Benefits of Cupping Therapy
By Dr (TCM) Attilio D'Alberto | Traditional Chinese Medicine Practitioner, Wokingham, Berkshire
Cupping therapy is one of the oldest physical therapies in traditional medicine, with documented use spanning more than two thousand years across Chinese, Middle Eastern, and Egyptian healing traditions. It involves placing cups — traditionally made of bamboo or glass, now more commonly silicone or plastic — on the skin and creating a vacuum that lifts the tissue beneath. The resulting suction increases local blood flow, releases fascial adhesions, and promotes the movement of qi and blood through the area being treated. In the modern era, cupping has gained significant mainstream attention after high-profile Olympic athletes including Michael Phelps were visibly treated with it — but the evidence base goes far beyond anecdote.
On this page
- How cupping therapy works
- Types of cupping
- Pain relief
- Respiratory conditions
- Muscle recovery and sports performance
- Other applications
- What to expect
- Frequently asked questions
How cupping therapy works
The suction created by cupping draws blood into the capillaries beneath the skin, stretches the fascia and connective tissue, and stimulates the nervous system in ways that reduce pain and promote relaxation. The characteristic circular marks left by cupping are not bruises — they are extravasations of blood from the capillaries into the superficial tissues, which resolve naturally within a few days. Modern research has identified multiple mechanisms: increased local microcirculation, release of tissue nitric oxide, modulation of inflammatory cytokines, activation of the endogenous opioid system, and mechanical release of myofascial trigger points. In TCM terms, the colour of the marks provides diagnostic information — darker marks indicate more significant blood stasis, while lighter or absent marks suggest the area is relatively clear.
Types of cupping
Several distinct cupping techniques are used in clinical practice, each suited to different conditions:
- Dry cupping — the most common form in my practice. Cups are placed on the skin and a vacuum created either by heat (fire cupping) or a manual suction pump. Cups remain in place for 5–15 minutes.
- Sliding (gliding) cupping — oil is applied to the skin and cups are moved across the body, producing a massage-like effect over larger areas
- Flash cupping — cups are applied and immediately removed, repeated rapidly across an area, producing a gentler stimulating effect
- Wet cupping (bleeding cupping, hijama) — small incisions are made and cups drawn over them to release a small amount of blood. Used in some traditions but not part of my UK practice.
- Needle cupping — an acupuncture needle is left in place and a cup applied over it, combining both therapies
- Moxibustion cupping — moxa is burned inside the cup for warming effect, particularly for cold patterns
Pain relief
Pain relief is the most widely researched benefit of cupping. A systematic review and meta-analysis of 21 randomised controlled trials found that cupping therapy significantly reduced pain compared to no treatment, sham cupping, and conventional care for conditions including chronic low back pain, neck pain, shoulder pain, tension-type headaches, and carpal tunnel syndrome. The proposed mechanisms include increased local blood flow bringing oxygen and clearing inflammatory metabolites, release of myofascial trigger points, and central modulation of pain processing. For chronic pain that hasn't responded fully to acupuncture alone, adding cupping typically produces meaningful additional benefit.
Respiratory conditions
Cupping has a long clinical tradition for respiratory complaints — particularly persistent coughs, bronchitis, and asthma. Applied to the upper back over the Lung shu points (BL 13) and adjacent paraspinal muscles, it is thought to promote the descending and dispersing functions of the Lung, loosen phlegm, and relieve chest tightness. Research has demonstrated improvements in peak expiratory flow and symptom scores in patients with chronic bronchitis and stable asthma. I use it regularly for patients with persistent coughs, chest congestion, and Lung qi deficiency patterns, alongside relevant Chinese herbal medicine.
Muscle recovery and sports performance
Athletes — including many high-profile Olympic competitors — have adopted cupping as part of their recovery protocols, and the research supports this application. Studies have demonstrated that cupping reduces delayed onset muscle soreness (DOMS), improves range of motion, and accelerates recovery from sports injuries by promoting local circulation and reducing inflammatory metabolite accumulation in the muscles. For chronic overuse injuries — tennis elbow, plantar fasciitis, iliotibial band syndrome — cupping combined with acupuncture often produces faster recovery than either alone.
Other applications
Digestive health
Cupping over the abdomen is used in TCM to stimulate digestive function, relieve bloating, and address patterns of Spleen qi deficiency and dampness in the middle burner. It is a useful adjunct for patients with IBS or sluggish digestion.
Menstrual pain and gynaecological conditions
Light cupping over the sacrum and lower back can help with period pain, particularly where there is cold in the uterus or blood stasis. It is avoided over the lower abdomen during menstruation and in pregnancy.
Stress and relaxation
Many patients find cupping deeply relaxing. The combination of warmth, sustained pressure, and the release of tension from the back muscles produces a parasympathetic response similar to a firm massage — useful for chronic stress and anxiety-related muscle tension.
Skin conditions
Some TCM traditions use gentle cupping for eczema, acne, and certain skin conditions thought to involve damp-heat accumulation. Evidence here is weaker than for musculoskeletal applications.
What to expect
Cupping is usually performed as part of a broader acupuncture treatment session in my clinic. Cups may be left static for 5–10 minutes, or moved across oiled skin (sliding cupping) for a broader massage-like effect. The sensation is one of pressure and warmth rather than pain — most patients find it pleasant once they get used to it. The circular marks that follow are painless and typically fade within 3–7 days, sometimes longer if the area has significant underlying stagnation. The marks are not a sign of injury but a therapeutic by-product. Many patients note an immediate sense of release and increased mobility after treatment.
Contraindications: Cupping is not suitable over broken skin, inflamed areas, areas of significant bruising, or directly over varicose veins. It is avoided during pregnancy over the abdomen and lower back. It is used with caution in patients on anticoagulants and those with bleeding disorders. Always discuss any medical conditions or medications with your practitioner before treatment.
Frequently asked questions
Does cupping therapy hurt?
No — cupping should not hurt. The sensation is one of pulling or tight pressure as the skin is drawn up into the cup, which most people find quite pleasant and releasing. If a cup is painful, the suction is too strong and should be adjusted.
What are the marks cupping leaves?
The circular marks are extravasations of blood from the capillaries into the superficial tissues — not bruises, as bruises are caused by impact. The darker the mark, the more stagnation was present in that area. Marks are painless and typically fade within 3–7 days.
How long do cupping marks last?
Usually 3–7 days for most people, though very dark marks in areas of significant stagnation can take up to two weeks to fade completely. The marks become progressively lighter with successive treatments as the underlying stagnation clears.
Is cupping the same as acupuncture?
No — cupping and acupuncture are distinct but complementary therapies within traditional Chinese medicine. Acupuncture uses fine needles to stimulate specific points; cupping uses suction over larger areas. The two are often combined in the same session for broader effect.
How many cupping sessions do I need?
For acute musculoskeletal conditions, 2–4 sessions are often sufficient. For chronic pain, 6–8 sessions are typical. Cupping is usually used as part of a broader treatment plan including acupuncture and, where appropriate, Chinese herbal medicine rather than as a standalone therapy.
Can I have cupping during pregnancy?
Cupping during pregnancy should only be performed by a practitioner experienced in pregnancy treatment. It is avoided over the abdomen and lower back throughout pregnancy, and over the sacrum until the third trimester. Light cupping over the upper back for neck and shoulder tension is generally safe.
Is cupping covered by health insurance?
If acupuncture is covered by your policy and cupping is provided as part of an acupuncture session, it is typically included. Standalone cupping treatment is rarely covered separately. Check with your insurer — see my page on private health insurance for details of insurers I'm registered with.
To discuss cupping therapy or book a treatment, get in touch or book a consultation at my Wokingham, Berkshire clinic.
