The essential mechanism of cupping is best described as “vacuum applied to the skin surface for a therapeutic effect”. In this short piece, I aim to present its versatility by first looking at its long cross-cultural history, and then to its compatibility with other modalities, based on the fact that it can be practised either as a stand-alone treatment or applied in combination with other therapies. It is a benevolent, non-invasive treatment, and by its very nature of drawing outwards it brings about the immediate advantage of alleviating the effects of injury and pain -which can be caused by a range of factors, including trauma and stress related problems that produce tightness and contracture. Cupping at a basic physiological level promotes a local increase in blood supply to the tissues, and reverses and neutralises the inward nature of contracture,i n doing so relieving stasis and discomfort.

The Three Phases of Cupping’s History

Vacuum applied to the skin surface for a therapeutic effect has been a primary response to discomfort since early humankind first sucked at stings and injury to withdraw intrusions and relieve pain. This ability to respond probably appeared during a certain stage of proto-humanoid development. A basic example of what now could be counted as an instinctive response is when we suck at a sore finger after it has been jammed. Homohabilisin Tanzania around 2 million years ago probably had cause to do just this while building the world’s first construction –a windbreak made by piling stones on top of each other.

Phase One of cupping's mammoth therapeutic career began within humankind’s first complex medical tradition, known as supernaturalistic curing. In this paradigm, the mysteries of illness, suffering and unexplainable death are attributed to malevolent otherworldly influences, such as spirits, ghosts, disgruntled ancestors, or alternatively by the infliction of an extraordinary power such as the evil eye. It is the shaman, the person endowed with the power and special skills required to mediate between these forces who is entrusted to carry out treatment and bring about a cure. Besides ceremonies of conciliation, the most important physical intervention performed upon the patient is sucking at the skin surface to withdraw whatever harmful intrusion has made its way inside the body or soul. Mircea Eliade(1989: 256), a professor of the history of religion and renowned scholar of shamanism describes suction as “a classic method of cure”.

I have called the traditional/naturalistic era of cupping Phase Two. The first historical evidence of cupping performed by using medical technology comes from Greece during the late 6th to early 5th century BC. Shortly afterwards cupping was championed by Hippocrates and his followers, who began a new way of viewing the cause of illness by linking pain and suffering to natural causes in much the same way that we do today. Cupping thereby successfully made a paradigm jump, and vacuum was recommended to draw out pathogenic influences and harmonize imbalances, somewhat akin to some of its traditional applications in Chinese and Islamic medicine and Ayurveda. The Greeks used cups made of bronze and their shape was almost the same as the Chinese glass cups we are familiar with today. Indeed the Greeks intentionally made their cups with a lip, a neck and belly (all body metaphors) in the manner that the mouth is formed to draw air into the body. Try sucking air in with your mouth wide open compared to rounding the lips as if drawing through a large straw. During this era, known as the beginning of the Western medical tradition, cupping was so well regarded that the cupping vessel became the symbol of the medical profession in the same way that the stethoscope identifies the modern biomedical doctor. Numerous coins were minted as well with depictions of cups on one side and Asklepios, the God of Medicine, on the other.

Phase Three belongs to what I coined as “Modern Cupping Therapy” by virtue of new recently designed non-flame cups facilitating a new set of treatment applications that are based on and best described by modern anatomical perspectives. For example, small facial cups can be applied to clear sinus congestion, ease temporomandibular pain, clear skin conditions including rosacea, and ease headache as well as benefit the complexion. However the most striking has been the application of new flexible silicone cups to maneuver easily and have an undeniable mending effect on discordant fascia, a tissue that up until recently was never considered worth investigating, let alone becoming a treatment focus.

Cupping’s Versatility as a Complement to Other Therapies

Having established cupping’s versatility as a cross-cultural practice spanning thousands of years, the second point I would emphasize is cupping’s versatility as a complement to other therapies. In many respects I should like to talk briefly about this based on conversations with past students of mine. Acupuncturists of course have a strong link with cupping because it is a recognised component of traditional medical practice. One interesting practice where the two go hand in hand and bring about an exponential gain is when a cup is placed over an acupuncture needle. The needle draws and regulates the qi while the cup removes blockages by withdrawing pathogenic factors such as wind or coldness. Massage therapists can get great benefits from practising cupping. Not only does it produce better treatment effects in some instances, but it also allows the therapist to rest the hands. Sliding cups after a base of oil has been smeared on the body surface also allows the massage therapist to perform facial release and supports the reknitting of errant fascia, which is so critical in massage therapy nowadays. Chiropractors, osteopaths and physical therapists (physiotherapists in Australia) have also reported that cupping has been a boon for them in practice. One of the gains for them has been how efficiently cupping can release the soft tissue before performing a manipulation. The list of possibilities and advantages for all kinds of therapists is long and extensive.

I hope that this brief summary will encourage more practitioners to seek out training and become proficient in this deep and significant therapy.