Cupping Therapy: What Patients Should Know Before Trying It

As a physical therapist, I’m often asked about cupping therapy—especially after high-profile athletes have made those circular marks on the skin instantly recognizable. Cupping is an ancient technique, but its modern use raises an important question: is it actually helpful, or just hype?

Cupping involves placing suction cups on the skin to create negative pressure. This draws blood into the area, which may promote circulation and tissue healing. Cupping therapy is typically used to address musculoskeletal pain, especially in the back, neck, and shoulders.

Benefits: What the Research Suggests

There is some encouraging evidence—particularly for pain management. A 2024 meta-analysis found moderate- to high-quality evidence that cupping can reduce pain and disability in low back pain patients (ScienceDirect). Other systematic reviews suggest cupping may help with chronic pain conditions such as knee osteoarthritis, neck pain, and myofascial pain, though the quality of evidence ranges from low to moderate (PMC).

Clinically, I’ve seen patients report short-term relief, especially when cupping is combined with exercise and manual therapy. Mechanistically, the suction may improve local blood flow, reduce muscle tension, and stimulate the nervous system (Cleveland Clinic).

That said, it’s important to be clear: cupping is best viewed as a complementary treatment, not a primary solution.

Drawbacks and Limitations

The biggest issue with cupping is the lack of strong, high-quality research. While many studies show benefit, results are inconsistent and often limited by small sample sizes or bias. Even systematic reviews note that the evidence is “low to moderate quality” at best (PMC).

Additionally, some studies comparing cupping to “sham” treatments (placebo versions) show no significant difference, suggesting part of the effect may be placebo-driven (ScienceDirect).

From a clinical standpoint, this doesn’t mean cupping doesn’t work—but it does mean we should be cautious about overstating its benefits.

Risks and Side Effects

Cupping is generally safe when performed by a trained professional, but it’s not risk-free. Common side effects include:

• Bruising (which is expected)

• Skin irritation or burns

• Mild soreness

More serious complications—such as infection or, in rare cases, vascular or neurological issues—have been reported, particularly with improper technique (Karger Publishers).

Contraindications: Who Should Avoid It

Cupping is not appropriate for everyone. I typically advise against it for patients who:

• Are on blood thinners

• Have bleeding disorders

• Have open wounds, skin infections, or fragile skin

• Are pregnant (in certain areas)

  
  

There is also caution for older adults or individuals with significant medical conditions, as their tissue tolerance may be lower (Cleveland Clinic).

Is Cupping Right for You?

In my practice, cupping can be a useful adjunct—especially for patients with persistent muscle tightness or chronic pain who haven’t responded fully to traditional care. However, it should never replace evidence-based treatments like strengthening, mobility work, and education.

If you’re considering cupping, ask yourself:

• Am I looking for short-term symptom relief or long-term change?

• Is this being combined with a comprehensive rehab plan?

The bottom line: cupping may help you feel better temporarily, and in some cases meaningfully reduce pain—but it’s not a cure-all. When used thoughtfully and appropriately, it can be one tool among many in a well-rounded physical therapy approach.