A placebo effect is present in all treatments, and I am sure that it is substantial in the case of cupping as well - Leonid Kalichman


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The ancient art of applying suction cups to the body has gotten a boost from several new studies that show it helps relieve a variety of painful conditions. But scientists say larger, more rigorous studies are needed.

Cupping, as the practice is called, was performed traditionally in China and other countries, and is now available from acupuncturists, and some chiropractors and massage therapists in the U.S. In the traditional method, called fire cupping, a ball of burning cotton is briefly placed inside a glass cup to heat the air inside, which then creates a partial vacuum as it cools. Newer-style plastic or silicone cups have valves that attach to hand pumps used to create suction.

Until recently, there was scant published evidence in favor of cupping for pain relief. Over the past three years, a handful of new studies have shown it helps relieve back, neck, carpal tunnel and knee pain.

There are a number of theories on how cupping may work to relieve pain. A widely held one is that suction on the skin "increases blood flow to the area and creates a mild immune response," says Kathleen Lumiere, an assistant professor of acupuncture and oriental medicine at Bastyr University in Kenmore, Wash. It also helps release fascia, connective tissue that can pull on muscles causing pain or limited motion, clinicians say.

Typically cups are on for up to 20 minutes and leave a temporary reddish mark that looks "like rare roast beef," says Brian K. Nathanson, a Norwalk, Conn., chiropractor who has been doing cupping for about five years.

Some clinicians slide the cups on the body, using them as massage tools in a technique sometimes called running cupping. "People who love deep-tissue massage love cupping," says Gabrielle Francis, a Manhattan chiropractor and acupuncturist who does both static cupping and running cupping. Both can cause mild discomfort in some patients, clinicians say.

The intrepid can opt for "wet cupping," in which the skin is punctured with a lancet before the cups are applied. The technique, which draws out a small quantity of blood, can have a powerful effect—particularly on areas where you can feel a hard lump of knotted muscles, says Kristine Tohtz, a Chicago chiropractor and acupuncturist who does wet and dry cupping.

Cost of cupping varies widely, from $40 to $100 or more for a half-hour session. It shouldn't be done on pregnant women, people with heart conditions or people with bleeding disorders, clinicians say. Caution should be used if a person has thin skin that might tear easily.

In a study of people with neck pain caused by computer use, "cupping therapy was effective in reducing pain," says Tae-Hun Kim, a researcher at the Korea Institute of Oriental Medicine in Daejeon, South Korea. The 40-person study, published online in September in the Journal of Occupational Health, found that six cupping sessions over two weeks was more effective on average in relieving pain than a heating pad—and the benefit lasted a month after treatment ended.

But, says Romy Lauche, a scientist at the University of Duisburg-Essen in Essen, Germany, "the studies are very preliminary. We cannot say it has proven its efficacy."

Dr. Lauche co-authored a 50-person study published last year that found a single wet-cupping treatment on average significantly reduced chronic neck pain three days after the treatment, compared with a control group that had no treatment. Location of the cups varied with each patient but typically was on the trapezius muscle, which spans the neck, shoulders and upper back. In unpublished results, she adds, scientists found the pain relief lasted for months.

In a 40-person German study published in October, cupping therapy significantly relieved knee arthritis pain compared with patients who received no treatment. But the study's lack of a control group treated with a sham technique "raises questions of whether it is cupping that is really working or if it has a placebo effect," says David Felson, who directs an arthritis research program at Boston University School of Medicine.

Dr. Lauche agrees that lack of a placebo control is a flaw in the studies. A new study, currently ongoing for fibromyalgia pain, is testing cupping against a sham cup that attaches with adhesive and provides minimal suction, she says.

Source: Laura Johannes, Centuries-Old Art of Cupping May Bring Some Pain Relief, Wall Street Journal, November 12, 2012.

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Last Updated : Friday, February 2, 2018