Cupping – More Than Just a Fad for Olympians

In recent years, there has been a strong uptick in interest surrounding the use of cupping therapy. This has been in large part to the rise of visibility of the cupping application from the characteristic circular “bruises” on many celebrities and high-profile athletes. With so many high-level athletes supporting the use of this intervention, more and more people are wondering if it can help them. More than that, patients are wondering: “can this help me?”

Cupping has been around for centuries and dates back to many ancient eastern medicinal approaches. These approaches often used more intense methods such as fire cupping or wet cupping (making small incisions in the skin before glass cups were put on and then “removing the toxins” using the cup). While these practices are still in use today, dry cupping is far more commonly used in Western medicinal approaches. Dry cupping uses plastic or silicone cups to create a negative pressure vacuum around tissues – essentially it finds tight tissue areas and “lifts” the tissue to create more room.

With cupping being so popular amongst athletes (thanks Michael Phelps) people are left wondering – can this enhance my physical performance? While it’s highly unlikely that regular application of cupping therapy is going to make you the next G.O.A.T. of Olympic swimming, it can actually have a very positive effect on short term pain relief. This makes it even more useful for the average American. A decrease in pain like this can often be accompanied by functional improvement gains and improved range of motion, at least in the short term.

Cupping can have a very positive effect on short term pain relief.

There is limited research proving the absolute effectiveness of cupping, but that has not been a barrier in patients asking their therapists if this specific intervention would be helpful for them. Seeing as how cupping has been practiced as far back as ancient Egypt, someone must have found some benefit in it. As the world of physical therapy has moved to “instrument assisted” soft tissue mobilization (so that your therapists’ hands don’t wear out by the time we’re 40) cupping has been a favorite of many therapists.

What does the research say?

While completing my final year of my doctorate in physical therapy, I worked with a group of fellow students to complete an analysis of cupping research to determine how cupping could be used in physical therapy and what it would be most effective for. We were able to find 7 studies with a high level of evidence that strongly demonstrated that cupping can have a positive effect on managing pain well over a 6 week period (it may be helpful for longer periods as well, but we only found one 12 week study). As our medical field has become more and more prescription drug based, this is a huge game changer!

After having cupping applied, patients in all 7 of the studies we reviewed rated their pain as being much lower! Some specific patient populations that were followed were patients with knee pain and neck pain. Patients in these studies not only reported that their pain was lower, but also that they felt that their function improved. This means that, at least in the short term, cupping therapy can be a useful technique to lower your pain and get you moving better! Cupping may be just one of the ways that our therapists at Paradigm can get you back and moving again!

References

1. Abolahrari-Shirazi, Sara et al. Is Cupping Therapy in Combination with Routine Physical Therapy Effective in the Management of Knee Osteoarthritis? A Randomized Controlled Trial. Journal of Rehabilitation Sciences and Research. 2018;05(04):93-98. doi:10.30476/JRSR.2018.44678. PMID: Not found.
2. AlKhadhrawi N, Alshami A. Effects of myofascial trigger point dry cupping on pain and function in patients with plantar heel pain: A randomized controlled trial. Journal of Bodywork & Movement Therapies. 2019;23(3):532-538. http://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=s3h&AN=138815886&site=eds-live. Accessed June 9, 2020. PMID:  31563366
3. Chi L-M, Lin L-M, Chen C-L, Wang S-F, Lai H-L, Peng T-C. The Effectiveness of Cupping Therapy on Relieving Chronic Neck and Shoulder Pain: A Randomized Controlled Trial. Evidence-based Complementary & Alternative Medicine (eCAM). 2016;2016:1-7. doi:10.1155/2016/7358918. PMID:  27073404
4. Covell J, Leah S, et al. What is the impact of dry cupping therapy on pain reporting? A Systematic Review; ACSM 2020 Presentation
5. Kim JI, Lee MS, Lee DH, Boddy K, Ernst E. Cupping for treating pain: a systematic review. Evid Based Complement Alternat Med. 2011;2011:467014. doi:10.1093/ecam/nep035 PMID: 19423657
6. Nasb M, Qun X, Ruckmal Withanage C, Lingfeng X, Hong C. Dry Cupping, Ischemic Compression, or Their Combination for the Treatment of Trigger Points: A Pilot Randomized Trial. J Altern Complement Med. 2020;26(1):44‐ doi:10.1089/acm.2019.0231 PMID:  31580695
7. Teut M, Ullmann A, Ortiz M, et al. Pulsatile dry cupping in chronic low back pain – a randomized three-armed controlled clinical trial. BMC complementary and alternative medicine. 2018;18(1):115. doi:10.1186/s12906-018-2187-8. PMID:  29609566
8. Teut M, Kaiser S, Ortiz M, et al. Pulsatile dry cupping in patients with osteoarthritis of the knee – a randomized controlled exploratory trial. BMC complementary and alternative medicine. 2012;12:184. doi:10.1186/1472-6882-12-184. PMID:  23057611
9. Tompkins DA, Hobelmann JG, Compton P. Providing chronic pain management in the “Fifth Vital Sign” Era: Historical and treatment perspectives on a modern-day medical dilemma. Drug Alcohol Depend. 2017;173 Suppl 1(Suppl 1):S11‐ doi:10.1016/j.drugalcdep.2016.12.002 PMID: 28363315
10. Williams JG, Gard HI, Gregory JM, Gibson A, Austin J. The Effects of Cupping on Hamstring Flexibility in College Soccer Players. Journal of Sport Rehabilitation. 2019;28(4):350-353. http://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=s3h&AN=136448478&site=eds-live. PMID:  29364033