MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

As predicted, thanks to its high visibility in Rio, to the journalists, editors, photographers, numerous ‘experts’ crawling out of the woodwork, and last but not least the gullible public, cupping has fast become fashionable, ‘cool’ and ‘en vogue’.

Yes! Literally ‘en vogue’!

It has conquered the pages of ‘VOGUE’ (and any quackery that achieves this feast must have a bright future!) where Dr. Alex Moroz, director of the Integrative Sports Medicine program at NYU Langone Medical Center’s Rusk Rehabilitation, offers some extraordinary ‘explanations’. Dr Moroz (yes, he does exist; I looked him up) claims that he uses cupping at home on himself and his family. He believes there’s wisdom in the ancient practice, as well as common sense. Cupping’s effect, he says, is “mechanical, much like a massage,” and though Moroz has not treated professional athletes personally, he says, “It makes sense that it would work for that group of muscular skeletal injuries and problems.”

Moroz believes, furthermore, that cupping’s benefits reach far beyond sports. “For people with muscle-based pain, tightness, spasms, or chronic pain of any sort, it’s a great modality to use. Like other short-term modalities, there’s a curve where you have a small number of people who have rather dramatic results, and then you have a group of people who will not be helped at all,” he says. “Everyone else will fall somewhere in between.”

Dr Moroz has opinions but seems to be remarkably short on the ‘common sense’ he praises and a bit under-developed in the area of evidence.

This is regrettable!

Where on earth can we find some reliable information?

Surely, with all the hype about cupping, there must be someone who is just a trifle more science-based. Of course there is. The ‘London Cupping Clinic’ seems serious enough; they even employ real GPs who explain the SCIENCE OF CUPPING’ as follows:

“[Cupping]… involves, as the name suggests, a series of glass or plastic cups being placed on the recipient’s skin. The cups are heated and come into effect upon cooling; the air trapped between the cup and skin contracts, creating a suction-like effect that pulls the skin upwards, drawing blood to the surface to increase blood flow and give the resulting marks their deep crimson-purple colour. At times, vacuum pumps can be used along with the cups to aid the process of suction.”

Drawing blood to the surface to increase blood flow? Really?

In my quest to find some factual information I stumble across the website of HOLISTIC LIVING TIPS. Yes, I know, ‘holistic living’ does not sound like factual information. Yet I read on and find that…

“…along with Irritable Bowel Syndrome, which is closely linked to a stressed digestive tract, cupping has been used for stomach pains, diarrhea, gastritis and other common digestive issues. Flowing the energy to help release tension in and around the digestive tract, while aiding the abdomen with added nutrients and oxygen can help stimulate a healthier digestive tract… The most common skin issues cupping has been used for is acne, skinflammation and even herpes. Your capillaries are expanded by cupping and the addition flow of blood helps tone your skin and clear unwanted toxins from the skin to help get rid of acne. Also, wet cupping, where a small cut is made before the cup is applied can reduce acne better because with the incision the therapy can extract more of the toxins from your body. Cupping has also been used for cellulite and varicose veins. An increased flow of blood throughout the skin will help tone and tighten the skin. Also, cupping stimulates and improves the flow of blood, helping reduce varicose veins…  Mainly, cupping increases the flow of blood and lymphatic fluid throughout the body. Both of these help your body protect itself from illnesses and toxins. Additionally, cupping can help extract and remove phlegm and congestion from your body. The purpose of cupping is to enhance circulation, help relieve pain, remove heat and pull out the toxins that linger in your body’s tissues. It is not something that everyone is aware of, but just like other Chinese Medicine practices, like acupuncture, it can be an effective and most importantly a natural way, to help treat several conditions and help improve your body’s overall health and function.”

Even considering that we are in the realm of alternative medicine, the claims and explanations currently made for cupping seem impressive. With such a solid base in holistic anatomy and New Age physiology, the future of cupping ought to be delightful.

I can see all sorts of profitable options for those who want to jump on the vacuum-driven bandwagon:

  • courses for aspiring cupping therapists [a safe career, as demand is bound to soar]
  • DIY books for amateur cuppers
  • car seats that give you a love bite while you are driving home from work [very practical for the less than faithful alt med fan]
  • vacuum suckers for the dental patient [cupping kills pain and reduces anxiety, they say]
  • similar devices for Indian restaurants who offer it for customers to control the well-known digestive problems after a good Vindaloo chicken [Charles’ Dutchy Originals might already be planning the launch]
  • cupping walk-in centres for every-day emergencies
  • cupping clinics for those who fear the effects of ageing [cupping ‘tightens the skin’, you know]
  • a face mask with integrated vacuum cups for teenagers suffering from acne
  • shoes that produce a sucking action on the sole of the feet as you walk [thus ingeniously combining cupping with reflexology]
  • a 24-hours cupping helpline for the less experienced DIY-cuppers…

There really are no limits (neither to profit nor to fantasy) – the future of cupping is bright!

15 Responses to The future of cupping: it’s bright, profitable and vacuous

  • Lovin’ the ‘What is Evidenced Based Cupping Therapy?‘ page of the British Cupping Society…

  • As an acupuncturist with +25years practice I’m also a little worried with so many new people buying piston pump style suction cups will have no idea how to use them safely and they will provide lots of stories for the skeptics to point to saying we told you cupping was bad very bad. Riding a bicycle has risks too. You can scald yourself taking a too hot bath. But they don’t go posting pictures of road rash or tell people to stop bathing. Cupping is not that complicated. Old fashion cupping does not necessitate bruising. It is more like deep tissue massage inverted. If you do bruise do not repeat over same area till discoloration fade. You skeptics may being my flogging, but I felt important people read this as novices aren’t getting this message delivered to them. Don’t suck your eyeballs out.

    • @Howard Wu

      Medical novices also shouldn’t go sticking fine needles in people without a shred of evidence to support they have any beneficial effect beyond placebo. Don’t be a prick.

      • http://anesthesiology.duke.edu/?p=530

        Duke Med did the research and is still doing the research.

        • Well, here’s a first (in my experience) for provision of ‘evidence’ by supporters of pseudo-medicine. Ana cites a Duke University press release dated 2015, which contains no reference to the publication for the work described. A search of the Web of Science database with the terms author, Gan TJ; address, Duke and title word, acupuncture turns up three hits, one of which is indeed a systematic review of acupuncture for chronic headache… published in 2008.

          But there’s more. The press release contains a link to the author featured that gives a ‘page not found’ error. Has Dr Gan perhaps left Duke University, where Ana assures us the research is still being done? Aha, here we learn that Dr Tan indeed left Duke for SUNY StonyBrook Medicine in 2014.

          So Ana provides us with evidence to convince us that acupuncture is effective in treatment of headache by cherry picking a mere press release, which describes as yet unpublished research by a scientist who left the university the year before.

          Ana, for the benefit of your education, the same database (Web of Science) searched for articles with ‘headache’ and ‘acupuncture’ in the title, produces 140 publications. So the research is not just being done at Duke. A filter for ‘review’ reduces the list to 14 studies, most or all of which are familiar to Prof. Ernst, who has discussed them on this blog. The most recent, by Linde et al., 2016, contains the ‘red light’ words: “Overall, the quality of the evidence assessed using GRADE [Grading of Recommendations Assessment, Development and Evaluation] was moderate or low, downgraded mainly due to a lack of blinding and variable effect sizes.” In other words, the research on acupuncture is all of dubious quality.

          Please click on ‘acupuncture’ in the list of categories to the right of this blog for further enlightenment.

    • “Don’t suck your eyeballs out.”

      Staying out of water for a while would be good, too. Don’t get cupped and go swimming.

      • While this is the usual advise given after cupping, One could surmise that Michael Phelps is so aclimated to swiming pools that this hasn’t been a problem. Still this “folk wisdom” is something to reflect upon. What’s the sense behind it.

        • Howard

          Totally agree about Phelps. But home piston cup users…maybe not. And, unless you’re Michael Phelps, you probably shouldn’t consume 12,000 calories per day either.

    • To Howard Wu: If it is “more like deep tissue massage” (which it is not), then why not massage the area instead of applying magic suction cups that do nothing? Any toxins you claim to remove are as make believe as energy forces and meridians.

      • I’m to accept that this is a genuine and not a rhetorical question. I do use/receive deep tissue massage and there is a qualitative difference in experience. Tactile events are hard to communicate in contrast to visual or auditory events so I won’t try. Really nothing magic about the cups. Simply Charle’s Law. Discusions of meridians and energy can go on another thread as not most pertinent to cupping which is polycultural. While I don’t use word toxins, cellular wastes do accumulate more in cases of “stagnate Qi” and “Blood Stasis” where one will see the most differences on the skin after some cupping. I recently saw online article on why muscles stay sore days after excess exercise not due to lactic acid. I will try to relocate the link.

  • Do I remember, oh, thirty-odd years ago, that we had glass cupping cups at Bolton Royal Hospital for the, then, perfectly respectable and well-intentioned bursting and draining of assorted boils and carbuncles. People used to get a lot of boils in Bolton in the 70s.

    Or have I misremembered?

  • As a physiotherapist, I am thinking about offering a course in “Advanced Cupping”. I plan on using coffee mugs. Mugging will cost more to get a “certified” or trained in, because “mugging” a patient really “steals” their self efficacy!

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