Cupping is a type of physical therapy that has a long history and is now widely used in clinal practice. Cupping uses negative pressure to act upon specific areas of the human body to create simulations or even local congestion and blood stasis to enable treatment. Terminologies and their contexts that are often involved in cupping such as stasis, toxin, pathogen, wind, dampness, cold, etc. are widely spread and recognized.

Through combustion or suction, cupping exhausts the air inside special cups, cans, or bottles to create negative pressure, so that they can be attached to the body surface where treatment is needed. These cups produce extensive stimulation and cause congestion or blood stasis, and thus achieve curative purposes. This type of therapy has been widely used because it has a wide range of applications, is safe, efficient, and has almost no pain or adverse reactions. There are three major physical principles of cupping:


As the rim of the cup is tightly attached to the skin, it pulls nerves, muscles, blood vessels, and subcutaneous glands, which can initiate a chain of neuro-endocrine reactions, regulate the widening and narrowing functions of blood vessels and the permeability of blood vessel wall, thereby improving local blood circulation.

Negative Pressure Effect

Negative pressure causes rapid local congestion, blood stasis, or even ruptures of capillaries and red blood cell damage, which leads to hemolysis. The release of hemoglobin from red blood cells is a benign stimulus to the body. This kind of stimulation can regulate the function of tissues and organs in both directions through the nervous system, and at the same time promote the phagocytosis of white blood cells, improving the sensitivity and tolerance of the skin to external changes, hence enhancing the body’s immunity. Moreover, the strong sucking and pulling force of negative pressure can fully open the pores and enhance the functions of sweat glands and sebaceous glands, so that the discharge of toxins and wastes in the body can be accelerated.

Warming Effect

The warming effect of cupping not only dilates local vessels and increases blood flow, but also enhances the permeability of blood vessel walls and the phagocytic ability of cells. Cupping can accelerate blood circulation, promote metabolism, remove metabolic wastes in time, directly improve the local internal environment, reduce or eliminate the stimulations from pain-inducing substances, and relieve spasms and pain. The change of vascular tension and mucosal permeability at the cupping areas, acceleration of lymphatic circulation, and enhancement of phagocytosis make a favorable environment against biological etiologies. In addition, the chronic stimulation of hemolysis has a health-promoting effect on the human body.

Respiratory system: acute and chronic bronchitis, asthma, pulmonary edema, pneumonia, pleurisy

Digestive system: acute and chronic gastritis, gastric neuralgia, dyspepsia, hyperacidity, acute and chronic enteritis

Circulatory system: hypertension, arrhythmia, insufficient blood supply to the heart

Movement system: spine pain, shoulder and scapula pain, elbow pain, back pain, lumbar pain, sacral pain, hip pain, ankle pain, heel pain

Nervous system:  neuropathic headache, occipital neuralgia, intercostal neuralgia, sciatica, nerve palsy caused by rheumatic strain, cervical muscle spasm, gastrocnemius muscle spasm, facial nerve spasm, diaphragm muscle spasm

Gynecology: dysmenorrhea, amenorrhea, menorrhagia, leucorrhea, pelvic inflammatory disease

Surgical sores: boils, multiple folliculitis, lower extremity ulceration, acute mastitis

In terms of health care: according to traditional Chinese medicine, cupping can relieve stress, strengthen the body, eliminate pathogenic factors, relax tendons and collaterals, and adjust qi and blood.

Generally, 7–10 days make a course, and the interval is 3-5 days. And then the second course can begin. The suction force should reach the maximum that the patient can endure.

If there’s any ecchymosis or Sha mass caused by special techniques, wait till these marks disappear before cupping again. It’s usually done once every 2-5 days, or once every day on different acupoints.

For common acute diseases (cold, fever), do cupping once per day for 2-3 days.

In case of severe illnesses and pain, do cupping 2-3 times per day (must alternate the cupping area)

For chronic diseases, do cupping once per day for 2-3 courses, and change to other methods if there’s no obvious improvement.

Congestion and Blood Stasis

If the color is red, and the degree of skin uplift is not obvious, it indicates excess and heat syndromes; if the skin is congested and noticeably lumped, and the color is dark red or purplish red, it suggests deficiency and cold syndromes.

The characteristics of congestion mainly depend on the color of the blood and the amount of water. If the color is red and the blood doesn’t agglomerate easily, it means the disease condition is mild.

If the color is purple and black, and the blood is sticky and chunky, it means the stasis or blockage is severe. If there’s much water, it indicates great dampness; water being yellow suggests dampness-heat, and clear, cold dampness.


The essence of blisters is having too much water under the skin. Pathological products such as phlegm, fluid retention, water, and dampness in the body pass through the subcutaneous tissue under the action of negative pressure, enter and stay in the skin, thus forming blisters.

The size and number of blisters reflect the condition of phlegm and dampness in the body.

If the blisters are obvious, numerous, opaque white, and the temperature of surrounding skin is not high, it suggests cold dampness syndrome.

If the blisters are not very obvious, less in number, slightly yellow in color or cloudy, and the temperature of the surrounding skin is relatively high, it suggests damp-heat syndrome.

Changes in Skin Temperature

If the skin temperature of the cupping areas moderately rises, it indicates that the body has rather sufficient healthy qi and good immunity.

If the skin temperature noticeably rises, it means the body is having yang and excess pathogen, or the disease symptoms are excess and heat.

If the skin temperature does not increase significantly or even decreases, especially after the body experiences wind, cold, and dampness pathogen, or when the patient have deficiency or cold syndromes.

Skin Exudate

It is normal for a small amount of water vapor to exude from the skin after cupping.

If a lot of water vapor adheres to the interior surface of the cup, it indicates that the phlegm, drink, water, and dampness in the body are serious.

If the color of the exudate is pale white, it indicates cold. If the texture is thin, it indicates deficiency-cold; if the texture is sticky, it indicates excess-cold.

If the color of the exudate is pale yellow or yellow, it suggests heat syndrome. If the texture is thin, it suggests deficiency-heat; and sticky, excess-heat syndrome.