Cupping

Chris Vi, PhD Candidate (Medicine), B.H&MedSci(Hons), B.BioMedSci

Deeya Mahadooa, MSc Mental Health Psychology, BA(Hons) Psychology 

 

Cupping – What is it and how does it work?

Cupping has been around since ancient time, used as an alternative medicine technique to treat ailments, illnesses, diseases, and pain (Furhad & Bokhari, 2020). Interestingly, Hippocrates – one of the most outstanding physicians who revolutionised modern medicine as we know it, advocated for the use of cupping as treatment of various diseases: gynecological complaints, back and extremity illnesses, lung diseases, pharyngitis, and ear ailments (Furhad & Bokhari, 2020).

However, the mechanism of action of cupping is not entirely understood from a medical perspective, thus, various hypothesises haves been proposed to explain the effects observed in cupping (Al-Bedah et al., 2018).

 

Study Review – Al-Bedah et al. 2018

• Examined six possible theories, from modern medicine perspective, on cupping therapy and its effects/mechanism of action.

Cupping and Pain Reduction

Reduction of pain due to cupping can be explained by three possible theories:

• Pain-Gate Theory: from the point of pain inception, these signals are sent to the brain, and how the brain processes it, then sends a ‘protective signal’ to the stimulated area – essentially blunting the perception of pain and increasing its threshold. Therefore, cupping influences chronic pain by altering the signal processes of the nociceptors (pain receptors) at both the brain and spinal cord.
• Diffuse Noxious Inhibitory Controls: offers a simpler explanation, such that the presence of a second pain stimulus (cupping) can inhibit the nociceptive response of the original chronic pain.
• Reflex Zone Theory: suggests that the stimulation of the ‘disturbed point’ through cupping and supplying the area with red blood cells from the vascular system enables the activation of biological processes to the treated area.

Immune System Regulation

The benefits of cupping can further extend towards the regulation of the immune system and increase its function, via activation at a physiological level and regulating blood cells and antibodies.

• Release of Nitric Oxide (NO) Theory: NO regulates blood pressure, contributes to the immune responses, controls neurotransmission, participates in cell differentiation other physiological functions. Cupping can induce beneficial biological changes and increase blood circulation.
• Activation of Immune System Theory: the activation of the immune system by cupping is of three-fold, cupping stimulates the immune system by:
  • Causing artificial inflammation
  • Activation of complementary system
  • Increasing levels of immunity factors such as interferons and tumour necrotising factors.
• Blood Detoxification Theory: cupping can also aid in the removal of ‘toxins’ and waste by-products leading to blood detoxification to enhance overall well. The increase in blood circulation, created by the negative pressure of cupping enables more efficient extraction of ‘trapped’ waste by-products and toxins.

Study Review – Chi et al. 2016

• Randomised controlled trial
• Used Neck Pain Intensity (NPI) score to measure pain in control and experiment groups
• Cupping significantly improve prognosis of patients suffering from neck and shoulder pain when compared to the control group.
  • NPI scores were significantly reduced from 9.7 to 3.6 in the cupping group.
  • NPI scores only reduced from 9.7 to 9.5 in the control group
• This indicates cupping to be an effective treatment in chronic neck and related pain conditions.
• Chi et al., 2016 noted that the observed effects could be due to the increase in blood circulation to the region and removal of ‘waste by-products’ which aided in improving physical functions.

 

Cupping benefits both the healthy population and those suffering from chronic diseases; headaches, lower back pain, neck pain, fibromyalgia, and some systemic illnesses; arthritis, hypertension, angina (Al-Bedah et al., 2018; Chi et al., 2016; Furhad & Bokhari, 2020).

 

Study Review – Moura et al., 2018

• Systematic review and meta-analysis
• 611 studies identified – 16 qualitative analysed and 10 quantitative analysed
• Cupping therapy showed positive results for chronic back pain
  • Significant reduction in pain intensity (p=0.001)

Important: there is no standardisation in the treatment protocol for cupping and chronic back pain. Thus, results will vary due to type of technique (fire/electric/manual cupping), duration of treatment, number of sessions, time of application, method and suction strength and targeted points on the body (Moura et al., 2018).

• However, despite this, results still produced such a significant result, implying the technique of cupping itself, has benefits on the reduction of pain and pain symptoms.

Subject to copyright, Rehab Plus 2020

 

References

Al-Bedah, A., Elsubai, I. S., Qureshi, N. A., Aboushanab, T. S., Ali, G., El-Olemy, A. T., Khalil, A., Khalil, M., & Alqaed, M. S. (2018). The medical perspective of cupping therapy: Effects and mechanisms of action. Journal of Traditional and Complementary Medicine, 9(2), 90–97. https://doi.org/10.1016/j.jtcme.2018.03.003

Chi, L. M., Lin, L. M., Chen, C. L., Wang, S. F., Lai, H. L., & Peng, T. C. (2016). The effectiveness of cupping therapy on relieving chronic neck and shoulder pain: A randomized controlled trial. Evidence-Based Complementary and Alternative Medicine, 7358918. https://doi.org/10.1155/2016/7358918

Furhad, S., & Bokhari, A. A. (2020). Cupping Therapy. In StatPearls. Treasure Island, FL: StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538253/

Moura, C. C., Chaves, É., Cardoso, A., Nogueira, D. A., Corrêa, H. P., & Chianca, T. (2018). Cupping therapy and chronic back pain: systematic review and meta-analysis. Revista Latino-Americana de Enfermagem, 26, e3094. https://doi.org/10.1590/1518-8345.2888.3094