Cupping Therapy Books

[Cara Canellas]

Byengaging in evidence-based discussions, analyzing case studies, and participating in practical demonstrations, learners review cupping therapy's potential effectiveness, safety considerations, and the methods for incorporating it as a complementary treatment option into their clinical practice. Healthcare professionals are equipped with the skills to enhance the competence required to make informed decisions about incorporating cupping therapy into patient care to improve patient outcomes and promote a holistic approach to healing.

Objectives:Differentiate between the various cupping techniques and their specific indications, ensuring the selection of the most suitable approach for individual patient needs.Implement cupping therapy safely and hygienically by following established sterilization protocols and maintaining infection control standards to ensure safe and successful treatment.Select appropriate cupping tools and materials, considering patient comfort and the specific treatment goals.Coordinate patient care effectively by documenting cupping therapy sessions in patient records, sharing relevant information with the patient's healthcare team, and ensuring continuity of care.Access free multiple choice questions on this topic.

Cupping therapy is a therapeutic technique that utilizes a vacuum force created beneath a small vessel applied onto the skin's surface. This approach focuses on blood and autologous healing substances in a specific area, stimulating metabolic activity, improving immune function, and stabilizing blood biochemistry.[1]

Cupping therapy has been a traditional practice dating back to ancient times. This therapy was practiced by the Egyptians and Macedonians around 5500 years ago, and Egyptians later introduced this method to the Greeks.[2] Cupping therapy was documented and endorsed in diverse civilizations, including China and Rome, as well as within the collective traditions (hadiths) of the Prophet Muhammad during the initial 6 centuries of the Common Era. Over time, cupping therapy extended to numerous parts of the world and has been consistently utilized, except in the United States, where it declined in popularity during the late 19th and early 20th centuries. [2]

Cupping has traditionally carried folkloric, cultural, religious, and spiritual significance within various societies. Within certain traditional Muslim communities, adhering to specific ceremonial practices was believed to improve treatment outcomes, resulting in regulations restricting the anatomical regions where cupping could be administered.[3] In traditional Eastern Medicine, cupping therapy was closely associated with acupuncture, whereas in Taoism, it was used to harmonize Qi by balancing Yin (negative energy) and Yang (positive energy).[1] In India, Ayurvedic medicine also incorporates a blood detoxification technique known as Ghati yantra, which bears similarities to wet cupping.[1] In certain less-dominant cultural and religious traditions, shamanic leaders utilized the cupping method to safeguard their communities from illnesses believed to be of demonic origin.[2]

Wet cupping, a traditional procedure, continues to be practiced in various regions, including China, Korea, and parts of Eastern Europe. In regions of the Middle East and Northern Africa, this practice is called Al-Hijamah in Arabic, which can be loosely translated as "restoring the body to its natural state."[1][4][5]

Although wet and dry cupping techniques remain relevant in contemporary medicine, a meta-analysis of cupping therapy's effectiveness in managing back pain indicated that most studies meeting inclusion criteria primarily focused on dry cupping. This preference is likely attributed to the noninvasive nature of dry cupping than wet cupping. The potential advantages of reduced invasiveness outweighed the additional physiological impact that wet cupping might offer.[6]

The specific mechanism through which cupping exerts its therapeutic effects remains unidentified. However, several theories have been proposed to elucidate its physiological benefits, as mentioned below.[7]

This theory proposes that the touch, pressure, and vibrational sensations generated during cupping therapy selectively stimulate large nerve fibers. This stimulation leads to the inhibition of pain signal transmission to the brain through the dorsal horn of the spinal cord. The increased stimulation of peripheral nociceptors caused by cupping results in the upregulation of receptor-fiber units, subsequently triggering the activation of large-fiber nerves. These large fiber nerves are responsive to stimuli, and the pumping mechanism used to create suction during cupping may contribute to pain relief.[7]

This theory proposes that pain in one part of the body can be suppressed or overshadowed by pain in a different area. More precisely, DNIC refers to the findings from animal studies that illustrate pain inhibition mediated by the lower brainstem. In humans, this phenomenon is called conditioned pain modulation (CPM). The effective utilization of CPM entails using conditioning to attain a reduced pain response. Cupping therapy has been used in the treatment of idiopathic pain syndromes. However, the precise mechanism through which DNIC operates in cupping therapy remains incompletely understood. Various hypotheses have been proposed, including the potential distraction caused by the sensation of cupping, the initiation of a DNIC response, or the induction of a deoxidation effect.[7]

This theory proposes that specific alterations in distal vascular, muscular, nervous, organ, or connective tissues could be a reflexive response to a proximal constriction of an autonomic nerve within the same or overlapping dermatome. According to this theory, the treatment approach should prioritize addressing the central restriction area rather than exclusively concentrating on the distal regions manifesting symptoms.[7] This concept resembles somato-visceral and somato-somatic reflexes in osteopathic medicine and the utilization of meridians in traditional Eastern medicine.

This theory suggests that cupping therapy may stimulate the increased production of nitric oxide (NO), which controls blood flow, volume, and vasodilation. This theory is supported by the findings from animal studies that have shown an association between the release of NO and acupuncture. Due to the parallel physiological effects observed in both cupping therapy and acupuncture, it is hypothesized that cupping may similarly induce NO-mediated vasodilation and other local physiological responses. As a result, cupping therapy might promote healthy blood circulation and prevent conditions such as atherosclerosis.[7]

This theory proposes that cupping therapy significantly enhances the body's biochemical and mechanical immune systems. Several studies cited by Al-Bedah et al suggest that cupping therapy can increase the production of various autoimmune modulators while concurrently reducing inflammatory substances. Moreover, it is believed that these positive changes may have lasting effects beyond the duration of the cupping treatments. In addition, cupping is assumed to stimulate the activity of the thymus, support the function of the neuroendocrine system, and bolster the body's antioxidant processes.[7]

This theory primarily applies to wet cupping. According to this theory, the blood drawn during wet cupping is found to have elevated concentrations of various substances, including uric acid, cholesterol, urea, and triglycerides. Furthermore, the blood obtained through wet cupping is believed to contain higher levels of red blood cells, hemoglobin, hematocrit, viscosity, and mean corpuscular hemoglobin. This theory has been applied in detoxification protocols, particularly for aluminum, mercury, silver, and lead.[7]

In both wet and dry cupping, the application of external suction leads to several physiological responses that contribute to the therapeutic effects of the therapy. These responses involve an increased blood volume, an elevated capillary filtration rate, and the expulsion of filtered and interstitial fluid into the treated area. The collected fluid contains elevated levels of disease-related and disease-causing substances, prostaglandins, and inflammatory mediators.[8]

In wet cupping, the scratches made with a scalpel during the procedure lead to a different set of effects. These minor skin incisions stimulate inflammatory cell migration and trigger the release of endogenous opioids, which are natural substances that function as pain relievers and mood enhancers. As previously mentioned, this action contributes to an increase in both innate and acquired immunity, thereby enhancing the body's ability to fight infections and restore immune balance.[1]

Cupping therapy can target numerous anatomical sites, and the choice of these sites depends on the specific ailment or condition under treatment. Cupping is frequently administered to regions with abundant muscle tissue, such as the back, chest, abdomen, and buttocks.[1]

To minimize potential risks and increase the chances of favorable outcomes in cupping therapy, it is advisable to avoid anatomical sites with significant dense hair, limited tissue mass, and insufficient surface area for effective cup placement.[10]

Cupping is a versatile therapy that benefits overall health and effectively addresses localized and systemic complaints. Dry and wet cupping techniques can be applied for effective musculoskeletal pain relief.[11] However, dry cupping is often preferred in Western settings because it poses significantly lower risks of exposure to biohazardous fluids, making it a safer option for practitioners and patients.

Despite the lower risk, evidence suggests that wet cupping may provide patients with broader benefits.[12] Research indicates that wet cupping can be beneficial for systemic disorders, including conditions related to obesity, hypertension, autoimmune and inflammatory diseases, diabetes mellitus, psychiatric disorders, systemic infections, and skin conditions.[4][10][13]

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