Cupping is an ancient Chinese practice where a cup is placed on the patient's skin. The pressure in the cup is removed, using different methods, creating a vacuum allowing the skin and superficial muscle layer to be drawn into the cup. From a Traditional Chinese Medicine point of view, this "pulling" effect on the skin stimulates the acupuncture point where the cup is placed. This regulates the flow of Qi and Blood, and helps to draw out and eliminate pathogenic factors such as Wind, Cold, Damp, and Heat. From a Western medicine point of view, the functioning of blood vessels within the muscles is activated in response to the stimulation of the subcutaneous capillary vessels created by the pulling effect of cupping. Thus the expansion of blood vessels in the muscles facilitates the flow of blood and has a remarkable effect on stiff muscles, and old injuries.
Although most practitioners use the traditional way of lighting up a cotton ball that has been soaked in alcohol and then inserting it and quickly removing it from the cup to create a vacuum, there are other ways of depressurizing the cups. In China, for example, almost every TCM hospital has electric cupping machines. With this system the cup is attached to the machine via a small suction tube where the suction strength and duration can all be adjusted and controlled electronically by the practitioner. The machines are expensive, bulky and are rarely used in the U.S. Another type of cup is the Screw-top cup. A handle on top of the cup is turned clockwise pulling a piston upwards which in turn creates the negative pressure necessary to do cupping. Valve cups are yet another type. Here the cup has a small valve at the top. Suction is created by attaching a small pump to the valve of the cup and pumping out the air. A popular cupping device for young children is the rubber cup. The practitioner simply squeezes the cup and places it on the desire acupuncture point. When the cup is released a vacuum is created. Generally, the cup is left in place for about 10 minutes (typical range is 5–15 minutes). The skin becomes reddened due to the congestion of blood flow. The cup is removed by pressing the skin along side it to allow some outside air to leak into it, thus equalizing the pressure and releasing it.
Besides the different types of cups, there are also different methods of doing cupping. The most popular methods are Weak, Medium, Strong, Moving and Needle. The first three methods have to do with the suction strength.
Weak cupping is considered tonifying (versus sedating) and is mainly used when Qi and Blood are deficient. Weak cupping can also be used when there is stagnation (of Qi and/or Blood) along with deficiency. This is the gentlest method of all and is particularly suitable for debilitated adults, elderly patients and young children, especially those under 7 years of age. This is a great technique to tonify the Qi and Blood of the weak and frail.
Medium cupping, also considered a tonifying technique, is the most common method used on patients with a relatively strong Qi, and children over 7 years of age. Joint pain, stress-related conditions, and children's ailments can all benefit from medium cupping technique.
Strong cupping is the most draining technique of all. For this reason the patient must show excess signs. The pulse, tongue, and observation diagnosis must all indicate excess before using Strong cupping. This method is mainly used to move Qi and Blood and eliminate internal and external pathogenic factors and stagnation from patients with a relatively strong Qi. It is particularly beneficial in the treatment of Frozen Shoulder.
Moving cupping Sometimes the cup may be moved while the suction of skin is active, causing a regional pulling of the skin and muscle. Moving cupping is the second most draining cupping technique (Strong cupping being the most draining), and as such it should only be used during excess conditions. It is usually done on the back (Bladder channel) after applying a thin coat of massage oil to reduce the amount of friction. Neurological conditions such as paralysis or post-stroke weakness can benefit from this cupping technique.
Needle cupping, also a draining technique, is the combination of acupuncture and cupping. After the needle is inserted in the required acupuncture point, a cup with either medium or strong suction is applied on top of the needle. Painful joints that are red, swollen and hot can benefit from Needle cupping where there is a need to stop the pain and remove the excess pathogenic Heat at the same time.
It is not uncommon to have markings in the area where cupping was done. This discoloration is the result of the release and clearing of stagnation and toxins from the body. This reaction is not bruising, but due to cellular debris, pathogenic factors and toxins being drawn to the surface to be clear away by the circulatory system.