It took millennia, but cupping is finally having its grandstand moment. At the 2016 Summer Olympics in Rio de Janeiro, swimmer Michael Phelps, winner of 23 gold medals, sported dark circular bruises across his back and shoulders, visible to all. Other Olympic athletes in Rio also had signs of cupping, and celebrities including Gwyneth Paltrow and Jennifer Aniston have been photographed with cupping bruises.
Dating to ancient Egyptians and integral to traditional Chinese medical practice since at least 300 AD, the technique has been embraced over the past decade by a growing number of athletes as a way to help muscles recover quickly after intense competition. Cupping isn’t limited to elite athletes and trend-setting stars; some studies and anecdotal experience show it may help ease some types of musculoskeletal pain, such as that caused indirectly by arthritis. But evidence is limited, and skeptics maintain that any perceived benefit is due the placebo effect.
There are several methods of cupping, but commonly, inverted cups or glass jars containing heated air are placed on the skin, creating a vacuum that pulls on underlying soft tissue and muscles. Traditionally, a bit of cotton is burned inside the jar to create the vacuum then quickly withdrawn before the cup is placed on the body. There are now modern techniques, such as self-adhering silicone cups and plastic cups with a small air pump, but most acupuncturists trained in cupping, prefer the time-honored method, says Laura Christensen, a certified acupuncturist and Chinese herbalist in Iowa City, Iowa.
The cups are typically applied in in sets of four, six or 10 and left on the body 5 to 20 minutes – long enough to break tiny capillaries under the skin, creating the bruises. In general, the longer the cups remain on the skin, the more intense the bruising, which clears within a few days to a week in most people. When performed correctly, cupping doesn’t hurt; most people say it feels like a moderately deep massage, and many claim to feel immediate relief.
What Science Says
Few, if any, rigorous trials have examined cupping’s effect on athletic recovery and performance, however. Most athletes and trainers who use cupping say it speeds up the natural muscle recovery process by improving microcirculation, removing waste products from overworked muscles, reducing inflammation and promoting capillary and tissue repair.
Many of the limited studies that do exist on cupping have focused on pain. In 2011, researchers in South Korea published a review of seven studies of cupping for various types of pain in the journal Evidence-Based Complementary and Alternative Medicine. The results of those trials suggest that cupping may be superior to standard care for low back pain and for cancer pain.
A randomized controlled trial published in 2016 in the same journal looked at the effectiveness of cupping for chronic neck and lower back pain. Sixty patients were randomized to receive cupping or no therapy. After just one treatment, neck pain severity was reduced by nearly two-thirds in the cupping patients but was unchanged in the untreated group. Other studies looking at neck, back and knee pain have had similar positive findings.
Cupping for Arthritis Pain
Christensen says cupping is also beneficial for the muscular pain that can accompany arthritis. For example, people with arthritis can experience muscular pain from the awkward postures they adopt to protect tender joints.
“Many people develop pain and spasms in their muscles related to arthritis – for example, muscle spasms in the back when there is pain in the hip or knee joint. In that case, we would apply cups to muscles around a hip joint or the low back,” she explains. “For shoulder arthritis, it can be very useful to apply cups to muscles over the shoulder blade and the top of the shoulder near the neck. And cupping on the back is very helpful for pain associated with arthritis in the spine; there are even specialized techniques for cupping between the spine bones.”
There are theories but no widely accepted medical explanation of why cupping might work. Ann Marie Chiasson, MD, a family practice physician and assistant director of the fellowship at the University of Arizona Center for Integrative Medicine in Tucson, explains that in traditional Chinese medicine, pain is believed to be a manifestation of blocked energy, or Qi (pronounced chee). Cupping is thought to draw the stagnant energy to the surface and clear it, allowing Qi to move more freely.
Dr. Chiasson says cupping is safe for most people, but should not be done on those who take blood thinners, are pregnant or have a bleeding disorder, bone fracture or neuropathic pain. Studies have shown that cupping may also not be a good idea for people with psoriasis or psoriatic arthritis, because it could trigger a flare.
Want to try it?
If you’re interested in cupping, it’s best not to try it with a do-it-yourself kit. Instead, Christensen says, look for a certified acupuncturist or a licensed massage therapist with special training in the technique.
To find a licensed acupuncturist check with your state acupuncture association, state acupuncture or medical licensing board or the National Commission for the Certification of Acupuncture and Oriental Medicine, the certifying body for most acupuncturists in the U.S.
Author: Linda Rath for the Arthritis Foundation