PT Classroom - Not Just Folk Medicine - Cupping in the Tech Age  ׀ by Theresa A. Schmidt, DPT, MS, OCS, LMT, CEAS, CHy, DD

You saw it on the Olympian swimmers in the 2016 Games, on Michael Phelps, on the backs of actresses sashaying down the red carpet, including Gwyneth Paltrow, (2004) Jessica Simpson, Victoria Beckham, Jennifer Aniston, and David Arquette. Serena Williams, Justin Bieber and Kim Kardashian also joined the "new" trend in expereincing this ancient modality. Those blotchy red or purple marks and perfect circles a tell-tale of the cupping procedures familiar to practitioners of Asian and traditional bodywork and folk medicine, used for centuries. History indicates cupping was used centuries ago in ancient Asia, China, (Ge Hong) Egypt (Ebers Papyrus), and Greece (Hippocrates).

The original cups were hollowed horns or bones of animals and bamboo plants, used to suck out toxins from snakebites and insect venom. Over time the cups were refined to the ones we use today, composed of glass, plastic, rubber, or silicone. Over the years, practitioners of Traditional Chinese Medicine have used glass fire-cups combined with acupuncture or even bloodletting (wet cupping) for a variety of clinical conditions. Western clinicians are now using cupping with suction cups as a massage therapy or soft tissue release tool, similar to foam rollers, massage balls, and the like. When I asked my physician about cupping, he said it was an old folk remedy, and he did not think it should be used for treating infections and pneumonia, but he heard of patients who reported good results with scar tissue. When I searched for information in the physical therapy literature, the first thing I found was an article condemning the technique as unproven and hokus-pocus. It is interesting how little most medical professionals know about cupping. In reality, there is a wealth of research in the literature regarding the effects of cupping, I will summarize some of the more rigorous studies for you to decide.

In a randomized conntrolled trial (RCT) of 70 soccer players, Fousekis et al compared the results of three interventions on myofascial trigger point pain in the low back: instrument-assisted soft tissue mobilization, static dry cupping and ischemic press ure, applied once weekly for 3 weeks. All interventions demonstrated a significant improvement in pressure pain thresholds, although the former showed the most improvement. (Fousekis, 2016). In a RCT of 50 patients with chronic neck pain, Saha et al showed improved function, mental health, quality of life and decreased pain after five 10-minute sessions of gliding cupping over two weeks. (Saha, 2017). Cao at al published a systematic review of clinical evidence for cupping therapy in 2015. The y reported a need for additional rigorous studies since the ones reviewed showed wither inadequate methodol ogical quality or an insufficient number of trials. For the trials meeting established criteria for inclusion the systematic review, they found that cupping therapy was superior to interventions including medications for conditions such as low back pain and cervical spondylosis, facial paralysis, acne and herpes zoster. (Cao, 2015) In a single blind RCT in 60 subjects with chronic neck and shoulder pain, Chi et al reported a significant reduction in neck pain intensity and skin surface temperature increase after a single treatment of10 minutes of static fire cupping bilaterally to three acupuncture points (SI15, GB21, LI15, upper trapezius and deltoid). (Chi,2016) Markowski et al. reported significant improvement in low back pain, range of motion, and leg raise in 21 subjects given cupping with four pressurized cups over the low back. (Markowski, 2014). These are just a sample of the studies available on cupping therapy. Rozenfeld and Kalichman provided a summary of cupping methods and literature review, in which they discussed the physiological effect of cupping, including increased circulation, immune system activation, lymphatic flow enhancement, mechanoreceptor stimulation with resultant reduction in nociceptive input and gating of pain. Several studies showed the efficacy of cupping for a variety of musculoskeletal conditions. More research is advised to determine the mechanisms involved in the physiological response to cupping, and to compare the effects of cupping to other standard interventions used to manage musculoskeletal dysfunction.

So want to learn more about the benefits of cupping to help your clients? Search the evidence as more is published, and check out my introductory cupping video on YouTube:

Want to learn more fast and easy ways to make a difference and save your hands? Visit www.educise.com, where you can sign on to experience the effects of cupping at a live seminar, and get CE hours approved by NCBTMB and the NY State Board of Massage Therapy.

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Last revised: April 21, 2017
by Theresa A. Schmidt, DPT, MS, OCS, LMT, CEAS, CHy, DD