Cupping therapy
Cupping therapy is a form of pseudoscience in which a local suction is created on the skin with the application of heated cups. As alternative medicine it is practiced primarily in Asia but also in Eastern Europe, the Middle East, and Latin America.[1][2] Cupping has been characterized as a pseudoscience and its practice as quackery.[3][4]
Cupping practitioners attempt to use cupping therapy for a wide array of medical conditions including fevers, chronic low back pain, poor appetite, indigestion, high blood pressure, acne, atopic dermatitis, psoriasis, anemia, stroke rehabilitation, nasal congestion, infertility, and menstrual period cramping.[1][2]
Despite the numerous ailments for which practitioners claim cupping therapy is useful, there is insufficient evidence it has any health benefits, and there are some risks of harm, especially from wet cupping and fire cupping.[1] Bruising and skin discoloration are among the adverse effects of cupping and are sometimes mistaken for child abuse.[2] In rare instances, the presence of these marks on children has led to legal action against parents who had their children receive cupping therapy.[2]
Scientific evaluation
The American Cancer Society notes that "available scientific evidence does not support claims that cupping has any health benefits" and also that the treatment carries a small risk of burns.[5] A review of literature in 2011 determined that "the effectiveness of cupping is currently not well-documented for most conditions", and that systematic reviews showing efficacy for the treatment of pain "were based mostly on poor quality primary studies."[6] This was further supported by a review in 2014 which demonstrated that previous evidence supporting cupping has resulted from "unreasonable design and poor research quality".[7] There is a lack of evidence to support the use of cupping therapy for acne.[8] Additionally, cupping is often practiced along with other acupuncture therapies[2][9] and therefore cannot exclusively account for resultant positive benefits. Many reviews suggest that there is insufficient scientific evidence to support the use of cupping techniques to combat relevant diseases and chronic pain.[10] Cupping has been characterized as quackery.[4]
The lack of apparent benefits of cupping treatments are discussed by Simon Singh and Edzard Ernst in their 2008 book Trick or Treatment.[11]
As a pseudoscientific detoxification ritual, proponents of cupping falsely claim that it can remove unspecified toxins from the body.[12][13] Proponents also falsely claim that cupping "improves blood flow" to help sore muscles.[14] James Hamblin notes that a bruise caused by cupping "is a blood clot, though, and clotted blood is definitionally not flowing."[15]
Critics of alternative medicine have spoken out against cupping therapy. Harriet Hall and Mark Crislip have characterized cupping as "pseudoscience nonsense", "a celebrity fad", and "gibberish", and observed that there is no evidence that cupping works any better than a placebo.[16][17] Pharmacologist David Colquhoun writes that cupping is "laughable... and utterly implausible."[18] Practicing surgeon David Gorski observes that "it's all risk for no benefit. It has no place in modern medicine, or at least shouldn't."[19]
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Safety
In 2016, the Cambodian Ministry of Health warned that cupping could be a health risk and particularly dangerous for people with high blood pressure or heart problems.[20] According to the NCCIH "Cupping can cause side effects such as persistent skin discoloration, scars, burns, and infections, and may worsen eczema or psoriasis".[21]
Cupping may cause breaks in the capillaries (small blood vessels) in the papillary dermis layer of the skin, resulting in the appearance of petechiae and purpura.[1] These marks are sometimes mistaken for signs of child abuse when cupping is performed on children.[1]
Cupping therapy adverse events can be divided into local and systemic adverse events. The local adverse events may include scar formation, burns, linear bruising or streaks (wet cupping), skin ulcers, undesired darkening of the skin, panniculitis, erythema ab igne, induction of the Koebner phenomenon in susceptible individuals with psoriasis, and pain at the cupping site.[1][2] A theoretical risk of infection exists but there are no reports of this as of 2012.[2]
Claimed uses
Cupping practitioners use cupping therapy for a wide array of medical conditions including fevers, pain, poor appetite, indigestion, high blood pressure, acne, atopic dermatitis, psoriasis, anemia, stroke rehabilitation, nasal congestion, infertility, and dysmenorrhea.[1]
There is low to moderate evidence that cupping can reduce pain associated with musculoskeletal pain and myofascial pain syndrome,[22][23][24] although the benefits may be indistinguishable from those of a placebo.[24]
Claimed mechanism of action
Proponents claim cupping has a therapeutic effect and removes unspecified "toxins", stagnant blood, or "vital energy" when used over acupuncture points with the goal of improving blood circulation.[1][2]
A person receiving wet cupping
Blood drawn by wet cupping
Society and culture
Cupping has gained publicity in modern times due to its use by American sport celebrities including National Football League player DeMarcus Ware and Olympians Alexander Naddour, Natalie Coughlin, and Michael Phelps.[40] Medical doctor Brad McKay wrote that Team USA was doing a great disservice to their fans who might "follow their lead", calling cupping an "ancient (but useless) traditional therapy."[41] Steven Novella noted "It is unfortunate that elite athletics, including the Olympics, is such a hot bed for pseudoscience."[42]
There is a description of cupping in George Orwell's essay "How the Poor Die", where he was surprised to find the antiquated practice applied to him in a Paris hospital.[43] In the 1964 Hollywood film, Zorba the Greek cupping is depicted with the character Zorba, played by Anthony Quinn, performing it on the character played by Lila Kedrova.
Perceived benefits of cupping have often been perpetuated by celebrities and athletes who use these therapeutic interventions in their daily lives. Professional swimmer Michael Phelps received publicity during the 2016 Olympics for the purple bruises evident on his back resulting from cupping. He has been known to "do it before every meet he goes to" in order to "speed up recovery".[44] Celebrity endorsements such as these may bias individuals to feel benefits from the practice.
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