Cupping is one of the most visible practices associated with Traditional Chinese Medicine (TCM). Cups placed on the skin create suction, and the round marks they can leave have become familiar from athletes at international competitions. This article covers where cupping comes from, how it is done, what research reviews have found, and what is known about its safety. It is an educational overview, not a recommendation for treatment.
A practice with many roots
Forms of cupping appear in the medical traditions of China, the Middle East and Europe, and the practice is far older than modern medicine. Early cups were made of animal horn or bamboo, and later of glass. In TCM it was traditionally used alongside acupuncture and described in terms of moving Qi and blood in the area being treated. Like other TCM concepts, that is a traditional explanation, not a modern physiological one. An introduction to those ideas is in What Is Traditional Chinese Medicine?
How cupping is done
There are two main types. In dry cupping, the cup is placed on the skin and suction is created, either by briefly heating the air inside the cup or with a mechanical pump, and the cup is left in place or moved across the skin. In wet cupping, the skin is first lightly punctured so that a small amount of blood is drawn into the cup. Treatments are typically on the back, shoulders or other large muscle areas.
Cupping in Sherman Lai's career
Cupping was one of the techniques used during Sherman Lai's three decades of practice in Guelph (1986–2017). In 1996 he presented a comparative clinical observation of acupuncture alone versus acupuncture with cupping for musculoskeletal pain at the Fourth World Conference on Acupuncture in New York, co-sponsored by the World Health Organization. Like his other conference reports, it was a clinical observation from his own practice, not a randomized controlled trial, and it is listed as part of the historical record on the Research & Practice page.
What research reviews have found
A 2012 systematic review in PLoS One by Cao and colleagues looked at randomized trials of cupping published up to 2010. It found that cupping combined with other TCM treatments was reported to do better than other treatments alone for a few conditions, including shingles (herpes zoster), facial paralysis, acne and cervical spondylosis. The authors called for more rigorously designed trials, since many of the studies they reviewed had methodological weaknesses.
A 2025 systematic review and meta-analysis of cupping for pain included 72 randomized trials with 5,720 participants. It reported improvements in pain and quality of life, but rated every included trial as having a high risk of bias and described the overall evidence as low quality.
The U.S. National Center for Complementary and Integrative Health (NCCIH) summarizes the field the same way. It notes that most cupping studies are of low quality, that the evidence for pain relief is weak, and that there is not enough high-quality research to draw conclusions about other conditions. As with acupuncture, it is hard to design a convincing sham version of cupping, which makes results more difficult to interpret. More on this problem is in What Does Research Say About Acupuncture?
Safety
NCCIH lists the side effects that have been reported. These include persistent skin discoloration, scars, burns and infections, and cupping may worsen skin conditions such as eczema or psoriasis. Rare severe events have been reported, including bleeding inside the skull after scalp cupping and anemia after repeated wet cupping. Equipment used on more than one person can spread bloodborne infections such as hepatitis B and C unless it is properly sterilized. NCCIH also advises telling health care providers about recent cupping, since the marks can be mistaken for injuries.
In Ontario, practitioners of TCM and acupuncture are regulated by the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario, which sets standards including infection control. That history is covered in Why Ontario Regulated Traditional Chinese Medicine.
Sources
- National Center for Complementary and Integrative Health (NIH). Cupping.
- Cao H, Li X, Liu J. An updated review of the efficacy of cupping therapy. PLoS One. 2012;7(2):e31793.
- Update evidence of effectiveness on pain relieving of cupping therapy: a systematic review and meta-analysis of randomized controlled trials. Journal of Traditional Chinese Medicine. 2025. PubMed 40151111.