What is Cupping Therapy?
Cupping therapy is a therapeutic practice that involves placing specialized cups on the skin and creating negative pressure—or suction—to draw tissue upward into the cup. This mechanical action increases local blood circulation, releases fascial adhesions, and stimulates the body’s natural healing response. Practitioners use glass, bamboo, silicone, or plastic cups applied to areas of pain, stiffness, or energetic blockage. The treatment leaves temporary circular marks on the skin where capillaries expand under suction.
The term “cupping” encompasses multiple techniques and philosophies. In Traditional Chinese Medicine it is called ba guan and is understood as a method to move stagnant Qi and blood through meridians. In Islamic medicine, the wet cupping variant is known as hijama and involves controlled bloodletting for detoxification. Modern clinical applications treat musculoskeletal pain, sports injuries, respiratory conditions, and chronic inflammation.
Origins & Lineage
Cupping therapy has no single point of origin; archaeological and textual evidence places its practice independently across ancient Egypt, China, Greece, and the Middle East.
The earliest recorded use appears in the Ebers Papyrus, an Egyptian medical text dating to approximately 1550 BCE, which describes cupping for treating fever, pain, vertigo, and menstrual imbalances. Drawings of cupping were also discovered on the Temple of Kom Ombo near Luxor.
In China, the earliest documented use appears in A Handbook of Prescriptions for Emergencies (241–381 CE), written by herbalist Ge Hong. Historical records trace cupping therapy back to ancient China as early as 3000 BCE, when practitioners used animal horns and bamboo cups to remove toxins from the body. Over centuries, it became integrated into the foundational practices of Traditional Chinese Medicine alongside acupuncture and herbal medicine.
Greek physicians, including Hippocrates (460–377 BCE), also used cupping to treat internal diseases and muscular pain. Cupping was used widely in Europe and America until the 1800s, when it fell out of favor as the practice of medicine became more scientific and focused on treating illnesses from the inside out.
The Islamic Prophet Muhammad also recommended cupping in his writings, where he called it hijama. This practice remains widespread in the Arab world and South Asia today, often performed on specific lunar dates for preventive health.
How It’s Practiced
Cupping sessions typically last 15 to 60 minutes. The practitioner selects treatment sites based on areas of pain, tension, diagnostic findings, or traditional meridian theory. Cups range from one to two inches in diameter.
Dry cupping is the most common Western method. It involves placing cups on the skin to create a suction effect without any incisions or bloodletting, making it a non-invasive option. The cups are left in place for 5–10 minutes. The suction draws skin and superficial muscle layers upward, leaving circular red or purple marks that fade within 3–7 days.
Fire cupping uses heat. A cotton ball soaked in alcohol is set alight to heat the air inside the cup; as the oxygen inside the cup is consumed, a vacuum is formed. The flame is extinguished before the cup touches skin. This method is traditional in Chinese medicine clinics.
Wet cupping (hijama) involves controlled bloodletting. Also known as hijama, this approach involves making small, superficial cuts on the skin before applying the cups. After using dry cupping for up to 5 minutes, the therapist will make small incisions in the area. The cup is prepared once again and applied to the affected area. Blood will be drawn out of the body in the vacuum. This variant is emphasized in Islamic medicine traditions.
Silicone or massage cupping uses pliable cups that glide across oiled skin. Sliding cupping uses soft silicone cups applied over oiled skin. Rather than being left in a fixed position, the cups are moved smoothly across the surface of the skin in long strokes, covering a broader area of the body. This technique produces a sensation similar to a deep tissue massage.
Cupping therapy can be performed in two main ways: static and dynamic. Static cupping involves placing the cups in one location on the body and leaving them there for a set amount of time, usually 5 to 15 minutes. Dynamic cupping involves movement.
Cupping Therapy Today
Cupping gained mainstream visibility in the West after swimmer Michael Phelps appeared at the 2016 Rio Olympics with circular marks on his shoulders. It is now offered in sports medicine clinics, acupuncture practices, physical therapy offices, spas, and integrative health centers.
Cupping therapy fell out of favor in the 17th and mid-18th centuries but recovered popularity in modern medicine. Currently, cupping therapy is used for health promotion, prophylaxis, and treatment of a variety of diseases around the world.
The American College of Physicians has acknowledged cupping as a complementary therapy for chronic lower back pain. Research studies examine its effects on conditions including arthritis, migraines, asthma, fibromyalgia, carpal tunnel syndrome, and respiratory illness. A randomized controlled trial by Kim, Lee, and Kim (2019) found that cupping therapy significantly improved range of motion and reduced pain in the hip joint.
Practitioners may be licensed acupuncturists, massage therapists, chiropractors, naturopathic doctors, or physical therapists with additional cupping certification. Some wellness centers offer cupping as a standalone modality; others integrate it with acupuncture, myofascial release, or Traditional Chinese Medicine diagnosis.
Home cupping kits made of silicone or plastic with manual pumps are available for self-care, though beginners are advised to learn proper placement and pressure from a trained professional first.
Common Misconceptions
The marks are not bruises. Though they resemble bruises, the circular discolorations result from capillary expansion and interstitial fluid accumulation, not tissue trauma. They are typically painless and indicate the degree of stagnation in the area.
Cupping does not “remove toxins” in a biochemical detox sense. While traditional systems describe it as eliminating pathogenic factors or stagnant blood, no single theory exists to explain the whole effects of cupping. The details of every part and process of a mechanism are not fully understood, making it difficult to have a complete scientific description on how that mechanism works in cupping.
Evidence quality is mixed. The available evidence quality for the effectiveness of cupping therapy ranges from very low to moderate, with an absence of high-quality evidence. There isn’t a lot of research on the therapy. Most studies show modest benefits for pain, but mechanisms remain debated.
It is not a cure-all. Cupping is best understood as a complementary intervention for symptomatic relief—particularly muscle pain and tension—not a standalone treatment for systemic disease.
Wet cupping requires rigorous hygiene. Wet cupping is performed by trained professionals who prioritize hygiene and safety protocols, ensuring a sterile environment and minimizing potential risks. Improperly performed wet cupping carries infection risk.
How to Begin
If you are new to cupping therapy, start with dry cupping or silicone cupping, which are non-invasive and widely available. Silicone or dry cupping is ideal for beginners due to its gentle nature and ease of application.
Find a qualified practitioner. Seek a licensed acupuncturist (L.Ac.), certified massage therapist (LMT), or physical therapist trained in cupping. Ask about their training, experience, and whether they are familiar with your specific concern (sports injury, chronic pain, respiratory support, etc.).
Book an initial session. Expect an intake discussion about your health history, pain patterns, and goals. The practitioner will place 3–10 cups on your back, shoulders, legs, or other areas. Sessions typically last 20–45 minutes.
Observe your response. Notice changes in pain, mobility, and tension over 24–72 hours. Most patients can safely have cupping once a week initially, then once every 2–3 weeks for maintenance—the marks typically clear within 3–7 days.
Consider integration. Cupping often complements acupuncture, massage, and movement therapy. In Traditional Chinese Medicine settings, it may be combined with moxibustion or herbal medicine.
For self-study, consult Cupping Therapy for Bodyworkers by Ilkay Z. Chirali or workshops offered through organizations like the National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) or acupuncture colleges.