Cupping is a technique used in conjunction with acupuncture or dry needling. Cupping pulls blood to a region to stimulate healing. It is effective at stretching tight fascia and muscles. Cupping helps the tissue develop new blood flow and causes anti-inflammatory chemicals in the body. Cupping is generally painless and many say is more effective than massage for muscle problems.
Versions of Cupping can be found in many cultures from Latin America, Europe, the Middle East and Asia.
Most people I talk to have heard about cupping. Many have seen movie stars in magazines with the round, painless hickey on their back that is left behind after the process. When I talk to people about it almost all of them are willing to give it a try.
I remember the first time I used it on myself. I had a two year flair up of shoulder pain. Turned out to be bone on bone arthritis of the acromioclavicular joint (AC joint). I did all the traditional western treatments knowing they would be temporary but desperate for relief did them none the less.
I got just what I expected, temporary relief with anti-inflammatories, better relief with acupuncture, 2 days of relief with steroid injections (I even gave myself a shot in the mirror on Saturday I was in so much pain). I got to the point where I tried every topical prescription drug and herb I could find. I found I could not sleep on my side, do pushups or even adjust my patients like I used to without causing a lot of discomfort.
After returning from a sports acupuncture and trauma course in Boulder, CO with my teacher Yun Tao Ma, I rediscovered cupping and thought what the heck it can’t hurt anything. I made this bold statement to myself after learning more about the mechanisms of how it worked, which I will get into a little later in this paper.
had changed considerably than when I first learned it 25 years ago. Back then as originally taught a small fire was created in a glass cup that was placed on the body. As the fire went out a vacuum was created causing a sucking action to the surrounding tissues. Dr. Ma had turned me on to a vacuum pump and a plastic cup with a two way valve that worked faster, cleaner, safer and better.
I taught my wife how and where to place the cups. She put the first on right on the top of my left AC joint. Withdrew the air with the vacuum and ouch, it caused an aching sensation I hadn’t felt there before. It was a different discomfort but it also felt good. I knew something good was about to happen. I could only take the sensation for about 5 minutes. As she removed the cup the area was like a hickey only much more black than blue.
I told Dr. Ma’s wife what I was doing and she told me to keep doing it and it would get better. That was easy to believe since I already was feeling some improvement after only a couple sessions. About 6 more treatments and I was feeling 90% relief. The thing about this remedy over all the others I had tried is that this one was making things feel progressively better each time and over the few weeks I had been doing it. It felt like more permanent relief, and it was. Occasionally I would get a minor flair-up requiring me to treat it again but only as needed. It’s been over two years and I have to say I’m greater than 95% improved and rarely need a tune up.
So how does cupping work?
I wanted to know as well because the first time I learned about it 25 plus years ago the explanation didn’t stich with me enough to incorporate it into my practice. However this time Dr. Ma had research from the Russian Health Ministry where they had been studying it and collecting data for over 40 years.
Here’s how cupping works.
As we age, especially after 40 years old, our body begins to break down. This includes loss of muscle, adhesions in fascia and decrease in blood flow. You can see this as your muscle tone decreases, we get stiffer and wrinkles start to appear in new places. As we move less and decrease our physical activity the blood supply to tissues decrease and the fascia gets knotted and scarred up further limiting movement and becoming a vicious cycle.
Putting cups over a region helps the body reverse some of these effects. What I’m about to tell you was revealed in the Russians research on cupping.
Initially it pulls blood into an area. The tissues get saturated with fresh blood while the vacuum pulls stagnant blood out of the area. You can see this in the hickey like appearance that is typically left behind. You may have a black and blue appearance that is rarely painful. I have noticed a couple characteristics about this phenomenon. One is that it happens more in people over 40 and two the more cupping you receive the less the bruising happens.
As new blood is forced into the tissues around the cups the body will begin to develop new blood vessels called neovascularization, new blood vessel formation. I believe this is why cupping can cause a lasting effect. As the new vessels form they will have the capability to feed the tissues with nutrient and oxygen. Like you and me, all tissues need food and oxygen to survive.
Something else happens early in this process as well. It is called sterile inflammation. Now many hear the word inflammation and think it is a bad thing. After all we take anti-inflammatory when there is pain and swelling so inflammation must be bad, right? But that couldn’t be farther from the truth. Inflammation is the first line of healing. The body releases white blood cells, platelets, fibroblasts and other healing chemicals to promote healing. When the vacuum occurs it causes separation of the different layers of tissue which can cause micro trauma and tearing. The healing chemicals I mentioned above get released and stimulate healing. The inflammation is not chronic nor is it bad.
Next the fascia and tissue can be stretched several feet with cupping. The micro trauma is occurring, the new blood vessels are being formed and the blood and nutrients are starting to flow to the damaged tissue. But when you put 10 or so cups on the back or around the injured area it can begin to stretch the connective tissue and fascia for better movement. Many tell me that cupping works faster and last longer for them than massage. It’s amazing to see the connective tissue stretch this much. Many people start out very tight but over time they can confirm what I see when doing this to people that the tissue is getting looser.
I have seen cupping work very well when used in conjunction with acupuncture and manipulation. While these other techniques address different tissues and functions of the body, no painful condition or injury exists without other tissue being involved.
So to wrap up, cupping can help you overcome old and new injury by:
- Increasing circulation
- Increasing oxygenation and tissue delivery
- Remove old stagnant blood
- Cause micro trauma and beneficial inflammation
- Create new blood vessels
- Stretch fascia and connective tissue.
Cupping is helpful when used in conjunction with joint manipulation and acupuncture. Cupping, like many holistic techniques works at different rates for different people.
I recall when I brought cupping into the office. My first patient was a truck driver who was involved in a truck accident. He was a slow responder to most of his treatments including drugs and surgery. By time he came to me he was cynical and pessimistic. I told him about cupping and he was willing to try it.
I came into the room on the next visits and it started with “I don’t know what you did to me last visit but… I feel a ton better. ”
Now I have to say as he said this I was quite surprised not expecting to hear this from him. Remember he was pessimistic and cynical. We continued with cupping and acupuncture and his case resolved quite well and he went back to work full time and as his pain improved so did his outlook on life.
If you have chronic muscle and joint pain
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Mark A. Testa, DC, CAc, MHA