Its History and Efficacy on the
Relief of Pain
During the 2016 Summer Olympics in
Rio de Janeiro, Brazil, millions of Americans tuned in to witness
internationally known and Maryland native gold medalist Michael Phelps dive
into the pool for what would be, as he announced, his final Olympic Games.
Although his upcoming retirement was the main topic of conversation, another
question would soon arise: what were those strange bruises all over his back
and arms? Onlookers seemed to be confused and somewhat concerned by this
collection of strategically placed round, bluish welts all over this athlete’s
body. These hickey-like bruises would soon be explained to be the marks of a
long-established, yet unfamiliar holistic therapy known as “cupping.” Almost
overnight, cupping was soon being researched by the lay community as a means of
pain relief, among other ailments.
While unfamiliar to the western
world until just recently, cupping is actually a very ancient therapeutic
method with Chinese, Egyptian, Greek, and Arabic roots. Ancient Egyptians are
thought to be the earliest to administer this therapy, with references dating
back to 3500 BCE (Qureshi, et al., 2017). Various methods to
this procedure exist, but the purpose of the therapy bears commonalities
throughout all practices. According to the Journal of Integrative Medicine,
cupping is known to be used to “extract toxic substances from the body by
creating negative pressure in the cup” (Qureshi, et al., 2017). In the modern age,
the two most common types of cupping are wet and dry. Wet cupping involves the cutting
of skin using a scalpel in order to allow blood to be sucked into the cups,
while dry cupping is simply applying suction to the skin using the cups without
the drawing of blood. The suction for dry cupping is created by lighting fire
to a small piece of paper, allowing it to die, and then placing it under each
cup applied to the skin. A negative pressure is created as the cup cools, which
causes a vacuum seal around the skin. Both forms of cupping are performed by
acupuncturists or other licensed therapists and are administered on
acupunctural pressure points. Typically glass cups are used for this practice,
but vessels made of bamboo, animal horn, and other materials were historically
known to be used as well.
The most common purpose of cupping,
whether it be wet or dry, is to aid in the relief of pain, such as that of the
neck and shoulders as well as the legs and back. Because this treatment is
considered to be alternative and unconventional, however, questions arise on
the actual efficacy of it in the relief of chronic pain. According to a study
conducted by the Tzu Chi University of Science and Technology in Taiwan where a
total of sixty-two participants of both men and women 24 to 61 years of age, it
was noted that there was a decrease in neck and shoulder pain by 6.1 in the
group subjected to cupping therapy whereas the control group only experienced a
decrease of 0.2 in pain (Chi, et al., 2016). The baseline of pain in both groups
was recorded to be 9.7 in the beginning of the study. Additionally, it was
documented that there was a decrease in the systolic blood pressures of those
in the cupping group from 117.7 to 111.8. Another clinical trial researched by
the NIH suggested that there was a substantial report of pain relief at 2.2 of
6 points of present pain 3 months after three sessions of wet cupping paired
with usual care (Kim, Lee, Lee, Boddy, & Ernst, 2011). There is also
evidence of the effectiveness of dry cupping in the relief of cancer pain.
After 3 days of treatment, it was shown that cancer pain reduced from 67% to
43% (Kim, Lee, Lee, Boddy, & Ernst, 2011).
While the research on cupping
appears to lean more toward positive outcomes, like any procedure, there are
some side effects to this form of holistic treatment. Wet cupping involves the
use of scalpels to cut the skin, which in itself, can be a painful experience.
Individuals with blood disorders such as hemophilia must not seek this form of
treatment because of the risk of hemorrhage. A 2012 study by Evidence-Based
Complementary and Alternative Medicine found that some patients suffered from
other adverse side effects as well. Dizziness and circulatory instability
immediately following the procedure was reported, as well as tension headaches,
migraines, tinnitus, and itchiness at the treatment sites (Lauche, et al., 2012).
While conventional medicine is well
known to be beneficial to patients seeking relief from chronic pain, it can be
made even more effective when coupled with alternative therapies such as wet or
dry cupping. Those seeking this form of treatment, however, must first be fully
informed of the benefits and side effects, as well as how the actual procedure
is performed in order to make an educated decision. A pamphlet of some form
with statistical analyses, advantages, and disadvantages may be helpful for the
patient. Allowing the patient to see the glass cups for him or herself and a
demonstration of the procedure may also be helpful. When presenting this
practice to health care professionals, it is important to be prepared with
statistical data supporting the benefits of cupping when used to treat various
ailments. It is also important to emphasize to health care providers the
significance of keeping “an open mind” when using alternative therapies. It
should be noted that alternative therapies can and should be utilized alongside
traditional medical practices in order to achieve the best possible outcomes
for our patients.
Lin, L.-M., Chen, C.-L., Wang, S.-F., Lai, H.-L., & Peng, T.-C. (2016).
The effectiveness of cupping therapy on relieving chronic neck and shoulder
pain: a randomized controlled trial. Evidence-Based Complementary and
Alternative Medicine, 1-7.
Kim, J.-I., Lee, M., Lee,
D.-H., Boddy, K., & Ernst, E. (2011). Cupping for treating pain: a
systematic review. Evidence-Based Complementary and Alternative Medicine,
Lauche, R., Cramer, H.,
Hohmann, C., Choi, K.-E., Rampp, T., Saha, F. J., . . . Dobos, G. (2012). The
effect of traditional cupping on pain and mechanical thresholds in patients
with chronic nonspecific neck pain: a randomised controlled pilot study. Evidence-Based
Complementary and Alternative Medicine, 1-10.
Qureshi, N. A., Ali, G. I.,
Abushanab, T. S., El-Olemy, A. T., Alqaed, M. S., El-Subai, I. S., &
Al-Bedah, A. (2017). History of cupping (Hijama): a narrative review of
literature. Journal of Integrative Medicine, 15(3), 172-181.