Cupping therapy is one of the oldest medical treatments still in use today, with roots stretching back thousands of years into ancient Chinese, Egyptian, and Middle Eastern medicine. You might have seen the telltale circular bruise-like marks on the backs of athletes or celebrities and wondered what on earth was going on. Here’s everything you need to know, in plain English.
What Is Cupping?
At its most basic, cupping involves placing cup-shaped vessels — traditionally made from bamboo, glass, or ceramic, and nowadays often silicone or plastic — onto the skin and creating a vacuum inside them. That suction pulls the skin and the tissue just beneath it upward into the cup. A typical session lasts anywhere from 5 to 20 minutes, and the cups are placed most commonly on the back, shoulders, neck, and legs, though they can be used almost anywhere on the body.
The cups are left in place (called “dry cupping” or “static cupping”), or the therapist may apply oil to the skin and glide the cups slowly across the surface — a technique known as “sliding” or “moving” cupping. Some practitioners use “wet cupping,” which involves making tiny, shallow incisions in the skin and drawing a small amount of blood into the cup. Wet cupping is less common in Western practice and is a more traditional medical form used in certain cultures, particularly in parts of the Middle East under the name hijama.
How Does the Suction Actually Get Created?
There are two main methods. The older, traditional method uses heat: the practitioner briefly holds a burning cotton ball inside the cup to heat the air inside, then quickly places it on the skin. As the air cools, it contracts, creating a natural vacuum. This is called “fire cupping.” You might picture it looking a little alarming, but the flame never touches the skin — only the air inside the cup is heated.
The modern method is far simpler: cups fitted with a small hand pump or valve allow the therapist to squeeze out the air mechanically. Silicone cups skip the pump entirely — you just squeeze the cup, place it on the skin, and let go. Easy and mess-free.
What’s Actually Happening Under the Skin?
This is where it gets genuinely interesting. When the cup creates suction, it pulls the skin and the layer of connective tissue beneath it (called fascia) upward. Think of it like a reverse deep-tissue massage — instead of pressing down into muscle, you’re lifting tissue away from the body.
Several things happen as a result:
Increased blood flow. The suction draws blood into the area under the cup. This brings fresh oxygen and nutrients to tissue that may have been sluggish or restricted. The redness — and those signature circular marks — are simply blood vessels near the surface responding to the sudden change in pressure.
Fascial release. Fascia is a web of connective tissue that wraps around every muscle, organ, and bone in your body. When it becomes tight, stiff, or stuck together (which can happen from injury, inactivity, or chronic tension), it can restrict movement and cause pain. The lifting action of cupping helps separate fascial layers that have essentially glued together, allowing them to slide more freely.
Nervous system signaling. The skin is densely packed with nerve endings. The pressure change from cupping sends signals to the nervous system that may help shift the body from a “tense” state into a more relaxed one — similar to how a good massage can make you feel calm and heavy-limbed afterward.
Lymphatic stimulation. The lymphatic system is your body’s drainage network — it carries waste products away from tissues and plays a key role in immune function. Cupping is thought to encourage lymphatic fluid to move more efficiently through an area.
Microtrauma and healing response. Those round marks cupping leaves behind are not bruises in the traditional sense. A regular bruise happens when blunt force damages tissue from the outside. Cupping marks appear because blood vessels near the skin’s surface are gently stretched and may release tiny amounts of blood into the surrounding tissue. The body responds to this as it would any minor tissue disruption — by sending in repair and anti-inflammatory signals. Some practitioners believe this healing response is part of what makes the therapy effective.
What Can Cupping Relieve?
Cupping has been used for an enormous range of complaints over the centuries, and while the scientific evidence varies in strength, here are the areas where it has the most support and the most consistent anecdotal backing:
Muscle tension and soreness. This is the bread and butter of modern cupping practice, particularly among athletes and physical therapy patients. The combination of increased blood flow, fascial release, and relaxation response makes it a popular choice for tight backs, sore shoulders, stiff necks, and overworked legs. Many professional sports teams now use it as a recovery tool.
Back pain. Several studies have looked specifically at chronic lower back pain, and the results are generally encouraging. Cupping appears to reduce pain levels and improve range of motion in people dealing with ongoing back trouble — at least in the short term.
Neck and shoulder pain. Desk workers, drivers, and anyone who carries tension in their upper body often report significant relief after cupping on the neck and upper back. The sliding cupping technique is particularly popular in this area.
Headaches and migraines. By releasing tension in the neck, shoulders, and base of the skull, cupping may reduce the frequency or intensity of tension-type headaches. Some practitioners use specific points on the back and shoulders associated with headache relief in traditional Chinese medicine.
Respiratory complaints. Traditional cupping on the back of the chest has long been used for coughs, asthma, and bronchitis. The theory is that it loosens congestion and improves circulation to the lungs. Modern evidence here is thinner, but many people still find it helpful alongside conventional care.
Digestive discomfort. Abdominal cupping — done with very light suction — is a traditional remedy for bloating, constipation, and irritable bowel symptoms. The gentle massage-like effect on the gut wall is thought to encourage normal movement through the digestive tract.
Anxiety and stress. The profound relaxation response that many people experience during and after cupping makes it useful as a complementary therapy for stress and anxiety. It likely works through the same pathways as massage — calming the nervous system, slowing the heart rate, and easing muscle tension that the body holds in response to emotional stress.
Skin conditions. Some practitioners use facial or body cupping to improve circulation to the skin, which may help with acne, eczema flares, or simply improving skin tone. Evidence here is mostly anecdotal, but the logic of improving blood flow to the skin is sound.
Is It Safe? Are There Side Effects?
For most healthy adults, cupping is quite safe when performed by a trained practitioner. The main “side effects” are those distinctive circular marks, which typically fade within a few days to two weeks depending on how much suction was used and how reactive your skin is.
You may also feel mildly sore in the treated area for a day or two — similar to how muscles feel after a vigorous massage. Dizziness or lightheadedness during a session is possible if you’re prone to it, and the treated skin can be temporarily more sensitive to sun and heat.
Cupping is generally avoided over broken skin, inflamed or sunburned areas, bony prominences, and varicose veins. It is not recommended during pregnancy (on the abdomen or lower back), for people on blood thinners, or for those with active skin infections.
The Bottom Line
Cupping is a genuinely ancient technique that has survived for thousands of years because — for many people — it works. Whether you explain it through the lens of traditional Chinese medicine’s concept of qi and meridians, or through the modern physiological framework of blood flow, fascial release, and nervous system modulation, the practical result is often the same: reduced pain, looser muscles, and a deep sense of relaxation.
It’s not a magic cure, and it works best as part of a broader approach to health rather than a standalone treatment. But for muscle tension, chronic pain, and stress relief in particular, cupping has earned its place in the toolkit of many physical therapists, sports medicine practitioners, and wellness professionals around the world. If you’d like to learn more about cupping therapy may be an option for you, make an appointment with Dr. Pailin by clicking here.