Cupping therapy
What is cupping?
Cupping therapy belongs to traditional Chinese medicine, the heritage from several thousand years. It is used with one of several kinds of cups, such as bamboo cups,
glasses or earthen cups, placing them on the desired acupoints on patients’ skin, to make the local place hyperemia or hemostasis, which can obtain the purpose of curing the diseases.
There are Different Types of Cupping Therapy
Depending on the condition, the cupping method has different ways.
---Fixed Cupping
In this method, the experts fix cups to the body and allow them to stay for some time. The application may be through pump, suction, or fire cups. These cups stay fixed during the treatment and aim at the release of local tissue. The concentration of the cups stays local, allowing the connective tissue to stretch fully. Local tension and pain are the symptoms to which this method applies.
---Dry Cupping
In the dry cupping method, the experts apply plastic suction cups or a little lotion to the dry skin. The lotion allows the suction cup to glide over the affected area, offering deep tissue massage. Once the cups are removed, they may leave red circular areas corresponding to the diameter behind them. The level of cupping includes medium, strong, and weak. The weak cups are used for older people and young children and lightly move the blood and fluids. The weak cups may not reduce stasis or congestion in the surrounding tissues. People with slightly higher strength are more appropriate for medium cups. The cups stay for a short period to remove congestion and improve circulation. People with a high energy level are to be chosen for strong cups. In this method, the cups must stay for a short time and are used for chronic localized stasis.
---Wet Cupping / Hijama / Bleeding
Wet cupping is a method in which the specialists puncture the skin to draw blood before placing the cups. Usually, about three to five cups are common during the first session. Once the therapy finishes, antibiotic ointment and a bandage help prevent infection. The skin must return to normal within about ten days.
---Flash Cupping /Empty cupping
In this method, cups are applied and removed immediately, and the procedure repeats over a broad area. It helps stimulate local circulation.
---Oil cupping / Sliding cupping
Its a technique where massage oils are applied, cups are attached to the body and then slide across an area.
There are Different Materials Of Cups
• Horn / suction cups • Glass / fire glass cups • Plastic / Hijama cups
• Bamboo / wooden cups • Silicone / facial cups • Nabhi pump
The Benefits of Cupping Therapy
The major benefits of cupping therapy are as follows:
1. Fast and effective pain relief: Cupping therapy can provide fast and effective pain relief for individuals experiencing chronic pain, muscle tension, and arthritis. As a form of myofascial release, cupping can help to loosen tight muscles and increase circulation to the affected area. Physiotherapists may use cupping therapy as complementary to other manual therapy techniques, such as massage or joint mobilization, to help alleviate pain.
2. Treats lung diseases: Cupping therapy has been utilized as a complementary treatment to address respiratory conditions like asthma, bronchitis, and chronic cough. Physiotherapists may incorporate cupping into breathing exercises to help improve lung function and alleviate symptoms of respiratory distress.
3. Relief from digestive problems: Physiotherapists may use cupping therapy to address digestive issues such as bloating, constipation, and irritable bowel syndrome (IBS). Cupping therapy can help to stimulate the digestive system and reduce stress on the gut, leading to improved digestion and relief from discomfort.
4. Healthy skin: Cupping therapy can promote healthy skin by improving circulation and oxygenation to the skin's surface. Physiotherapists may use cupping therapy to treat skin conditions such as acne or cellulite and promote overall skin health.
5. Relief from chronic fatigue: Cupping therapy can effectively address chronic fatigue by promoting relaxation and improving blood flow to the affected areas. As part of a comprehensive physiotherapy treatment plan, cupping therapy may help individuals experiencing chronic fatigue feel more energized and rejuvenated.
6. Treats urinary problems: Physiotherapists may use cupping therapy to treat urinary problems such as urinary retention or bladder dysfunction. By improving circulation to the urinary system, cupping therapy can help to alleviate symptoms and promote healing.
7. Fast healing: Cupping therapy can promote rapid healing by increasing blood and energy flow to the affected area. Physiotherapists may use cupping therapy with other modalities, such as exercise or manual therapy, to accelerate the healing process.
8. Relaxation: Cupping therapy can promote peace and reduce stress by helping to release muscle tension and promote a sense of well-being. Physiotherapists may use cupping therapy as part of a comprehensive treatment plan to promote relaxation and reduce stress in their patients.
Indications of cupping therapy
Cupping is a versatile therapy that benefits overall health and effectively addresses localized and systemic complaints. Cupping therapy has been used for health promotion, preventive, and therapeutic purposes. Cupping therapy has reported benefits in the treatment of lower back pain, neck and shoulder pain, headache and migraine, knee pain, facial paralysis, brachialgia, carpal tunnel syndrome, hypertension, diabetes mellitus, rheumatoid arthritis, and asthma. These diseases can be categorized into localized diseases (neck pain, lower back pain, and knee pain) and systematic diseases (diabetes mellitus, hypertension, and rheumatoid arthritis)(see review on J Acupunct Meridian Stud 2018;11(3):83)
Even if considered safe, cupping is not for everyone. There are some Absolute Contraindications:
1. Skin conditions such as eczema, psoriasis, or Excessive dry or cracked skin dermatitis in the area to be treated, open wounds, cuts, or burns or ulcer on the skin.
2. Abcess, Excessive swelling or edema).
3. Fractured bone, Dislocated joint,Muscle dystrophy, severe malnutrition.
4. Blood clotting disorders or the use of blood-thinning medications,Severe anemia.
5. Pregnancy or menstruation.
6. Varicose veins or other vascular disorders.
7. Severe medical conditions such as cancer or organ failure or Pacemaker.
8. Patients with fear of blood or bleeding, empty stomach, <7 years of age for wet cupping and < 2 years of age for dry cupping.
Theories Associated With Cupping Therapy
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. For more information about those theories, please visit NCBI Bookshelf about cupping therapy authored by Shabi Furhad et al.
---The pain-gate theory
---The diffuse noxious inhibitory controls (DNIC) theory
---The reflex zone theory
---The release of nitric acid (NO) theory
---The activation of immune system theory
---The blood detoxification theory
Physiological Responses and Therapeutic Mechanisms in Wet and Dry Cupping
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.The increased oncotic pressure in dry cupping is believed to stimulate lymphatic uptake, thereby facilitating the removal of accumulated fluids and waste products from the treated area(Furhad S.)
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.
What are the pros and cons of cupping?
Cupping may help reduce pain, but the evidence is not very strong. There are several purported benefits of cupping that include reduced pain, muscle tightness and inflammation, improved blood flow (circulation) and increased range of motion, yet there is very little data or high-quality clinical research to support these claims. There are very few risks of cupping but be aware cupping can leave behind those hickey-like bruises on your skin and may worsen eczema or psoriasis. There is also a small risk of skin infection, especially if wet cupping is involved.
What are the potential side effects of cupping?
Cupping is a low-risk therapy. The side effects will typically occur during your treatment or immediately after. there are not any dangerous side effects of cupping therapy(AA Mohamed ,JBMR2023), while there is still some mild side effects. Such as skin bruising(marks), temporary localized itching, which are the mose common two side effects. Some other rare adverse effects may occur for different type of cuppings:
---Blisters : second degree of burn than can caused by dry cups if stayed for a long time.
---Fatigue, Headaches, Muscles tension or soreness,Nausea, which depends on the health condition and sensitivity of the skin to the negative pressure of the individual.
---Skin infections, or scarring.
---Burns from heated cups.
Based on the report of a systematic and evidence-based review(A.A. Mohamed et al2023) , some other adverse effects may be experienced. Which included hematoma at the site of application of a cupping for 2 days,; mild low back pain related to the seated position; muscle soreness for 1-2 days, and increased neck pain for 1-5 h; , slight reactions pain such as circulatory instability in the first minute after treatment, tension headaches, migraine attack, reappearing tinnitus, and wound healing itches; an aggravation of pain after the cupping sessions for few hours; headache after cupping lasted for no longer than 60 min; minor burns as a result of the steam in the cups; and mild hematomas at cupping site, self-limiting light tingling sensations for a few minutes, and increased pain.
( sources from internet and publications)