Acupuncture & Cupping

Acupuncture & Cupping

Cupping therapy is widely used to manage musculoskeletal diseases in China and Egypt, including neck pain, lower back pain, myofascial pain syndrome, osteoarthritis, and pain in athletes. Recently, elite athletes, such as Michael Phelps and Russel Westbrook, revealed these circular marks on their shoulders through the media . Subsequently, the awareness and curiosity about cupping therapy has been continuing to grow in the western countries[1].

Cupping Theory

Six theories have been suggested to explain the effects produced by cupping therapy. Pain reduction and changes in biomechanical properties of the skin could be explained by “Pain-Gate Theory”, “Diffuse Noxious Inhibitory Controls” and “Reflex zone theory”. Muscle relaxation, changes in local tissue structures and increase in blood circulation might be explained by “Nitric Oxide theory”. Immunological effects and hormonal adjustments might be attributed to “Activation of immune system theory”. Releasing of toxins and removal of wastes and heavy metals might be explained by “Blood Detoxification Theory”. These theories may overlap or work interchangeably to produce various therapeutic effects in specific ailments and diseases[2].


How Does Cupping Work

How Cupping WorksThere is converging evidence that utilizing cups can induce comfort and relaxation on a systemic level and the resulting increase in endogenous opioid production in the brain leads to improved pain control.[3-4] Other researchers proposed that the main action of this therapy is to enhance the circulation of blood and to remove toxins and waste from the body.[5]  That could be achieved through improving microcirculation, promoting capillary endothelial cell repair, accelerating granulation and angiogenesis in the regional tissues, thus helping normalize the patient’s functional state and progressive muscle relaxation.[6-7]  Cupping also removes noxious materials from skin microcirculation and interstitial compartment[8] which benefit the patient. This treatment may be an effective method of reducing low density lipoprotein (LDL) in men and consequently may have a preventive effect against atherosclerosis[9] and cardiovascular diseases (CVDs). Cupping is known to significantly decrease in total cholesterol, low density lipoprotein LDL/high density lipoprotein (HDL) ratio.[10] Utilizing cups can significantly lower the number of lymphocytes in the local blood related to the affected area with an increase in the number of neutrophils, which is one of the antiviral mechanisms that reduces the pain scores.[11]  It has also been found that this treatment increases red blood cells RBCs.[12] It has been claimed that this treatment tends to drain excess fluids and toxins, loosen adhesions and revitalize connective tissue, increase blood flow to skin and muscles, stimulate the peripheral nervous system, reduce pain, controls high blood pressure and modulates the immune system.[13] Cupping has been found to improve subcutaneous blood flow and to stimulate the autonomic nervous system.[14]

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[1].Wang X, Zhang X, Elliott J, Liao F, Tao J, Jan YK. Effect of Pressures and Durations of Cupping Therapy on Skin Blood Flow Responses. Front Bioeng Biotechnol. 2020;8:608509. Published 2020 Dec 8. doi:10.3389/fbioe.2020.608509

[2].Al-Bedah AMN, Elsubai IS, Qureshi NA, et al. The medical perspective of cupping therapy: Effects and mechanisms of action. J Tradit Complement Med. 2018;9(2):90-97. Published 2018 Apr 30. doi:10.1016/j.jtcme.2018.03.003

[3] .Chiu YC, Manousakas I, Kuo SM, Shiao JW, Chen CL. Influence of quantified dry cupping on soft tissue compliance in athletes with myofascial pain syndrome. PLoS One. 2020;15(11):e0242371. Published 2020 Nov 19. doi:10.1371/journal.pone.0242371

[4].Seo J, Chu H, Kim CH, Sung KK, Lee S. Cupping Therapy for Migraine: A PRISMA-Compliant Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2021;2021:7582581. Published 2021 Mar 24. doi:10.1155/2021/7582581

[5].Yoo Simon S., Tausk Francisco. Cupping: east meets west. Int J Dermatol. 2004;43:664–665. 9. [PubMed] [Google Scholar]

[6].Lauche R., Materdey S., Cramer H., Haller H., Stange R. vol.8. 2013. Effectiveness of Home-Based Cupping Massage Compared to Progressive Muscle Relaxation in Patients with Chronic Neck Pain—a Randomized Controlled Trial; p. 65378. 6. [PMC free article] [PubMed] [Google Scholar]

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[8].Goodwin J. Alternative therapy: cupping for asthma. Chest. 2011;139:475. [PubMed] [Google Scholar]

[9].Niasari Majid, Kosari Farid, Ahmadi Ali. The effect of wet cupping on serum lipid concentrations of clinically healthy young men: a randomized controlled trial. J Alternative Compl Med. 2007;13:79–82. 1. [PubMed] [Google Scholar]

[10].Mustafa Layla A., Dawood Rukzan M., Al-Sabaawy Osama M. Effect of wet cupping on serum lipids profile levels of hyperlipidemic patients and correlation with some metal ions. Raf. J. Sci. 2012;23:128–136. 3. [Google Scholar]

[11].Hao P., Yang Y., Guan L. Effects of bloodletting pricking, cupping and surrounding acupuncture on inflammation-related indices in peripheral and local blood in patients with acute herpes zoster. Zhongguo Zhen Jiu. 2016;36:37–40. 1. [PubMed] [Google Scholar]

[12].Aeeni Z., Afsahi A., Rezvan H. An investigation of the effect of wet cupping on hematology parameters in mice. Pejouhesh. 2013;37:145–150. [Google Scholar]