Cupping Therapy Scientific Evidence

[Lorriane Nasuti]

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Abstract: This study aimed to describe and assess the current evidence in systematic reviews on cupping therapy for various conditions. We searched PubMed, EMBASE, Cochrane Database of Systematic Reviews, China National Knowledge Infrastructure, and six Korean databases for systematic reviews of trials on cupping treatments for any condition published prior to March 2021. We used a bubble plot to graphically display the clinical topics, the number of articles, the number of participants in the total population, confidence, and effectiveness. Thirteen systematic reviews that met the inclusion criteria were included in the evidence map, and 16 bubbles were created. The findings from six reviews showed potential benefits of cupping for conditions such as low back pain, ankylosing spondylitis, knee osteoarthritis, neck pain, herpes zoster, migraine, plaque psoriasis, and chronic urticaria. Cupping has been applied in a variety of clinical areas, and systematic reviews in a few of these areas have demonstrated statistically significant benefits. The evidence map provides a visual overview of cupping research volume and findings. Evidence mapping can facilitate the transfer of knowledge from researchers to policymakers and promote research on musculoskeletal pain (such as low back pain, neck pain, and knee osteoarthritis) and skin disease (plaque psoriasis). Keywords: evidence map; cupping therapy; systematic review; evidence synthesis

Cupping therapy is an ancient form of alternative medicine where a therapist puts special cups on your skin for a few minutes to create suction. The idea is to draw blood to or away from parts of your body. People get it for many reasons, such as pain and inflammation relief, relaxation and well-being, and as a type of deep-tissue massage.

The Egyptians introduced cupping to the ancient Greeks who used it as a cure for almost every illness. In traditional Chinese medicine, it's closely linked to acupuncture. The Islamic Prophet Muhammad also recommended cupping in his writings, where he called it hijama.

For either type, in the traditional method (fire cupping), your healer puts a flammable substance such as alcohol, herbs, or paper, inside a cup and sets it on fire. As the fire goes out, they put the cup upside down on your skin.

Dry cupping is simple and is the preferred method in the West because it's easy to do and doesn't involve blood. The therapist just applies the cups to your skin, compressing them with their hands, a pump, or a flame if using glass cups. (They may apply lotion first). They leave the cups in place for 5-10 minutes. You can have this therapy done as often as once or twice a week.

Dry cupping may be combined with a massage. This is called massage cupping or running cupping. Your therapist puts lotion or oil on your skin and moves silicone cups back and forth, up and down, or in circles on your skin for a massage-like effect.

In wet cupping, your therapist first creates a mild suction by leaving a cup on your back for about 3 minutes. They remove the cup and use a small scalpel to make light, tiny cuts on your skin. Next, they do a second suction to draw out a small quantity of blood. They might leave those cups in place for 10-15 minutes.

The idea is the cuts attract inflammatory cells and cause the release of natural pain relievers and mood enhancers called endogenous opioids. These help your body fight infections and maintain immunity.

One report, published in 2015 in the Journal of Traditional and Complementary Medicine, notes that it could help with acne, herpes zoster, and pain management. But the researchers said many of the studies they reviewed could have been biased and that better studies were needed.

The "pain-gate" theory says that the touch and pressure from cupping stimulate large nerve fibers, which results in the blocking of pain signals to the brain sent by other nerves. The gate control system is in our spinal cords. So, activating these nerve fibers can block pain transmission.

Does it work? One 2023 review of existing studies found that cupping seemed effective for managing chronic pain, knee osteoarthritis, low back pain, neck pain, chronic back pain, and herpes zoster. But the studies were all of low to moderate quality. In general, experts see cupping as something that should complement conventional medicine rather than replace it.

In the immune system theory, cupping can reduce inflammatory substances and increase the production of substances to improve your immune system. Cupping may also boost your body's antioxidant processes. So, cupping might be able to help with skin conditions. One Iranian study compared two groups of people. One got acne medicine along with wet cupping, while the other got acne medicine and "sham cupping" (a device that felt like real cupping but had a tiny hole). The group that got the medicine and the wet cupping showed more improvement than the control group.

Some people get "needle cupping," where the therapist first inserts acupuncture needles and then puts cups over them. The idea is that the cupping loosens muscles while the needles relieve the pain. One study showed that ear acupuncture combined with cupping therapy was more effective in treating chronic back pain than treatment using only ear acupuncture.

Burns from fire cupping are a hazard but seem to be rare. Overheating the cup is usually the problem. An Australian study looked at 18,703 patients enrolled in the Burns Registry of Australia and New Zealand over a 7-year period and found just 20 had cupping-associated burn injuries. Sixteen of these occurred at home. Still, more people could have been burned but not badly enough to go to a hospital. There have been some other reports of people getting burned at cupping clinics.

Cupping marks are a common side effect of applying suction cups to your skin. They're usually circular and can range in color from light pink to dark purple, depending on your skin tone and how much pressure was used to apply the cups. These usually fade over time, in about 1-10 days.

There's no conclusive evidence, but some believe it's a risk. Experts warn to avoid cupping if your skin is scraped, oozing, or infected, as this can increase the chance of blood clotting. Also, if you're on a blood thinner or have heart disease, you shouldn't do cupping therapy.

Cupping could be good for shoulder pain, as it increases circulation in the pain area (which encourages healing) and reduces muscle tension. But there aren't definitive studies that say cupping reduces shoulder pain.

Back pain is a popular reason why people seek out cupping. The theory is the same as for shoulder pain -- cupping increases blood circulation and reduces muscle tension. Some studies do show it can reduce back pain, but they aren't conclusive.

Cupping may reduce knee inflammation by increasing blood flow and flexibility. It also encourages tissue repair. One study said cupping for knee osteoarthritis was as effective as taking 650 milligrams of acetaminophen three times a day. But other studies showed weak evidence.

You're most likely to get cupping from a massage therapist or an acupuncturist. They don't need to have special certification to offer cupping therapy, but they often have it. They usually need to be a licensed massage therapist or acupuncturist to offer any services. Requirements depend on the state you live in.

Costs run about $30-$100 per session, depending on where you live and how long your session lasts. It could be as short as 15 minutes or as long as 1 hour. Also, wet cupping will cost more than the dry type. Some places offer a discount if you buy a package of appointments.

Yes, you can give yourself cupping therapy. Many kits are available containing plastic, silicone, or glass cups. Please do not buy glass cups, as these need to be heated to be applied and are too dangerous for beginners to use. Stick with plastic or silicone. Plastic ones usually come with a pump. Silicone cups are for doing massage cupping, which involves moving the cups around.

You can learn how to use cups by reading books, watching videos, or following instructions online. Let your doctor know you intend to try this therapy, as you might have a health problem that could make cupping a bad idea.

Cupping is an ancient therapy that's now back in style. It aims to increase blood flow, soften scar tissue, and decrease muscle pain by placing suction cups on your body and leaving them on for 10-15 minutes. Practitioners say it can help with back pain, arthritis, depression, migraines, acne, and many other conditions. Not many scientific studies support these claims, but some people who've had cupping therapy done swear by it.

Some studies say that cupping helps with pain relief, but most of the studies were not high-quality. Scientists aren't exactly sure how cupping works, so more research is needed. Cupping has minor side effects, so trying it usually won't hurt. Just let your doctor know you want to do it. And don't stop your normal treatment unless your doctor says it's OK.

After a cupping session, you'll probably see round red marks on your skin, which should fade in a week or two. Your therapist may advise you to drink lots of water (to flush out toxins), stay warm, and rest. You may feel a little tired as if you're fighting a minor illness. Therapists say this is normal, a side effect of your body getting rid of toxins.

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