Cupping is a form of therapy widely used in traditional Chinese medicine (TCM). It consists of creating a local suction on the skin using either heat (fire) or mechanical devices (hand or electrical pumps). It is believed this method draws out toxins, mobilizes blood flow, soothes muscle pain and, in some cases, helps cure insomnia.

At the Rio Olympic Games, American swimmer Michael Phelps caught everybody’s attention not only for his remarkable achievements but also for some dark purple circles on his shoulders and back. They were the result of having undergone the cupping technique to relax his muscles before entering the races.

The Ebers Papyrus, written sometime around 1550 B.C., considered one of the oldest medical textbooks in the Western world, describes how the Egyptians used cupping to help cure some frequent medical issues and how it was also used by Saharan peoples. Hippocrates, the famous Greek physician, used this technique around 400 B.C. to treat internal disease and some structural problems.

Ge Hong (281-341 A.D.), a minor southern official during the Jin Dynasty, was responsible for its first known use in China. He was interested in alchemy, herbalism and techniques of longevity. Ge popularized the saying, “Acupuncture and cupping, more than half of the ills cured.” Later on, this method found its way throughout Asia and Europe. In 1465, Serefeddin Sabuncuoglu, a Turkish surgeon, recommended this technique, which he called “mihceme.” In Japan, cupping (kyukaku) is still used, together with some acupuncture and massage techniques.

In the dry cupping procedure, practitioners place specialized cups on the skin. They then use either heat or an air pump to create suction between the cup and the skin. As a result, a vacuum is created on the patient’s skin to dispel stagnant blood and lymph. It is used on the back, shoulders and other muscles such as those on the back of the neck. Skin markings are common after the cups are removed, the result of the rupture of capillaries located under the skin.

Athletes who use this technique claim it is highly effective. They include U.S. gymnast Alex Naddour and Belarusian swimmer Pavel Sankovich., who said that cupping is a great recovery tool. American actresses Gwyneth Paltrow and Jennifer Aliston, and Canadian pop star Justin Bieber, use it.

In the U.S., the technique was very popular until approximately the middle of the 20th century, and now is only used occasionally among the general population. In an essay titled “How the Poor Die,” the British writer George Orwell describes his surprise when he saw it practiced in a hospital in Paris.

Following the Phelps incident, there has been a significant increase in the sales of cupping equipment, according to Jessica MacLean, acting director of the International Cupping Therapy Association. Phelps himself featured a promotional cupping treatment in a video for a sponsor. New silicone cups alleviate bruising provoked by traditional cupping.

Cupping has been used to treat a wide variety of medical conditions. Among them, blood disorders, rheumatic diseases, gynecological problems and skin disorders such as eczema and acne. Those who receive the treatment also claim improvement in their physical and psychological well-being.

Cupping has also been used by some as an alternative treatment for cancer. Despite the practitioners’ claim for effectiveness, however, the American Cancer Society said recently that “there is no scientific rationale for expecting any health benefit from cupping,” warning that the treatment also carries a small risk of burns.

It is difficult to carry out controlled experiments to test the efficacy of cupping. However, an experiment involving 40 patients suffering from knee arthritis reported less pain after four months of treatment compared with those who hadn’t received the cupping treatment.

The obvious question is, in essence, how effective is this treatment? One can’t deny there could be a placebo effect. This is a beneficial effect, produced by a placebo drug or treatment that cannot be attributed to their properties, and must therefore be due to the patient’s belief in that treatment. Perhaps, as with other alternative treatments, cupping is as good as it makes you feel.

Dr. Cesar Chelala is an international public health consultant.

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