The medical perspective of cupping therapy

Cupping Therapy (CT) is an ancient technique used to treat various medical illnesses. The effect mechanism of (CT) has yet to be discovered entirely. This review was designed to pinpoint possible mechanisms for the action of (CT) from a modern medical viewpoint and provide possibilities for explanations of its results. English literature from PubMed, Cochrane Library and Google Scholar was searched using keywords. There were only 223 results, with 149 records being screened, and 74 items were excluded due to insignificance. The number of full-text articles considered eligible, and the number of studies included in the review comprised 64. A total of six theories were proposed to explain the changes caused by cupping therapy. The reduction in pain and the changes in the biomechanical properties of the skin may be explained through “Pain-Gate Theory”, “Diffuse Noxious Inhibitory Controls” and “Reflex zone theory”. Relaxation of muscles, changes in local tissue structures, and increased blood circulation could be explained by “Nitric Oxide theory.” In addition, hormonal changes and immunological effects may be related to the “Activation of immune system theory.” The release of toxins and the elimination of heavy metals and waste may be explained by the “Blood Detoxification Theory.” These theories could be interspersed or used interchangeably to generate various therapeutic effects for particular illnesses and conditions. Only some theories can explain the entire effect of cupping. More research is needed to confirm or debunk the theories mentioned above and to develop new concepts that incorporate (CT) shortly.

Abstract graphic

  1. Introduction

Cupping therapy is an old method of treatment utilized to treat various conditions.1 There are many cupping therapies; however, dry cupping and wet are two primary types.2 Dry cupping is a method of bringing the skin inside the cup with no scarifications, and in wet cupping, the skin is cut in such a way that blood can be drawn into the cup.3 Cupping has been used as a treatment for thousands of years and practiced by different cultures and societies; the mechanism of action still needs to be understood.4 Cupping’s popularity has recently returned, and various studies have begun to explore the mechanisms behind cupping therapy.5 For mainstream physicians who are trained in western medical science The focus is mainly on the biological causes of disease, whereas traditional medical practitioners employ the holistic approach.6 Cupping therapy may result in various effects due to various mechanisms.7 Research scientists usually describe a specific phenomenon or result of a particular drug or cupping device by describing its mechanism (s). In reality, the description of the mechanism is only sometimes exhaustive because the specifics of associated processes still need to be fully discovered. 8 The research based on hypotheses allows researchers to discover the causal and effect relationships and is an effective way to alter the intervention-outcome theories. 9 Fonnebo and Co. (2007) reported that a standard approach for traditional medical treatment is to employ reverse research strategies because traditional therapies, including cupping therapy, have been in practice for a long time. In this regard, researchers must know what the treatment process is, what variations there are, what theories underlie the concepts of diseases and health, its historical structure, and the essential treatment components.10 The most controversial opinion about the cupping treatment is that it is the potential to have a placebo effect.11 This theory of placebo about cupping therapy will be around until a scientifically proven and valid mechanism is figured out.12 The debates surrounding cupping therapy have prompted researchers of the study to contribute to resolving this scientific issue by reviewing the literature relevant to cupping therapy. Comprehensive studies on the mechanisms behind it backed by scientifically sound studies will aid in the safe and efficient use of cupping therapies. 13 This research project will provide scientific explanations of the evidence-based processes that underlie cupping therapy.

This review aims to determine and analyze the possible mechanisms of cupping therapy that works from a modern medical perspective. We also provide possible explanations for the various benefits of cupping.

1.1. A brief description of the cupping therapy technique

Cupping is a straightforward application of swift, decisive, and rhythmic strokes to energize muscles. It is especially beneficial in treating discomfort and aches caused by various ailments. Therefore, cupping has the potential to improve your quality of life. 14 Every cupping session lasts approximately 20 minutes and can be carried out with five simple steps. The first stage involves suction primary. This is when the therapist selects specific areas or areas for cupping and cleanses the region. A cup of the appropriate dimension is placed at the desired location, and the therapist suctions the air into the cup with a torch or electric suction. The cup is then applied to the skin and left on for three to five minutes. The next step involves scarring or cutting. Superficial incisions are made on the skin using Surgical Scalpel Blades No. 15 to 21 or puncturing using an auto-lancing device or a needle for plum blossoms. 15 The next stage is suction and bloodletting. The cup is then returned to the skin with the abovementioned procedures for three to five minutes. The fourth step involves taking the cup off, then the fifth step, which involves dressing the area following cleaning and disinfecting it with FDA-approved skin disinfectants. Additionally, appropriate sizes of tape are applied to the scarred area and stay for 48 hours. 16 It is important to understand that scarification and suction are the principal methods used in wet cupping treatment. Each cupping method could cause certain changes in tissues, body cells, or organs. Certain treatments can boost or reduce body hormones and enhance or modify immunity or help the harmful chemicals in the body, and in the end, it may reduce discomfort.

  1. Materials & methods

The review focuses on hypotheses and theories which explain the mechanism of cupping therapy from a contemporary medical viewpoint. Theories relating to traditional methods of medicine like Traditional Chinese Medicine, Unani Medicine, or other traditional healing methods were included in this review.

The relevant literature written in English was accessed through PubMed, Cochrane Library, and Google Scholar databases. It was determined that the Boolean operators and keywords that were used for multiple searches included used to cupping [All Fieldsand] [mechanism for action [All Fieldsor effecting [All Fieldseffect [All Fields]. The search strategy as well as the keywords were changed in accordance with the search in databases. Furthermore, the studies referenced in the articles were searched manually. The number of articles found was 223 that were evaluated independently by two appraisers. They both voted that 64 research studies should be included in this review.


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