Cupping therapy is an ancient technique of healing, performed by applying cups to selected skin points and creating a subatmospheric pressure, either by heat or by suction. This therapy was a popular historical treatment in Arabic and Islamic countries. It was recommended by the physicians there. The practice spread to Italy and, subsequently, the rest of Europe between the 14th and 17th centuries, during the Renaissance. Cupping was a popular treatment of gout and arthritis in Italy during this period. The main proposed mechanisms of action were effects of subatmospheric pressure suction, promoting peripheral blood circulation, and improving immunity.
Reported effects of cupping therapy include promotion of the skin’s blood flow, change in the skin’s biomechanical properties, increased pain thresholds, improved local anaerobic metabolism, reduced inflammation, and modulation of the cellular immune system.
Many theories explain the mechanism of action of cupping. The immune modulation theory suggests that cupping and acupuncture had the same mechanisms of action. Immune modulation theory suggests that changing the microenvironment by skin stimulation could transform into biological signals and activate the neuro endocrine immune system. Early classification of cupping therapy categorised it into dry and wet cupping.
The updated classification categorised cupping therapy into six categories:
* Technical types: Dry, wet, massage, and flash cupping
* Power of suction: Light, medium, and strong cupping
* Method of suction: Fire, manual vacuum, and electrical vacuum cupping
* Materials inside cups: Ozone, moxa, needle, and magnetic cupping
* Area treated: Facial, abdominal and orthopaedic cupping
* Other cupping types: Sports, cosmetic cupping
A typical set should contain six or more different-sized cups and a method of suction. Cupping therapy sets can be classified into three main categories:
a) Related to the types of cups, which include plastic, glass, rubber, bamboo and silicone cupping sets
b) Related to the methods of suction, which include manual, automatic, and self-suction cupping sets
c) Related to uses, which include facial and massage cupping sets. Cupping is contraindicated directly on veins, arteries, nerves, skin inflammation, any skin lesion, body orifices, eyes, lymph nodes, or varicose veins. It is also contraindicated on open wounds, bone fractures, and sites of deep vein thrombosis.
The therapy has been used for health promotion, prevention and therapeutic purposes. It has reported benefits in the treatment of lower back pain, neck and shoulder pain, headache and migraine, knee pain, facial paralysis, brachialgia, carpal tunnel syndrome, hypertension, diabetes mellitus, rheumatoid arthritis and asthma. These diseases can be categorised into localised diseases (neck pain, lower back pain, and knee pain) and systematic diseases (diabetes mellitus, hypertension, and rheumatoid arthritis). The therapy sites are selected according to the treated ailment. The back is the most common site of application, followed by the chest, abdomen, buttocks, and legs. Other areas, such as the face, may also be treated by cupping.
In summary, cupping therapy is an ancient, traditional and complementary medicine practice. There is growing evidence of its potential benefits in the treatment of some diseases, especially pain-related conditions. Following infection control measures is an important component of cupping therapy practice.
(The author is Head of the Department of Acupuncture, Sir Ganga Ram Hospital, Delhi)