Cupping is a commonly used therapeutic procedure used by AOM and other healthcare practitioners. Cupping uses a partial vacuum that causes the tissue to tumefy and stretch into the cup. Cupping intentionally creates therapeutic petechiae (pinpoint, round spots) and ecchymosis (bruising) that appear in round or “nummular” areas.

There are three types of cupping, each with different safety profiles: fire cupping, suction cupping, and wet cupping (cupping after the use of a lancet for blood withdrawal). Fire cupping and suction cupping are variations of dry cupping. Both dry and wet cupping are used in traditional East Asian medicine, the traditional medicine of Gulf Arabs (hijamah), in European countries, and in early Western medicine through its lineage of early Greek, Roman and Egyptian medicine. Cups used in the modern setting are made of glass, plastic, or silicone.

• Fire cupping: in this procedure, a ball of burning cotton or a lit alcohol swab is briefly placed inside a glass cup to heat the air inside, which then creates a partial vacuum as it cools. Glass cups are used, as glass is impervious to heat at the levels used for this procedure. Typically, cups are left on the patient’s skin for 2-10 minutes, but may be left in place for up to 20 minutes, and leave a temporary reddish mark that is a result of cutaneous petechiae and ecchymosis.
• Suction cupping: this procedure involves the use of plastic or silicone cups with valves at the top that attach to hand pumps. The pumps create suction by removing a quantity of air after the cups have been placed on the skin. Typically cups are on for 2-10 minutes, but may be left in place up to 20 minutes and leave a temporary reddish mark that is a result of cutaneous petechiae and ecchymosis.
• Wet cupping: in this procedure, the skin is punctured with a lancet or sterile needle, such as those used for plum blossom tapping, before the cups are applied. Wet cupping may be done with either suction cups or fire cups. This technique is specifically employed to draw out blood to release heat or local stagnation.
• Other cupping procedures: practitioners also use cupping techniques that include (1) moving or sliding cupping during which they gently move the cup along a lubricated surface area, channel, or muscle fibers; (2) empty cupping, which means the cups are removed after suction without delay; or (3) needle cupping, during which the practitioner applies the acupuncture needle first, then applies the cups over the needles.

Cupping is utilized by practitioners to treat conditions including acute or chronic pain; mild to severe conditions such as colds, flu, and fever; respiratory problems such as asthma, bronchitis, and emphysema; functional internal organ problems; musculoskeletal problems; and in any case of recurring or persistent fixed pain. Since 1950, cupping therapy has been applied as a formal modality in hospitals throughout China and elsewhere in the world.

Photo Credit: Antoni Shkraba