recovery and wellness care.
In China, the earliest documented use of this holistic treatment can be traced back to around 300 AD. Meanwhile, in Greece, Hippocrates—who's considered the father of modern medicine—used as well as advocated the technique for treating various ailments.
The traditional practice is even mentioned in the Ebers Papyrus—one of the oldest medical textbooks which dates back to 1550 BC, notes Dr. Propes.
If you're looking to hop on the cupping bandwagon, there are a few key things you should keep in mind, prior to booking your appointment, to get the most out of the treatment.
First things first, how does cupping therapy work?
"Cupping therapy is a type of instrument-assisted soft tissue mobilization (IASTM), more specifically known as myofascial decompression," says Dr. Propes.
MORE FROMFORBES VETTED
Factors like a sedentary lifestyle, poor posture, inflammation, overusing muscles or a muscle strain or injury can cause fascia (connective tissue fibers) to bind with the underlying soft tissues.
These myofascial adhesions or muscle adhesions, if not treated or released, lead to stiffness and pain. Over time, they can also result in tender muscle knots commonly known as trigger points, muscle weakness and restricted mobility.
Cupping therapy works by decompressing or separating the layers of muscle and fascia to break up these adhesions while simultaneously increasing local blood flow and oxygenation, explains Dr.Propes.
Essentially, it’s almost like an equivalent of deep tissue massage but instead of having a trained masseuse knead your muscles to release pain and tension, it uses suction from the cups to lift and separate the soft tissues, says Ani Baran, founder of NJ Acupuncture Center and a trained practitioner of holistic treatments like acupuncture, massage and cupping therapy.
This suction is thought to increase blood flow, release tension and knots in the muscles, relieve pain, improve lymphatic drainage to reduce swelling and remove built-up toxins, among other things.
"Think of cupping like a household vacuum cleaner to carpet—it pulls out metabolic waste and other unwanted materials from your tissues," says Dr. Propes.
Dry Cupping vs Wet Cupping
The treatment can be done wet or dry, says Baran. The former involves making minor incisions in the skin to draw blood out during the suction process, hence the name “wet cupping". Meanwhile, "dry cupping uses a rubber pump for suction and has more of a massage-like effect," Baran explains.
Some traditional practitioners also use a flame to heat the cups in order to create a vacuum inside them.
The special cups that are used in the process can be made from a variety of materials like plastic, silicone, glass or bamboo.
Although it's just as effective, wet cupping has a higher risk of infection than dry cupping, adds Baran.
What is cupping good for?
"Cupping is useful for musculoskeletal pain, fibromyalgia and other pain conditions such as headaches or migraines, tendinitis, bursitis, plantar fasciitis and release of trigger points. So, athletes, weekend warriors or anyone with acute or chronic pain can benefit from cupping," says Dr. Heather Moday, board-certified allergist, immunologist and physician and author of The Immunotype Breakthrough.
"In addition to immediate relief of tension and discomfort, cupping therapy can also be used to rehabilitate injuries such as tendinosis," says Dr. Propes. Acute and chronic tendinopathies are characterized by decreased blood flow to the injured tissue. IASTM promotes healing by increasing the blood flow to tissues and improving oxygenation, explains the holistic health expert.
"A study published in 2018 in the Journal of Bodywork and Movement Therapies found that myofascial decompression or cupping therapy is also beneficial in treating iliotibial band syndrome—a very common injury in both recreational and professional athletes," says Dr. Propes.
Other than that, "cupping may activate the parasympathetic nervous system inducing a relaxation response which increases the threshold to pain," adds Dr. Moday.
Even so, the scientific evidence on the benefits of cupping is fairly limited. So if you want irrefutable evidence of the clinical efficacy before trying a new treatment, you may want to pass on cupping therapy for now.
Are there any side effects of cupping?
Cupping, if done correctly, is generally considered safe and pain-free. The only side effects are mild muscle soreness and the distinctive purplish-red welts which may last for a week or so, says Dr. Moday.
In rare cases, it can result in burns, severe bruising, irritation or scarring. This is why it's imperative to seek treatment only from a qualified practitioner.
Who should avoid cupping therapy?
"Cupping is contraindicated in patients on kidney dialysis, those with severe cardiovascular disease or in cancer patients undergoing immunosuppressive treatment," says Dr. Moday.
In addition, cupping is also inadvisable for anyone with bleeding disorders such as hemophilia or taking blood thinners, notes the internist.
According to the National Center for Complementary and Integrative Health (NCCIH), those with eczema or psoriasis should also avoid cupping as it may worsen their symptoms.
Cupping 101: The Do's and Don'ts
- Choose a well-qualified practitioner. "My advice first and foremost to get the most out of a cupping session would be to locate a qualified practitioner who has experience and training with IASTM and cupping. This may be a physical therapist, chiropractor, massage therapist or traditional Chinese medicine practitioner," says Dr. Propes.
- Drink lots of water. "Hydrate well before and after the cupping session," Dr. Moday recommends. The fluids will help your lymphatic system flush out the toxins that cupping helps release from your tissues. It's also best to have a light meal at least an hour before the therapy session.
- Don't get it done on inflamed skin. If you have a sunburn, minor surface wounds or inflamed skin, wait until you're fully recovered before you make an appointment. Also, cupping is not to be done directly over arteries and varicose veins, Dr. Moday advises.
- Plan in advance. If you have an important event and you don’t want the telltale marks to show, plan the treatment out several weeks in advance as it may take more than a week for them to fade away, says Dr. Moday.
- Don't be afraid. People usually think it's super painful or scary, it’s not, says Baran. You may be a little sore afterward but that just means that it's working, adds the acupuncturist.
- Avoid intense physical activity. Friction from exercise, exposure to excessive heat or cold and chemicals can irritate the sensitive skin where the suction cups were applied. So steer clear of any heavy exercises as well as humid and heated environments like saunas, steam showers, hot tubs and hot showers, suggests Dr. Moday.
What should you expect during and after a cupping session?
"Your practitioner will more than likely sit with you first and discuss why you are seeking cupping therapy to determine whether or not it's an appropriate therapy for you," says Dr. Propes.
Once the treatment area has been determined, the therapist will put a lubricant of some sort onto the skin before applying the cups, explains the chiropractor.
Next, you'll be asked to sit or lay in a comfortable position as cups are applied, typically to larger, flat areas using heat or a rubber pump, says Baran.
The cups are applied at an angle that creates deep suction. "Usually they are applied for anywhere between 10 to 20 minutes," notes Baran.
The cups may remain stationary or they may be gently moved over the skin to create a massage-like effect. This technique is commonly known as "moving cupping" or "running cupping".
In some cases, the practitioner may also ask you to move through exercises or ranges of motion with the cups applied, adds Dr. Propes.
"A typical cupping session lasts about 45 to 60 minutes and pricing can vary based on region and the practitioner's expertise," Baran says.
The number of sessions needed can vary based on the condition you're seeking treatment for but results are often felt in as little as one session, says the acupuncturist.
"Cupping done in conjunction with acupuncture treatment is most effective—so definitely try to get both at the same session. They are truly complementary therapies," adds Baran.