Cupping Therapy

What cupping is

Cupping is a practice used in traditional medicine in several parts of the world, including China and the Middle East. It creates suction on the skin using a glass, ceramic, bamboo or plastic cup. The suction comes either from applying a flame to the cup to remove oxygen before placing it on the skin, or from attaching a suction device. [1]

• Dry cupping does not pierce the skin.
• Wet cupping pierces the skin so that blood flows into the cup. [1]

Methods, including fire cupping and the practice called hijama, are covered on Dry, Fire and Wet Cupping and Hijama. This page does not give instructions for doing cupping, and it should not be tried at home without training (see TCM Practices That Should Not Be Tried at Home).

How it is traditionally explained

In the traditional Chinese framework described in one overview, cupping helps the body expel pathogenic factors such as cold, dampness and wind, and treats conditions related to stagnation of qi and blood. [2] These are traditional concepts, not measured findings; see Qi, Yin and Yang, Five Phases and Meridians as Traditional Concepts.

How it is proposed to work

A review of modern theories listed six that have been suggested, including pain-gate and nitric oxide ideas and an immune-activation idea, and a "blood detoxification" theory. It concluded that no single theory explains the effects and that more research is needed. [3] A small lab study in 16 healthy young adults found that a 3-minute suction cup on the forearm increased blood-vessel measurements locally and reduced finger blood flow in the same arm, but the authors say it does not show why. [4] Suction on the skin clearly does something to the skin and small vessels; whether that explains any benefit is unproven. Claims that cupping "draws out toxins" are a traditional or marketing claim; we found no good evidence for it.

What a session involves

Cups are placed on the skin and held in place by suction. Cupping leaves temporary marks, which are round and discolored. NCCIH advises explaining their origin to health care providers so they are not mistaken for signs of physical abuse. [1] See Cupping Marks: What They Are and What They Do Not Show.

What research shows

NCCIH's bottom line is that research on cupping is mostly of low quality; it may help reduce pain, but the evidence is not very strong, and there is not enough high-quality research to reach conclusions about other conditions. [1]

1. Chronic pain vs sham cupping (2020 meta-analysis, 18 trials, 1,172 people)

   Mixed: placebo-type effect cannot be ruled out

   Large short-term pain relief compared with no treatment, but no significant effect compared with sham cupping; trials limited by heterogeneity and risk of bias [5]

2. Chronic musculoskeletal pain (2025 meta-analysis)

   Promising but limited

   Reduced pain intensity (moderate-quality, very high variation between studies); no improvement in disability or mental health [6]

3. Low back pain (2024, 11 trials, 921 people)

   Mixed

   Pain improved at 2 to 8 weeks, with no continued improvement at one month or 3 to 6 months; dry cupping alone did not improve pain, wet cupping did; authors note notable heterogeneity [7]

4. Chronic neck pain (2026, 9 trials, 401 people)

   Promising but limited

   Reduced pain and improved function; no serious adverse events; limited by methodological problems in several trials [8]

5. Musculoskeletal and sports conditions

   Limited

   Evidence for low back or neck pain was low to moderate and very low to low for other conditions; adverse events very low [9]

6. Myofascial pain (dry cupping)

   Insufficient evidence

   Only two dry cupping studies; evidence not greater than placebo [10]

Cupping cannot be blinded well, and people feel the cups, so expectation can shape pain ratings. Sham-controlled results matter most here. More is on Cupping Therapy Evidence by Use. For other conditions, such as skin problems, digestion or "detox", we did not find reviews strong enough to summarize. Proper evidence not found.

Who should take extra care

Cupping may worsen eczema or psoriasis, so check with a clinician first. [1] Talk to your provider first if you are pregnant, take blood thinners, have a bleeding or skin condition, or are treating a child. We did not find a source we could read describing cupping safety for those groups, so we make no claim beyond asking first. Do not use cupping instead of assessment for new, severe or worsening pain, and do not use TCM to replace or delay conventional care. [12]

Qualifications

Rules vary by country and state, and some places do not license cupping separately. In the US, NCCIH notes most states regulate acupuncture practice. [12] See TCM Qualifications, Licensing and Medical Care. Related: Gua Sha, Tui Na and Cupping, Gua Sha and Tui Na Compared.