Cupping Therapy

An Essential Guide to Cupping

Therapy, How it Works, and Its
Benefits
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Table of Contents
Introduction
Chapter 1: Preparing for a Session
Chapter 2: What to Expect from a Dry Session
Chapter 3: Ventosa—Moving or Rubbing Cupping
Chapter 4: Cupping and Acupuncture
Chapter 5: Cupping and Moxibustion
Chapter 6: Cupping and Gua Sha
Chapter 7: Cupping and Tuī Ná
Chapter 8: Wet Cupping
Chapter 9: A Brief Word About Chinese Medicine
Conclusion

Introduction

Cupping is a medical practice where cups are placed on parts of the body to
create a suction effect which raises the skin and draws the blood to the
surface. It is used throughout Asia, the Middle East, and Europe to treat pain,
swelling, inflammation, migraine, rheumatism, bronchitis, and the common
cold. Recent studies suggest that it could also be a promising form of
treatment for a host of other ailments, as well.

The earliest known use of this technique is found in the Ebers Papyrus from
Egypt, which is about 5,000 years old. In China, it is mentioned in medical
treatises that go back some 3,000 years. Hippocrates, the Greek doctor who
composed the Hippocratic Oath, mentions it in 400 BC. The prophet
Mohammad recommended the practice in the Koran 1400 years ago, while in
Finland, they’ve been doing it since the 15 th century.

Though little known here in America, this form of treatment is still popular
throughout Asia, the Middle East, and Finland. As such, it is called by many
names including ba gwan, giac hoi, bekam, buhang, and bentusa in
Southeast Asia. In the Middle East, it is commonly referred to as hijama ,
hejamat , and badkesh , among many others.

The procedure involves using glass or ceramic cups, metal bells, bamboo
tubes, animal horn, and a wide host of other items. Recently, however, the
use of glass jars, plastic, and silicone are becoming more popular.

Cotton is soaked in alcohol or medicated oil and ignited. This is then put
inside the container to heat it, lowering its internal pressure. The cup is
immediately placed on the skin, and as the air inside cools, it creates a
vacuum effect which makes it stick to the skin.

Blood immediately rushes to the area, creating a painless bruise which

actually feels good. Those who have gone through the procedure claim it
feels like a massage in reverse. Instead of pressure bearing down against the
skin, it feels like the skin is being pushed outward, instead.

Depending on how the bruising occurs, its coloration, and how long it lasts,
practitioners can tell where problems are located and can prescribe different
treatments accordingly. These can range anywhere from massage,
acupuncture, dietary recommendations, drug prescriptions, even to bleeding.

There are two types of cupping: wet and dry. The former involves bleeding
and tends to be used more throughout Finland and the Middle East. With the
exception of wet cupping, the process is generally painless and even feels
relaxing.

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Chapter 1: Preparing for a Session

While cupping is available in America, it qualifies as a form of alternative

treatment. As such, you should be wary of some of the health claims that fans
and practitioners say about it.

Some believe it can cure various forms of cancer, citing incredible medical
testimonies from China, Southeast Asia, and the Middle East. As of 2014,
the American Cancer Society insists that such reports are largely anecdotal
and not the result of credible research findings which would pass sufficient
medical scrutiny.

Cancer aside, in 1990, a peer-reviewed clinical study reported that cupping

was found to be effective in treating anterior knee pain and improving range
of motion. A 2012 study found that in tandem with other treatments, it was
also effective in treating some cases of acne, cervical spondylosis, facial
paralysis, and herpes zoster. Please note, however, that the operative words
here are “some cases of” and “in tandem with other treatments.”

Even practitioners generally admit that cupping’s ability to heal is extremely

limited. If you do have a medical condition you need treated, it’s best to
consult with your general practitioner first. You’re also better off using tried
and tested medical techniques as your primary source of treatment. It is
important to understand that this book only explains cupping. It neither
encourages it nor prescribes it as a viable form of therapy.

While not supporting claims that it can heal diseases, the American Medical
Association considers dry cupping to be a generally safe and harmless
practice. As such, a number of massage centers and spas can safely and
legally offer it as a form of relaxation—even without going through the years
of training that serious practitioners undergo.

In many Southeast Asian countries, cupping is offered on the sidewalks to

passersby who need a quick, cheap, and effective way of easing headaches,
neck and back pain, as well as joint and muscle stiffness. In Europe, cupping
has even evolved into a form of vacuum massage. Instead of burning alcohol,
a mechanical vacuum pump is placed on the skin and rubbed all over the
body to provide exactly the type of reverse massage described in the
introduction.

So the process is generally safe and it rarely hurts. If you do suffer from pain
in the knees and joints, as well as some of the other conditions listed earlier,
it could work for you. Some doctors suggest that those suffering from
hemophilia should avoid this treatment, but in 2001, some British researchers
found that it can help hemophiliacs in some cases (maybe because the entire
Royal Family are hemophiliacs).

Once again, please consult with your GP first.

Chapter 2: What to Expect from a Dry Session

This is the most common type and is relatively painless unless you suffer
from skin allergies, rashes, or overly sensitive skin. If you do have a dry
cupping session with experts, it is usually offered as part of a larger series of
treatments and is rarely used as a stand-alone form of therapy.

The procedure is usually done to your back, neck, and shoulders, but rarely
on the limbs. In Chinese medicine, they take care to avoid cupping on skin
ulcers or on the sacral regions of women who are pregnant.

Prior to a treatment, you may be asked to brush your teeth while taking care
to avoid scraping your tongue. This is because traditional Chinese medicine
uses body temperature, skin tone, heartbeat, and the appearance of your
tongue as a means of assessing your state of health.

You may then be asked to remove your shirt (and if you’re a woman, your
bra) and made to lie on your stomach. The doctor will then burn a bit of
cotton and stick it into a glass ball with an open lip on one end. This open
end will be stuck to your skin, causing an immediate suction.

The burning cotton will not be kept inside the ball, so you shouldn’t worry
about getting burned. The cup will only be heated briefly, so the most you’ll
feel is a warm, round, glass being stuck on you.

You will feel the suction immediately as your flesh rises into the lip.
Depending on your condition, you can expect anywhere from one to as many
as ten (or more) cups getting stuck to your neck, shoulders, and back. The
longer the cups are kept on, the tighter the suction becomes. Most find it
pleasurable and relaxing. Hopefully, so will you.

Bony areas, like your shoulders and neck, will get smaller cups to intensify
the suction and keep them on. Fleshier areas like your back will get bigger
cups so they can suck in more of your skin. Silicone is used more and more
for better suction on bonier sections.

Blood will then rush to the surface of your skin, causing a painless bruise,
and your pores will open up. Your doctor will be watching carefully,
because the extent of the coloration and other changes to the affected skin
area will form part of his/her diagnosis.

According to traditional Chinese medicine, the blood will also flow better to
areas that have been starved of oxygen. Chi, a power inherent in your body,
will also focus on the spot to promote healing and recharge that weakened
part.

Your doctor will then remove the cup after three to five minutes. Removal is
also painless, after which you’ll look like you’ve been attacked by an
octopus. The darker the bruising, the more your doctor will focus upon it. A
normal bruise should be a vibrant reddish or reddish orange.

It usually takes three to four days for it to leave completely, though in some
cases, it can take as long as a week. This is an important thing you must take
into consideration in case you’re expecting to join a bathing suit contest
shortly after.

If you do feel pain, you must let your doctor know right away, though this is
extremely rare. In lieu of glass, some clinics prefer to use plastic or
hypoallergenic silicone cups. It should be noted, however, that these other
materials do not in any way mitigate the amount of bruising that results.

The area will not be tender or sore, despite the ugly coloration left behind.
Normal bruising is usually caused because the area has been hit hard enough.
Since no hitting is involved, it will actually look a lot worse than it feels.

A massage or acupuncture treatment may follow if you go to a traditional

Chinese clinic. In cities throughout Southeast Asia where cuppers ply their
trade on the streets, cupping is about all you’ll get out of the session, though
some may insist on giving you a backrub if they feel you need it.

Some feel a mild tingling on their skin after the cups are removed. This can
last anywhere from several minutes to a couple of hours, which is normal,
depending on the situation.

In cases where you’re suffering from stiff joints or aching muscles, you may
be asked to come in for several sessions. If so, they’ll usually ask you to
come back after the bruising is gone. At most, you may get two sessions in a
week. Three sessions a week is not recommended, so if you get an offer for
one, you’re not in a traditional Chinese clinic. Most likely, you’ve wandered
into a spa.

Since Chinese medicine believes that ill-health is the result of many factors
including the accumulation of toxins in your body, you’ll be asked to drink
plenty of water after each cupping session. The general recommendation is
about eight 8 oz glasses of water everyday throughout the course of your
treatment.

Since dry cupping is usually part of a much more holistic series of

treatments, an entire session can last anywhere between 15 minutes to an
hour. Depending on your symptoms, your treatment can involve certain
exercises, the drinking of certain teas, and even lifestyle changes like cutting
down on alcohol or giving up smoking.

Other forms of treatment may also follow, which will be covered in the next
chapters.
Chapter 3: Ventosa — Moving or Rubbing
Cupping

In this version, medicated oil is rubbed on the skin. Once the cups are placed
on the skin, the therapist will wait several minutes to maximize the suction
effect. The cups will then be moved over the body, pulling up other parts of
your flesh. Since the cups will inevitably pop off, they have to be heated
repeatedly and replaced on the skin. After several minutes, the cups are
removed and a deep tissue massage usually follows.

A modern technique involves a vacuum device placed on oiled skin. The

therapist or masseur/masseuse then moves the nozzle over the shoulders,
neck, and back to provide a massage. Some move the pump quickly enough to
prevent the deep bruising that occurs with the traditional method. Though
relaxing, this is less about treatment and more about the simple pleasure of a
new massage technique.

Ventosa, using this new vacuum technology, can now also be used on the
face. The use of oils and creams together with silicone pumps mitigates the
bruising, and in some cases, gets rid of bruises which result from injuries.
This new application of ventosa has also been found promising in the
treatment of acne and facial tics.

Research is showing that ventosa with this vacuum may also be effective at
finding deep tissue and muscular problems, again by observing the bruising
which occurs without having to resort to surgery. Mitigating minor scars and
stretch marks are other areas which seem promising as of this writing.

Others simply prefer using this new technology because, in the hands of a
trained professional, they avoid the relatively long-term bruising which can
result from cupping. Although some centers which offer this method claim it
can also break down cellulite, no comprehensive research has yet been done
on the matter as of 2015. MediCupping is a company which provides this
technology, if you’re interested.

Whether your cupping session involves ventosa or not, you should see to it
that the cups are not kept on the same spot for more than 5 minutes. Prolonged
cupping, or having a session more than twice a week, can cause capillary
expansion, fluid accumulation in tissues, and even the rupture of blood
vessels. Skin inflammation and the more painful Indian rope burn on the skin
can also result if done excessively.

If done by a certified professional, you will never be left alone while those
cups are stuck to you. If you do find yourself in a clinic where the doctor or
attendant keeps leaving you to take care of other stuff, you may want to go
elsewhere. Remember, one of their jobs is to observe how your skin reacts to
the suction process.
Chapter 4: Cupping and Acupuncture

If you hate needles, stick to the masseurs, because cupping and needles are
virtually synonymous in traditional Chinese medicine. It wasn’t always so,
however. According to the historical texts, cupping once stood on its own
and was prescribed for chronic pulmonary diseases as it still is today.

By the time of the Tang Dynasty (AD 618–907), however, acupuncture was
used to lend greater “oomph” to cupping. They would cup the patient first,
then place needles on the acupuncture points, or acupoints, and finally place
heated bamboo tubes over the needles to make the acupuncture work faster
and deeper.

This is not practiced today, however. If you go to a traditional Chinese clinic,

you’ll first be assessed, and if they recommend cupping, they’ll also
recommend acupuncture, but not at the same time. The acupuncture session
will take place after you get cupped. Since the affected area will still be
bruised and tingling, the needles hurt a lot less as they go in, for some reason.

To give the needles greater penetrating power without having to push them in
deeper, there’s moxibustion (to be discussed later) and electricity. With the
latter, the needles are attached to electrodes which deliver an electrical
charge through the needles and deep into your flesh.

And yes, it hurts.

As to whether acupuncture works or not is best left up to the experts who

can’t seem to form a consensus on the practice. Just know that if you do have
a cupping session in a traditional Chinese clinic, it will almost always be
followed up by an acupuncture session.
Chapter 5: Cupping and Moxibustion

The Chinese word for moxibustion is jiǔ and involves heat and mugwort, as
well as needles, sometimes. If you dry mugwort, age it properly, then pound
it into a mold and set one end on fire, it’ll burn very slowly to the other end
like a cigar.

The mold is tubular and wrapped in coils of paper so that as it burns, the
paper slowly flakes off like cigarette ash. Since the dried mugwort is
concentrated in the middle, what’s left is a sharpened point that can focus the
heat while producing a medicinal smoke and scent (like incense, only less
fragrant).

Depending on the symptoms and treatment, as well as the bruising that results
after dry cupping, moxibustion is sometimes called for. There are three ways
this is applied.

Direct scarring is done by making a small cone of dried mugwort and

placing it directly on the skin. The tip is lit then blown out, allowing it to
burn like incense and singe the skin till it blisters. In such cases, this is
usually done after cupping (but not always) to mitigate the pain.

Direct non-scarring is the same as above, except that they remove the
burning mugwort before it singes your skin.

Indirect moxibustion involves using that tubular mold like a cigar and
placing its tip near various acupoints in lieu of needles. An alternative
method involves puncturing your skin with acupuncture needles, then placing
cones of dried mugwort atop those needles and setting them alight then
blowing them out. The incense-like mugwort heats the needles, carrying that
heat deep into your skin while avoiding a direct burn. A modern alternative
involves electrifying those needles instead of burning mugwort.

Moxibustion is used to treat stroke, constipation, hypertension, sore muscles,

cramps, and menstrual pain. Studies in Japan suggest that it might even
prevent breech presentation, which is when babies come out feet first instead
of head first. Such studies remain in contention, however.

The smell of burning mugwort also stimulates blood circulation to the pelvic
area and uterus, so it’s a typical remedy for women who suffer from
menstrual cramps and fertility problems. Moxibustion is also used to treat
chronic fatigue, lethargy, and mental dullness.

If getting your skin burned is not your thing, watch out for words like jiǔ and
jiǔshù (the formal term for this practice). And if you hear moxibustion being
muttered by your doctor, you definitely know what’s in store for you. If
you’re allergic to smoke or have respiratory problems, ask your therapist to
use the modern smokeless version.
Chapter 6: Cupping and Gua Sha

Sometimes, cupping is also done in tandem with gua sha , which literally
means scraping. This involves oiling the skin then scraping it with a coin,
ceramic spoon, or a scraper made of rhino horn (which is extremely smooth
and silky, yet hard) or jade.

This is used to treat fever, exhaustion, sore muscles, and even cellulite.
Whatever they use, the skin is scraped along meridian points, which is where
the acupoints lie.

In cases of flab, patients lie on their backs while doctors scrape the tummy
and/or thighs toward the groin. It’s believed this loosens and moves the
subcutaneous fat toward the excretory organs for later release.

This treatment causes soreness after a few minutes, and leaves bright red
scratch marks on the skin, which fade after 2 to 4 days. Often, the scratches
fade long before the bruises from cupping do.

In the 1960s and 1970s, many American doctors wrongly accused Chinese
and Vietnamese immigrant parents of child abuse when they discovered these
scrapes and cupping bruises on children. Many now understand that this is
part of traditional folk remedies, but it’s still disturbing to see if you’re not
used to it.

Gua sha has not yet been medically proven to be an effective form of
treatment. Done properly, however, and with sterilized equipment, it can be
relaxing except when it comes to treating fat.
In cases of extreme muscle fatigue, such as from hard work or a session at the
gym, the scraper is regularly dipped into a solution of ginger root soaked in
rice wine or vinegar. It is then used to scrape a person’s body from their
head, along their spine, and down to their feet.

Odd though this treatment may sound, many swear by it (including the
author).
Chapter 7: Cupping and Tuī Ná

Tuī means “to push,” while ná means “to grasp / lift / squeeze.” It’s a form of
massage that’s usually done after a cupping session, or after a cupping
session but before acupuncture.

Some prefer to call it acupressure, since it’s a form of massage that focuses
on the acupoints. Unlike Swedish massage which involves rubbing (and some
form of oil or cream to make it possible), tuī ná focuses on specific points
and areas, and rarely makes use of ointments.

Chinese medicine is based on the idea of balance, of symmetry, and of energy

streams (known as chi) which flow unobstructed through the body along set
paths called meridians. When there is imbalance in the body, then the chi gets
blocked, causing illness in areas where the chi can’t get to. Tuī ná therefore
seeks to reopen the blocked passages so that chi can flow through it without
problems, restoring harmony throughout the body.

Sometimes, a cupping bruise on the right shoulder (for example) comes out a
very dark, almost black color, while the bruise on the left shoulder comes out
a healthy, vibrant red. This tells the practitioner that there is an imbalance in
the right shoulder or on the right side of the body which needs balancing or
unblocking.

Both sides of the body will still be massaged equally to ensure that the chi
flows smoothly all over the body. Focusing on only one area could result in
an imbalance, further bringing the entire system out of whack.
It is believed that the human body contains eight defensive gates which are
located in the area between each joint. When chi is blocked or has difficulty
flowing to an area, it not only results in physical illnesses, it can also lead to
emotional problems, such as depression, anger, being overly sexed, etc.

A tuī ná session is therefore not just about making you feel good, improving
your range of motion, as well as getting rid of muscle cramps and stiff joints.
It is also about ensuring emotional well-being and improved health by
allowing the chi to flow better throughout your body.

It is also believed, however, that a massage is not enough. The acupoints also
need to be addressed directly, which is where acupuncture comes in.
Chapter 8: Wet Cupping

This is not used in traditional Chinese medicine, but is popular throughout the
Muslim world because the prophet Mohammad recommended it highly in the
hadiths (which are interpretations of the Koran). In Sahih al-Bukhari 5371 ,
for example, he said that, “Indeed the best of remedies you have is hijama .”

According to the prophet, wet cupping (hijama) is a blessing, a cure or

preventative to maintain health and improve memory. It is even said to
protect people from black magic, among many others (bearing in mind, of
course, that attributing the effect of the magic to anything other than Allah
renders one a disbeliever). As such, it isn’t always easy to separate fact from
fiction, especially under circumstances where an author’s belief can
sometimes act as a placebo thus rendering his accounts of success
unscientific.

Some studies show it to be effective in treating some problems such as

migraines, nonspecific lower back pain, and post-herpetic neuralgia. As to
its other acclaimed health benefits, on the other hand, those remain in
contention. Nevertheless, there are clinics throughout Europe and the
Americas which do provide wet cupping services under sterile medical
conditions, if you’re interested.

Although it requires bleeding, it should be understood that hijama is not the

same as bloodletting. Bloodletting requires the opening of veins by cutting
them with a scalpel, puncturing them with a needle, or by using a leech
applied to the skin. Hijama extracts blood with tiny incisions to the skin’s
surface after cupping.

In the UK, the clinics that provide this service make use of sterile plastic
cups which are disposed of after each use. The patient’s back is first
sterilized with alcohol, after which oil is rubbed on the shoulders, as well as
the upper and lower back.

The cups are then placed on the skin, after which the air is sucked out from
the top with a manual hand pump. The skin is allowed to rise and redden, and
after a few minutes, the cups are removed.

Using a surgical scalpel, several tiny incisions are made on the bruised area
so that the blood wells up in tiny beads. The cups are then replaced and the
practitioner pumps the air out once more, which forces yet more blood to
come up. After several minutes, the cups are removed and the blood is wiped
away, after which the area is again treated with alcohol.

This is the modern, clinical version, however. If you’re interested, you can
get in touch with the British Cupping Society for more information.

Since this is a very traditional form of medicine, other practitioners are less
clinical and sterile, so this is something you need to watch out for. Because
this practice is also deeply associated with religious beliefs, from less
scientific records, it is hard to say just how effective it really is, and how
much has to do with credulous minds.

That said, there are many who swear by it and undergo regular sessions of
hajima. Because the needles or scalpels used are very sharp, it really doesn’t
hurt too much—more like quick, sharp stings. If done by an expert, no
permanent scarring or marks are left behind. Some even believe that regular
doses of hijama can get rid of old scars, including mild stretch marks, as
well as skin discolorations.

Do note, however, that if the area to be wet cupped is hairy, it will be shaved
to ensure maximum suction. If you have a hairy back when you go in, you’ll
leave smooth.

Tradition dictates that hajima be done on an empty stomach, so those

undergoing the session are advised to avoid food and drink a full 2 to 3 hours
before. You are also advised to avoid strenuous activity for a full 24 hours
after. This includes running, swimming, bicycling, and lifting heavy objects.
Avoiding a bath a full 24 hours after a session is also recommended to avoid
causing the puncture marks to re-open.

Finland also practices wet cupping, which they call kuppaus . To avail of it,
you have to make your way to a sauna, which is a national obsession. The
belief is that the heat of a sauna stimulates better blood flow, making it ideal
for wet cupping. For Finns, regular sessions are necessary to get rid of bad
blood, release toxins, maintain health and vigor, and avoid more serious
illnesses.

After getting baked in steam, you lie face down on a bed. To further stimulate
blood circulation, you are gently beaten with a bundle of birch branches
called a vasta . Your back and legs are then washed, after which they place
cups on areas where you feel some aches. If you feel no aches, they’ll place
them all over anyway.

After a few minutes, they remove the cups and whack the raised spots with a
small hammer spiked with pins. Others resort to scalpels. Once the bleeding
begins, the cups are returned to draw out more blood. When the bleeding
stops, the body and legs are washed and a traditional cream of spruce sap is
applied to sterilize the skin. An entire session, from sitting in the sauna to the
wet cupping, can take anywhere from 30 minutes to an hour.

In hijama , practitioners take special care to avoid letting their patients see
their own blood. With the exception of posh resorts which boast such
treatments, kuppaus sessions are generally quite messy. Some practitioners
even make it a point to show patients examples of bad blood, such as thick
coagulated clots.

If you want to try wet cupping but are squeamish, therefore, stick to hijama .
Chapter 9: A Brief Word about Chinese Medicine

Since traditional Chinese medicine functions on a completely different model

than that used by modern medicine, it’s only inevitable that certain
misunderstandings arise when comparing the two. The same applies when
both systems look at the same problem.

Perhaps one of the greatest areas of contention lies in the field of cancer
treatments. Barring unscrupulous businesses, misguided professionals, and
gullible patients, traditional Chinese medicine has a different understanding
of cancer than modern medicine does.

In the former, cancer is not just a disease. It is also a symptom of something

else. Sometimes, that something else is an emotional problem, in others it has
to do with a digestive imbalance. In treating what it considers to be the root
cause, traditional practitioners sometimes claim to have treated the
underlying causes of cancer, even though the cancer itself is still present in
the patient.

Such claims, therefore, sometimes get taken out of hand or misunderstood

outright. Partly, this has to do with the language barrier. Culturally, it also has
to do with the fact that traditional doctors try to spare their patients from
emotional pain, believing such will only exacerbate the problem.

When the last Japanese Emperor Hirohito died, for example, he wasn’t told
about his condition, which raised an outcry outside Japan. This puzzled not
just the Japanese, but the Chinese, as well. Although modern medical doctors
treated the former emperor, they were still Japanese and therefore thought in
terms of the old paradigm set by traditional Chinese medicine.
In America, such a practice would be considered deceitful, immoral,
outrageous, and deserving of a law suit. It must be understood, however, that
we’re dealing here with a completely alien psychology, one that plays by a
completely different set of rules and values than what we’re used to.

At the risk of sounding repetitive, you should therefore consult your GP first
before making the final decision about an alternative medical approach.

Conclusion

Cupping, both wet and dry, is an ancient technique still practiced today by
millions. Recently, some American and European celebrities have even taken
it up, increasing its popularity further.

Dry cupping raises few eyebrows, in addition to the ugly bruises it leaves
behind, that is. However, there have been no reports of any complications
arising from cupping sessions. As such, it’s generally safe, if done properly.
There are even home kits that you can buy so you can do it on your own. If
you remember the five minute rule and do it no more than twice a week, you
should be good to go.

As to wet cupping… well, you’re on your own there. Under the right
conditions, it can be perfectly safe and can’t possibly be worse than some of
the other alternative treatments available.

Just be careful, keep an open mind, and once again—consult your GP.

Finally, I’d like to thank you for downloading this ebook! If you found it
helpful, I’d greatly appreciate it if you’d take a moment to leave a review on
Amazon. Thank you!

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