Cupping therapy

{{Short description|Pseudoscience whereby suction is applied to the skin}} {{Infobox alternative intervention | image = Cupping set, London, England Wellcome L0057395.jpg | caption = Cupping and bloodletting set, from London, dating from 1860–1875 | pronunciation = | classification =  | school = | risks = | legality = | MeshID = | other codes = |}} {{Alternative medicine sidebar |fringe}} {{infobox chinese | s = {{linktext|拔罐|}} | t = {{linktext|拔罐|}} | p = bá guàn | w = pa2 kuan4 | bpmf = ㄅㄚˊㄍㄨㄢˋ | y = baht gun | j = bat6 gun3 |phfs=Phat-kon | altname = Min name | c2 = 摑風 / 吊杯 | tl2 = kok-hong / tiàu-pue | poj2 = kok-hong / tiàu-poe | wuu = baq8 kuoe5 (bʌʔ12 kuø34) | qn = Giác hơi | chuhan = 覺有 | romaji = Shisho Gokyō | hangul = 부항 | hanja = 附缸 | rr = buhang }}

'''Cupping therapy''' (or '''cup massage''') is a pseudoscientific treatment method in which a local suction is created on the skin by using heated cups. As an alternative medicine practice, it is primarily used in Asia, but it is also used in Eastern Europe, the Middle East, and Latin America.<ref name="Vashi2018"/><ref name="Lilly2012">{{cite journal |last1=Lilly |first1=E |last2=Kundu |first2=RV |title=Dermatoses secondary to Asian cultural practices |journal=International Journal of Dermatology |date=April 2012 |volume=51 |issue=4 |pages=372–379 |doi=10.1111/j.1365-4632.2011.05170.x |pmid=22435423|s2cid=32407869 }}</ref> There is no conclusive evidence supporting the claimed health benefits of cupping,<ref name=":0">{{Cite journal |last1=Mohamed |first1=Ayman A. |last2=Zhang |first2=Xueyan |last3=Jan |first3=Yih-Kuen |date=2023-01-01 |title=Evidence-based and adverse-effects analyses of cupping therapy in musculoskeletal and sports rehabilitation: A systematic and evidence-based review |url=https://content.iospress.com/articles/journal-of-back-and-musculoskeletal-rehabilitation/bmr210242 |journal=Journal of Back and Musculoskeletal Rehabilitation |language=en |volume=36 |issue=1 |pages=3–19 |doi=10.3233/BMR-210242 |pmid=35848010 |issn=1053-8127}}</ref><ref name=":1">{{Cite web |last=MD |first=Robert H. Shmerling |date=2016-09-30 |title=What exactly is cupping? |url=https://www.health.harvard.edu/blog/what-exactly-is-cupping-2016093010402 |access-date=2025-01-02 |website=Harvard Health |language=en}}</ref> and critics have characterized the practice as quackery.<ref name="Crislip">{{cite web |url=https://www.sciencebasedmedicine.org/acupuncture-odds-and-ends/ |title=Acupuncture Odds and Ends |last1=Crislip |first1=Mark |author-link=Mark Crislip |date=24 December 2014 |website=Science-Based Medicine|access-date=8 August 2016}}</ref><ref name=quack/>

Cupping practitioners attempt to use cupping therapy for a wide array of medical conditions including fevers, chronic low back pain, poor appetite, indigestion, high blood pressure, acne, atopic dermatitis, psoriasis, anemia, stroke rehabilitation, nasal congestion, infertility, and menstrual period cramping.<ref name="Vashi2018"/><ref name="Lilly2012"/>

Despite the numerous ailments for which practitioners claim cupping therapy is useful, there is insufficient evidence demonstrating any health benefits. Cupping is generally not harmful for most people.<ref name=":1" /><ref name=":2">{{Cite web |title=What Is Cupping? Does It Work? |url=https://www.cedars-sinai.org/blog/cupping-therapy.html |access-date=2025-01-02 |website=Cedars-Sinai |language=en-US}}</ref><ref name=":4">{{Cite web |date=2022-11-03 |title=Cupping Therapy: The Pros, Cons and How It Works {{!}} Banner |url=https://www.bannerhealth.com/healthcareblog/teach-me/does-cupping-therapy-really-work |access-date=2025-01-02 |website=www.bannerhealth.com |language=en-US}}</ref> However, there are some risks of harm, especially from wet cupping and fire cupping.<ref name="Vashi2018" /> Bruising and skin discoloration are among the adverse effects of cupping and are sometimes mistaken for child abuse.<ref name="Lilly2012" /> In rare instances, the presence of these marks on children has led to legal action against parents who had their children receive cupping therapy.<ref name="Lilly2012" />

==History== thumb|right|An illustration from the medical textbook ''Exercitationes practicae'', published in 1694, shows a man undergoing cupping on his buttocks.|245x245px The origin of cupping is unclear. Iranian traditional medicine uses wet-cupping practices, with the belief that cupping with scarification may eliminate scar tissue, and cupping without scarification would cleanse the body through the organs.<ref>{{cite journal|author1=Nimrouzi M|author2=Mahbodi A|author3=Jaladat AM|author4=Sadeghfard A|author5=Zarshenas MM|year=2014|title=''Hijama'' in traditional Persian medicine: risks and benefits.|journal=J Evid Based Complementary Altern Med|volume=19|issue=2|pages=128–136|doi=10.1177/2156587214524578|pmid=24647093|s2cid=7387100}}</ref>

In ancient Greece, Hippocrates ({{Circa|460|370 BC}}) used cupping for internal disease and structural problems, and Roman surgeons used it for bloodletting.<ref>{{Cite book |last=Chirali |first=Ilkay Z. |url=https://books.google.com/books?id=guDTBQAAQBAJ&dq=Cupping+vessels+ancient+rome&pg=PA18 |title=Traditional Chinese Medicine Cupping Therapy - E-Book |date=2014-06-27 |publisher=Elsevier Health Sciences |isbn=978-0-7020-5834-9 |page=18 |language=en}}</ref><ref>{{Cite book |last=Baker |first=Patricia A. |url=https://books.google.com/books?id=eZfqAAAAQBAJ&dq=Cupping+vessels+ancient+rome&pg=PA74 |title=The Archaeology of Medicine in the Greco-Roman World |date=2013-09-30 |publisher=Cambridge University Press |isbn=978-1-107-29213-0 |page=74 |language=en}}</ref> The method was highly recommended by Islamic Prophet Muhammad<ref name="indeed22"/> and hence well-practiced by Muslim scientists who elaborated and developed the method further. Consequently, this method in its multiple forms spread into medicine throughout Asian and European civilizations. In China, the earliest use of cupping that is recorded is from the Taoist alchemist and herbalist Ge Hong (281–341 AD).<ref name=":022">{{Cite web|url=http://www.itmonline.org/arts/cupping.htm|title=Cupping|last=Dharmananda|first=Subhuti|website=itmonline.org|publisher=Institute for Traditional Medicine|access-date=2016-08-10|archive-url=https://web.archive.org/web/20230306022614/https://www.itmonline.org/arts/cupping.htm|archive-date=2023-03-06}}</ref> Cupping was also mentioned in Maimonides' book on health and was used within the Eastern European Jewish community.<ref>{{cite web|url=http://www.tabletmag.com/scroll/210759/everything-you-ever-wanted-to-know-about-cupping-and-some-stuff-you-probably-didnt|title=Everything You Ever Wanted to Know About Cupping – and Some Stuff You Probably Didn't|last=Ingall|first=Marjorie|date=2016-08-11|publisher=Tablet Magazine|access-date=2016-08-14}}</ref> William Osler recommended its use for pneumonia and acute myelitis in the early twentieth century.<ref name="Lilly2012"/>

The practice has been used in hospitals in China since the 1950s as a traditional Chinese medicine modality.<ref name="Cao2012">{{cite journal |last1=Cao |first1=H |last2=Li |first2=X |last3=Liu |first3=J |title=An updated review of the efficacy of cupping therapy. |journal=PLOS ONE |date=2012 |volume=7 |issue=2 |article-number=e31793 |doi=10.1371/journal.pone.0031793 |pmid=22389674 |pmc=3289625 |bibcode=2012PLoSO...731793C |doi-access=free }}</ref>

== Scientific evaluation == The American Cancer Society notes that "available scientific evidence does not support claims that cupping has any health benefits" and also that the treatment carries a small risk of burns.<ref name="acs2">{{cite book|title=American Cancer Society Complete Guide to Complementary and Alternative Cancer Therapies|publisher=American Cancer Society|year=2009|isbn=978-0-944235-71-3|editor1=Russell J|edition=2nd|pages=[https://archive.org/details/americancancerso0000unse/page/189 189–191]|chapter=Cupping|editor2=Rovere A|chapter-url=https://archive.org/details/americancancerso0000unse/page/189}}</ref> A review of literature in 2011 determined that "the effectiveness of cupping is currently not well-documented for most conditions", and that systematic reviews showing efficacy for the treatment of pain "were based mostly on poor quality primary studies."<ref>{{cite journal|last1=Lee|first1=MS|last2=Kim|first2=JI|last3=Ernst|first3=E|date=March 2011|title=Is cupping an effective treatment? An overview of systematic reviews|journal=Journal of Acupuncture and Meridian Studies|volume=4|issue=1|pages=1–4|doi=10.1016/s2005-2901(11)60001-0|pmid=21440874|doi-access=free}}</ref> This was further supported by a review in 2014 which demonstrated that previous evidence supporting cupping has resulted from "unreasonable design and poor research quality".<ref>{{cite journal|last1=Chen|first1=B|last2=Li|first2=MY|last3=Liu|first3=PD|last4=Guo|first4=Y|last5=Chen|first5=ZL|date=July 2015|title=Alternative medicine: an update on cupping therapy.|journal=QJM: Monthly Journal of the Association of Physicians|volume=108|issue=7|pages=523–525|doi=10.1093/qjmed/hcu227|pmid=25399022|doi-access=free}}</ref> Subsequent systematic reviews have also identified poor research quality, inconsistent approaches to study blinding, and varying methodologies among studies.<ref name="Wood et al. 2020">{{cite journal|title=Dry cupping for musculoskeletal pain and range of motion: A systematic review and meta-analysis|first1=Sarah|last1=Wood|first2=Gary|last2=Fryer|first3=Liana Lei Fon|last3=Tan|first4=Caroline|last4=Cleary|journal=J Bodyw Mov Ther|date=October 2020|volume=24|issue=4|pages=503–18|pmid=33218554|doi=10.1016/j.jbmt.2020.06.024|s2cid=225353128 }}</ref><ref name="ccm">{{Cite journal |last1=Moura |first1=Caroline de Castro |last2=Chaves |first2=Érika de Cássia Lopes |last3=Cardoso |first3=Ana Carolina Lima Ramos |last4=Nogueira |first4=Denismar Alves |last5=Corrêa |first5=Hérica Pinheiro |last6=Chianca |first6=Tânia Couto Machado |date=2018-11-14 |title=Cupping therapy and chronic back pain: systematic review and meta-analysis |journal=Revista Latino-Americana de Enfermagem |volume=26 |article-number=e3094 |doi=10.1590/1518-8345.2888.3094 |issn=1518-8345 |pmc=6248735 |pmid=30462793}}</ref>

There is a lack of evidence to support the use of cupping therapy for acne.<ref name="CaoYang2015">{{cite journal | vauthors = Cao H, Yang G, Wang Y, Liu JP, Smith CA, Luo H, Liu Y | title = Complementary therapies for acne vulgaris | journal = The Cochrane Database of Systematic Reviews | volume = 1 | article-number = CD009436 | date = January 2015 | issue = 1 | pmid = 25597924 | pmc = 4486007 | doi = 10.1002/14651858.CD009436.pub2 | type = Systematic Review & Meta-Analysis }}</ref> Additionally, cupping is often practiced along with other acupuncture therapies<ref name="Lilly2012"/><ref name="Kim, J. I. 2011">Kim, J. I., Lee, M. S., Lee, D. H., Boddy, K., & Ernst, E. (2011). Cupping for treating pain: a systematic review. Evidence-Based Complementary and Alternative Medicine, 2011.</ref> and therefore cannot exclusively account for resultant positive benefits. Many reviews suggest there is insufficient scientific evidence to support the use of cupping techniques to combat relevant diseases and chronic pain.<ref name="Cao2012"/> Cupping has been characterized as quackery.<ref name=quack>{{cite web |title=Quackery and Mumbo-Jumbo in the U.S. Military |first=Harriet |last=Hall |date=21 August 2012 |url=https://slate.com/technology/2012/08/quack-medicine-in-the-military-acupuncture-cupping-and-moxibustion-are-endangering-troops.html?via=gdpr-consent |publisher=Slate}}</ref>

The lack of apparent benefits of cupping treatments are discussed by Simon Singh and Edzard Ernst in their 2008 book ''Trick or Treatment''.<ref>{{cite book|url=http://simonsingh.net/books/trick-or-treatment/|title=Trick or Treatment|last1=Singh|first1=Simon|last2=Ernst|first2=Edzard|publisher=Transworld Publishers|year=2008|isbn=978-0-552-15762-9|page=368|author-link1=Simon Singh|author-link2=Edzard Ernst}}</ref>

As a pseudoscientific detoxification ritual, proponents of cupping falsely claim that it can remove unspecified toxins from the body.<ref name="fashionably-toxic">{{cite web |last1=Gorski |first1=David |title=Fashionably toxic |url=https://sciencebasedmedicine.org/fashionable-toxins/ |website=Science-Based Medicine |date=23 May 2011 |access-date=12 May 2020}}</ref><ref>{{cite web |last1=Colquhoun |first1=David |title=Cupping: bruises for the gullible, and other myths in sport |url=http://www.dcscience.net/2016/08/10/cupping-bruises-for-the-gullible-and-other-myths-in-sport/ |website=DC's Improbable Science |access-date=12 May 2020 |date=10 August 2016}}</ref> Proponents also falsely claim that cupping "improves blood flow" to help sore muscles.<ref name="salzberg-forbes-cupping">{{cite news |last1=Salzberg |first1=Steven |title=The Ridiculous And Possibly Harmful Practice Of Cupping |url=https://www.forbes.com/sites/stevensalzberg/2019/05/13/the-ridiculous-and-possibly-harmful-practice-of-cupping/ |access-date=12 May 2020 |work=Forbes |date=13 May 2019 |language=en}}</ref> James Hamblin notes that a bruise caused by cupping "is a blood clot, though, and clotted blood is definitionally not flowing."<ref name="hamblin-cupping">{{cite news |last1=Hamblin |first1=James |title=Please, Michael Phelps, Stop Cupping |url=https://www.theatlantic.com/health/archive/2016/08/phelps-cupsanity/495026/ |access-date=12 May 2020 |work=The Atlantic |date=9 August 2016}}</ref>

Critics of alternative medicine have spoken out against cupping therapy. Harriet Hall and Mark Crislip have characterized cupping as "pseudoscience nonsense", "a celebrity fad", and "gibberish", and observed that there is no evidence that cupping works any better than a placebo.<ref name="Crislip" /><ref name="Harriet2">{{cite web|url=https://www.sciencebasedmedicine.org/therapy-or-injury-your-tax-dollars-at-work/|title=Therapy or Injury? Your Tax Dollars at Work|last1=Hall|first1=Harriet|author-link=Harriet A. Hall|website=Science-Based Medicine|date=31 July 2012|access-date=8 August 2016}}</ref> Pharmacologist David Colquhoun writes that cupping is "laughable... and utterly implausible."<ref name=dc>{{cite web|url=https://www.independent.ie/sport/rio-2016-olympics/revealed-why-some-olympic-athletes-have-those-little-red-marks-on-them-34947356.html|title=Revealed – Why some Olympic athletes have those little red marks on them |date=8 August 2016|website=Irish Independent}}</ref> Practicing surgeon David Gorski observes that "it's all risk for no benefit. It has no place in modern medicine, or at least shouldn't."<ref name="Gorski2">{{cite web|url=http://scienceblogs.com/insolence/2016/07/01/whats-the-harm-cupping-edition/|title=What's the harm? Cupping edition|last1=Gorski|first1=David|author-link=David Gorski|date=July 1, 2016|website=Respectful Insolence|publisher=Science-Based Medicine|access-date=8 August 2016}}</ref>

==Safety== Cupping is generally considered safe for most people when performed by trained practitioners; however, it may not be suitable for everyone.<ref name=":0" /><ref name=":1" /><ref name=":2" /><ref name=":4" />

In 2016, the Cambodian Ministry of Health warned that cupping could be a health risk and particularly dangerous for people with high blood pressure or heart problems.<ref>{{Cite web |first=Sopheng |last=Cheang|date=2016-08-10 |title=Cupping and coining: I did it long before Phelps |url=https://apnews.com/4038fb0c8c9a47f1a930f4cdc3d90b37 |access-date=2023-08-19 |website=AP News |language=en |quote=The Cambodian Health Ministry does not advocate cupping, and warns that it could be a health risk. Health Ministry spokesman Ly Sovann told me that the practice is not known to cure any illnesses, and in fact, can be dangerous for people with high blood pressure or heart problems. Still, the practice is not banned in the country because it is almost a way of life for Cambodians, he said.}}</ref> According to the NCCIH "Cupping can cause side effects such as persistent skin discoloration, scars, burns, and infections, and may worsen eczema or psoriasis".<ref name="nccih">{{cite web |date=8 November 2018 |url=https://www.nccih.nih.gov/health/cupping |title=Cupping |publisher=NCCIH}}</ref>

Cupping causes breaks in the capillaries (small blood vessels) in the papillary dermis layer of the skin, resulting in the appearance of petechiae and purpura.<ref name="Vashi2018"/> These marks are sometimes mistaken for signs of child abuse when cupping is performed on children.<ref name="Vashi2018"/>

Cupping therapy adverse events can be divided into local and systemic adverse events. The local adverse events may include scar formation, burns, linear bruising or streaks (wet cupping), skin ulcers, undesired darkening of the skin, panniculitis, erythema ab igne, induction of the Koebner phenomenon in susceptible individuals with psoriasis, and pain at the cupping site.<ref name="Vashi2018">{{cite journal |last1=Vashi |first1=NA |last2=Patzelt |first2=N |last3=Wirya |first3=S |last4=Maymone |first4=MBC |last5=Zancanaro |first5=P |last6=Kundu |first6=RV |title=Dermatoses caused by cultural practices: Therapeutic cultural practices. |journal=Journal of the American Academy of Dermatology |date=July 2018 |volume=79 |issue=1 |pages=1–16 |doi=10.1016/j.jaad.2017.06.159 |pmid=29908818|s2cid=49268995 }}</ref><ref name="Lilly2012"/> A theoretical risk of infection exists but there are no reports of this as of 2012.<ref name="Lilly2012"/>

There are also issues with a lack of safety in cup massages as there is still a need to establish proper application protocols.<ref name="ccm"/>

== Claimed uses == Cupping practitioners use cupping therapy for a wide array of medical conditions including fevers, pain, poor appetite, indigestion, high blood pressure, acne, atopic dermatitis, psoriasis, anemia, stroke rehabilitation, nasal congestion, infertility, and dysmenorrhea.<ref name="Vashi2018"/>

There is low to moderate evidence that cupping can reduce pain associated with musculoskeletal pain and myofascial pain syndrome,<ref name="Wood et al. 2020"/><ref>{{cite journal|title=Evidence-based and adverse-effects analyses of cupping therapy in musculoskeletal and sports rehabilitation: A systematic and evidence-based review|first1=Ayman A.|last1=Mohamed|first2=Xueyan|last2=Zhang|first3=Yih-Kuen|last3=Jan|journal=J Back Musculoskelet Rehabil|date=2023|volume=36|issue=1|pages=3–19|pmid=35848010|doi=10.3233/BMR-210242|s2cid=250511730 |doi-access=free}}</ref><ref name=Charles>{{cite journal|title=A systematic review of manual therapy techniques, dry cupping and dry needling in the reduction of myofascial pain and myofascial trigger points|first1=Derek|last1=Charles|first2=Trey|last2=Hudgins|first3=Josh|last3=MacNaughton|first4=Eric|last4=Newman|first5=Joanne|last5=Tan|first6=Michael|last6=Wigger|journal=J Bodyw Mov Ther|date=July 2019|volume=23|issue=3|pages=539–46|pmid=31563367|doi=10.1016/j.jbmt.2019.04.001|s2cid=132721136 }}</ref> although the benefits may be indistinguishable from those of a placebo.<ref name=Charles/>

== Claimed mechanism of action == Proponents claim cupping has a therapeutic effect and removes unspecified "toxins", stagnant blood, or "vital energy" when used over acupuncture points with the goal of improving blood circulation.<ref name="Vashi2018" /><ref name="Lilly2012" />

== Methods == Modern suction devices are sometimes used instead of the traditional cups.<ref name="Lilly2012" />

A cup massage is performed with medical cups, which have vacuum-sucking, thermochemical, and reflectory impact on the skin, hypoderm, muscles and nerves.{{citation needed|date=April 2015}}

A cup massage lasts 10 to 20 minutes and is accompanied with the feeling of warmth. It can be slightly uncomfortable to the patient.{{citation needed|date=April 2015}}

A cup massage can be performed on almost all areas of human body. Most often cup massage is used to massage back, chest, limbs, and even face.<ref>{{Cite news|url=http://timesofindia.indiatimes.com/life-style/beauty/Vacuum-your-face-for-a-glowing-skin/articleshow/24819204.cms|title=Vacuum your face for a glowing skin - Times of India|website=The Times of India|date=28 November 2013}}</ref>

While details vary between practitioners, societies, and cultures, the practice consists of drawing tissue into a cup placed on the targeted area by creating a partial vacuum – either by the heating and subsequent cooling of the air in the cup or via a mechanical pump.<ref>{{cite web|title=What is cupping therapy|url=http://www.webmd.com/balance/guide/cupping-therapy|website=WebMD|access-date=15 August 2016}}</ref> The cup is usually left in place for somewhere between five and fifteen minutes.

Cupping therapy types can be classified using four distinct methods of categorization. The first categorization system relates to "technical types" including dry, wet, massage, and flash cupping therapy. The second categorization relates to "the power of suction-related types" including light, medium, and strong cupping therapy. The third categorization relates to "the method of suction-related types" including fire, manual suction, and electrical suction cupping therapy. The fourth categorization relates to "materials inside cups" including herbal products, water, ozone, moxa, needle, and magnetic cupping therapy.<ref>{{Cite book|title=Cupping Therapy Encyclopedia|last=Shaban|first=Tamer|publisher=CreateSpace|year=2013|isbn=978-1-4947-8051-7|page=29}}</ref>

Further categories of cupping were developed later. The fifth relates to areas treated including facial, abdominal, female, male, and orthopedic cupping therapy. The sixth relates to "other cupping types" that include sports and aquatic cupping.{{citation needed|date=June 2021}} {{Gallery |title=Cups of various materials |width=160 | height=170 |align=center |footer= |File:Cupping_glasses._Wellcome_L0007482.jpg |alt1= |Glass |File:Rsz 20150730173451 22585.jpg |alt2= |Plastic |File:Fire cupping in Haikou - 01.JPG |alt3= |Bamboo |File:Indian cupping horns of horn and copper Wellcome M0020070.jpg |alt4= |Horn/copper |File:Bronze_Roman_cupping_vessel,_1-79_CE_Wellcome_L0058046.jpg |alt5= |Bronze }}

===Dry cupping=== Dry cupping involves the application of a heated cup on the skin of the back, chest, abdomen, or buttocks.<ref name="Vashi2018"/> The cooling of the air is then thought to create a suction effect. Bamboo and other materials are sometimes used as alternatives to glass cups.<ref name="Vashi2018"/>

=== Fire cupping === thumb|A person receiving fire cupping Fire cupping involves soaking a cotton ball in almost pure alcohol. The cotton is clamped by a pair of forceps and lit via match or lighter, and, in one motion, placed into the cup and quickly removed, while the cup is placed on the skin. The fire heats the air in the cup which, after cooling reduces in volume creating a negative pressure inside the cup. The cup is then quickly placed onto the body and the negative pressure "sucks" the skin up. Massage oil may be applied to create a better seal as well as allow the cups to glide over muscle groups (e.g. trapezius, erectors, latissimus dorsi, etc.) in an act called "gliding cupping" or "sliding cupping". Dark circles may appear where the cups were placed because of capillary rupture under the skin. There are documented cases of burns caused by fire cupping.<ref>{{cite journal|last1=Iblher|first1=N.|last2=Stark|first2=B.|year=2007|title=Cupping treatment and associated burn risk: a plastic surgeon's perspective|journal=J Burn Care Res|volume=28|issue=2|pages=355–358|doi=10.1097/BCR.0B013E318031A267|pmid=17351459}}</ref><ref>{{cite journal|last1=Sagi|first1=A.|last2=Ben-Meir|first2=P.|last3=Bibi|first3=C.|date=Aug 1988|title=Burn hazard from cupping--an ancient universal medication still in practice|journal=Burns Incl Therm Inj|volume=14|issue=4|pages=323–325|doi=10.1016/0305-4179(88)90075-7|pmid=3224303}}</ref>

=== Wet cupping === Wet cupping, also known as ''hijama'' ({{langx|ar|حجامة|4=sucking}}) or medicinal bleeding, is where blood is drawn by local suction from a small skin incision.<ref>{{cite journal |last=Albinali |first=Hajar |date=June 2004 |title=Traditional Medicine Among Gulf Arabs Part II – Blood Letting |url=http://www.heartviews.org/text.asp?2004/5/2/74/64567 |journal=Heart Views |volume=5 |issue=2 |pages=74–85 |archive-url=https://web.archive.org/web/20070911211305/http://www.hmc.org.qa/heartviews/VOL5NO2/special_section.htm |archive-date=11 September 2007 |url-status=live}}</ref>

The first reported usages are found in the Islamic hadith, sayings attributed to or describing the actions of the Islamic prophet Muhammad.<ref name="RippinKnappert1986">{{cite book|last1=Rippin|first1=Andrew|last2=Knappert|first2=Jan|title=Textual Sources for the Study of Islam|url=https://books.google.com/books?id=m8xRAQAAIAAJ&pg=PA78|year=1986|publisher=Manchester University Press|isbn=978-0-7190-1884-8|page=78}}</ref><ref name="indeed22">{{cite book|title=Healing with the Medicine of the Prophet|author1=Qayyim Al-Jauziyah|date=2003|publisher=Darussalam |isbn=978-9960-892-91-7|editor1-last=Abdullah|editor1-first=Abdul Rahman (formerly Raymond J. Manderola)|quote=Indeed, the best of remedies you have is ''hijama'', and if there was something excellent to be used as a remedy then it is ''hijama''.}}</ref> Hadith from Muhammad al-Bukhari, Muslim ibn al-Hajjaj Nishapuri and Ahmad ibn Hanbal support its recommendation and use by Muhammad.<ref>{{Hadith-usc|usc=yes|abudawud|11|2097}}, {{Hadith-usc|abudawud|28|3848}}, {{Hadith-usc|usc=yes|muslim|26|5467}}, {{Hadith-usc|muslim|10|3830}}, {{Hadith-usc|bukhari|usc=yes|7|71|584}}, {{Hadith-usc|usc=no|bukhari|7|71|602}}</ref> As a result, wet cupping has remained a popular remedy practiced in many parts of the Muslim world.<ref>{{cite journal |last=El-Wakil |first=Ahmed |date=9 December 2011 |title=Observations of the popularity and religious significance of blood-cupping (''al-ḥijāma'') as an Islamic medicine |journal=Contemporary Islamic Studies |publisher=Hamad bin Khalifa University Press |volume=2 |doi=10.5339/cis.2011.2}}</ref>

In Finland, wet cupping has been done since the 15th century, and it is done traditionally in saunas. The cups were made of cattle horns with a valve mechanism inside to create a partial vacuum by sucking the air out.<ref>{{cite journal |last=Kaups |first=Matti |year=1976 |title=A Finish Savusauna in Minnesota |url=http://collections.mnhs.org/MNHistoryMagazine/articles/45/v45i01p011-020.pdf |journal=Minnesota History |publisher=Minnesota Historical Society |issue=Spring |pages=11–20 |access-date=2018-09-19 |archive-date=2016-07-05 |archive-url=https://web.archive.org/web/20160705072918/http://collections.mnhs.org/MNHistoryMagazine/articles/45/v45i01p011-020.pdf }}</ref> Cupping is still practiced in Finland as part of relaxing and/or health regimens.<ref>{{Cite web|last=Burns|first=Monique|date=30 January 2012 |title=Finland's Magnificent Obsession|url=https://travelsquire.com/finlands-magnificent-obsession/|access-date=12 June 2023 |website=Travel Squire|quote=...a cupping session – a recently revived, if archaic procedure, during which a therapist uses a cupping hatchet to make small cuts in your back and places glass cups fitted with bulb syringes over the cuts to draw out 'bad blood' and release 'feel-good' endorphins. Cupping is considered perfectly safe and aficionados say the procedure energizes them, but it's definitely not for germophobes or the squeamish.}}</ref>

The points used in wet and dry cupping are varied and intended to correspond to areas of pain and blockage. Over the years treatment plans have been created but, due to their holistic nature, the points used may vary depending on the individual.<ref>{{Cite web|last=Points|first=Hijama|date=11 July 2023 |title=Hijama Points by Ailment|url=https://hijamapoints.com/hijama-points-by-issue-links/|access-date=11 July 2023 |website=Hijama Points}}</ref><ref name="Clinical Manual of Hijama Therapy">{{cite book|last1=Osman-Latib|first1=Feroz|title=Clinical Manual of Hijama Therapy|url=https://books.google.com/books?id=o9anxgEACAAJ|year=2019|publisher=EDI Publishers|isbn=978-0-9911455-6-0}}</ref>

<gallery> File:Hijama therapy1.jpg|A person receiving wet cupping File:Drawn_blood.jpg|Blood drawn by wet cupping </gallery>

===Traditional Chinese medicine=== [[File:Fire cupping in Haikou - 02.JPG|thumb|Woman receiving fire cupping at a roadside business in Haikou, Hainan, China]] In Chinese, cupping is known as "pulling-up jars" ({{zh|c=拔罐|p=báguàn}}). According to traditional Chinese medicine (TCM), cupping is done to dispel stagnation (stagnant blood and lymph), thereby improving ''qi'' flow,<ref name="china" /> to treat respiratory diseases such as the common cold, pneumonia and bronchitis. Cupping is used on the back, neck, shoulder, and other musculoskeletal conditions. Its advocates claim it has other applications as well.<ref name="china">State Administration of Traditional Chinese Medicine and Pharmacy, ''Advanced Textbook on Traditional Chinese Medicine and Pharmacology,'' Volume IV, 1997 New World Press, Beijing</ref> Cupping is not advised, in TCM, over skin ulcers or to the abdominal or sacral regions of pregnant women.<ref> ''Chinese Acupuncture and Moxibustion'' (Revised Edition), Xingnong, Foreign Languages Press, Beijing, China, 1987, p. 370.</ref>

==Society and culture== Cupping has gained publicity in modern times due to its use by American sport celebrities including National Football League player DeMarcus Ware, National Basketball Association star Shaquille O'Neal, Olympians Alex Naddour, Natalie Coughlin, and Michael Phelps and tennis player Ben Shelton.<ref name="Chinese Cupping in Olympics">{{cite web |url=http://well.blogs.nytimes.com/2016/08/08/what-are-the-purple-dots-on-michael-phelps-cupping-has-an-olympic-moment/?_r=0 |title=What Are the Purple Dots on Michael Phelps? Cupping Has an Olympic Moment |date=August 8, 2016 |last1=Reynolds |first1=Gretchen |last2=Crouse |first2=Karen |website=Well |publisher=The New York Times |access-date=8 August 2016}}</ref><ref>Wise, Mike (April 23, 2000) [https://archive.nytimes.com/www.nytimes.com/library/sports/basketball/042300bkn-shaquille.html "L.A. Story: Shaq is the Talk of the Town"] ''The New York Times''</ref><ref>Philogene, Haniyah (September 8, 2023) [https://thegrio.com/2023/09/08/curious-about-ben-sheltons-bruises-in-the-us-open-heres-how-athletes-use-alternative-medicine/ "Curious about Ben Shelton's bruises in the US Open? Here's how athletes use alternative medicine"] ''The Grio''</ref> Medical doctor Brad McKay wrote that Team USA was doing a great disservice to their fans who might "follow their lead", calling cupping an "ancient (but useless) traditional therapy."<ref name="McKay">{{cite news|last1=McKay|first1=Brad|author-link=Brad McKay (doctor)|title=Why Team USA's use of cupping therapy really sucks|newspaper=News.com.au|url=http://www.news.com.au/lifestyle/health/why-team-usas-use-of-cupping-therapy-really-sucks/news-story/39e6da472eba56e564139cc17e38ee5b|date=August 9, 2016|access-date=9 August 2016}}</ref> Steven Novella noted "It is unfortunate that elite athletics, including the Olympics, is such a hotbed for pseudoscience."<ref>{{cite web |url=https://sciencebasedmedicine.org/cupping-olympic-pseudoscience/ |title=Cupping – Olympic Pseudoscience |date=August 10, 2016 |last=Novella |first=Steven |website=Science Based Medicine}}</ref>

There is a description of cupping in George Orwell's essay "How the Poor Die", where he was surprised to find the antiquated practice applied to another patient in a Paris hospital.<ref name="orwellHowPoor">{{cite journal|last1=Orwell|first1=George|title=How the Poor Die|journal=Now|date=November 1946|url=http://gutenberg.net.au/ebooks03/0300011h.html#part39|access-date=10 August 2016|quote=As I lay down I saw on a bed nearly opposite me a small, round-shouldered, sandy-haired man sitting half naked while a doctor and a student performed some strange operation on him. First, the doctor produced from his black bag a dozen small glasses like wine glasses, then the student burned a match inside each glass to exhaust the air, then the glass was popped onto the man's back or chest and the vacuum drew up a huge yellow blister. Only after some moments did I realize what they were doing to him. It was something called cupping, a treatment that you can read about in old medical textbooks but which till then I had vaguely thought of as one of those things they do to horses.}}</ref> In the 1964 Hollywood film ''Zorba the Greek'', cupping is depicted with the character Zorba, played by Anthony Quinn, performing it on the character played by Lila Kedrova.{{reference needed|date=December 2021}}

The perceived benefits of cupping have often been perpetuated by celebrities and athletes who use these therapeutic interventions in their daily lives. Professional swimmer Michael Phelps received publicity during the 2016 Olympics for the purple bruises evident on his back resulting from cupping. He has been known to "do it before every meet he goes to to "speed up recovery".<ref>{{cite news |last1=Reynolds |first1=Gretchen |last2=Crouse |first2=Karen |title=What Are the Purple Dots on Michael Phelps? Cupping Has an Olympic Moment |url=https://well.blogs.nytimes.com/2016/08/08/what-are-the-purple-dots-on-michael-phelps-cupping-has-an-olympic-moment/ |access-date=22 March 2020 |agency=New York Times |work=The New York Times |date=8 August 2016}}</ref> Celebrity endorsements such as these may bias individuals to feel benefits from the practice.

== References == {{Reflist}}

==External links== * {{Skeptoid | id=4359 | number= 359| title= Cupping for the Cure| date= April 23, 2013| access-date=}}

{{Pseudoscience|state=autocollapse}} {{Traditional Medicine}} {{Traditional Chinese medicine}} {{Islamic medicine}} {{Unproven and disproven cancer treatments}} {{Authority control}} {{DEFAULTSORT:Cupping Therapy}}

Category:Acupuncture Category:Alternative cancer treatments Category:Alternative detoxification Category:Health fraud Category:Medicine in the medieval Islamic world Category:Obsolete medical theories Category:Iranian traditional medicine Category:Pseudoscience Category:Traditional Chinese medicine