Cupping

Cupping comes from the traditional medicine of several regions, China and the Middle East among them. A cup made of glass, ceramic, bamboo or plastic is placed on the skin and suction is created inside it. In Australia, the Chinese Medicine Board of Australia treats cupping as a practice related to acupuncture, and registered practitioners who use it must meet the Board's infection control requirements.

Description

Methods

There are two ways of creating the suction. Either a flame is briefly applied inside the cup to remove oxygen before the cup goes on the skin, or a pump is attached to the cup once it is in place. Cups are placed over acupuncture points, painful areas or reflex zones.

Dry and wet cupping

Cupping takes two main forms, and the difference between them matters for safety, because one breaks the skin and the other does not:

• Dry cupping does not pierce the skin. The cup creates a mild vacuum that acts on the tissue under the skin without drawing blood.
• Wet cupping involves piercing the skin so that blood flows into the cup.

How practitioners explain it

In traditional medicine theory, cupping is said to move qi (vital energy) and blood through the treated area, easing pain and tension caused by stagnation, and to draw out factors that cause disease, so that the body returns to harmony and balance. Victoria's Better Health Channel describes the suction used by acupuncturists as intended to bring blood to the acupuncture point. These are the tradition's own explanations; the research described below has not established them.

Scope

What it includes

• Dry cupping, using suction without piercing the skin
• Wet cupping, in which the skin is pierced
• Cupping as one of the techniques an acupuncturist may use

What it is not

• Cupping is not a proven treatment. There is not enough good-quality research to say whether it helps most conditions. The US National Center for Complementary and Integrative Health (NCCIH) says that most research on cupping is of low quality, that cupping may help reduce pain but the evidence for this isn't strong, and that there is too little high-quality research to draw conclusions about other conditions.
• A 2021 evidence map of 13 systematic reviews found that six reported possible benefits of cupping for conditions including low back pain, neck pain and knee osteoarthritis, but rated most of the reviews as of moderate to critically low quality. A 2023 evidence-mapping study of 14 meta-analyses on pain found no high-quality evidence that cupping relieves pain. It found some moderate-quality evidence for neck pain, low back pain and knee osteoarthritis, and low or very low quality evidence for other pain conditions.

Traditions and lineage

Cupping has been used in traditional and alternative medicine in China, Korea and elsewhere in East Asia, and is part of traditional medicine in the Middle East. In more recent years it has become popular in Europe, the United States and Arabia. In one study in Taiwan, 12.8% of participants said they had had cupping in the previous year.

Context

Within Spiritualism

Spiritfold has found no published source linking cupping with Spiritualism.

In Australian Spiritualism

Spiritfold has found no published source linking cupping with Spiritualism in Australia.

A Spiritualist perspective

Cupping belongs to traditional medicine in China, the Middle East and elsewhere. A Spiritualist would respect it as part of those traditions, not treat it as part of Spiritualism; nothing in the sources above connects the two.

A Spiritualist teacher would keep it well away from the healing chair, and the reason is worth understanding. Spiritual healing is gentle and needs no equipment: the healer attunes to spirit, places hands only with permission, and never marks, pierces or puts pressure on the body. Cupping, by contrast, is a physical procedure with real risks, which is why registered practitioners in Australia must follow strict infection control rules. Mixing the two would confuse the person receiving healing about what is being offered. A Spiritualist who wished to learn cupping would need to train properly and practise it as separate work, apart from any healing service. Anyone with pain or illness should first speak with their doctor.

Cupping in Australia

Who regulates it

In Australia, cupping is one of the practices covered by the Chinese Medicine Board of Australia's infection prevention and control guidelines, along with needle insertion, moxibustion, laser acupuncture, gua sha and dermal hammering. Registered Chinese medicine practitioners who use these practices must follow the guidelines, the national guidelines for infection prevention and control in health care, and state, territory and local requirements. Better Health lists cupping among the techniques an acupuncturist may use.

Why the guidelines exist

The Board uses the guidelines in its role of protecting the public by setting and keeping standards of practice. Anyone can make a complaint (called a notification) about a registered practitioner, and the guidelines help the Board decide whether action is needed to manage risk to patients. A practitioner whose conduct falls well short of the guidelines should be ready to explain and justify it, and serious or repeated failure to comply may lead to action over their health, conduct or performance.

Safety and good practice

Effects and risks

• Marks on the skin. Cupping leaves marks on the skin for a time. NCCIH advises explaining where these marks came from to health care providers, so that they are not mistaken for signs of physical abuse.
• Skin damage. Cupping can cause lasting skin discolouration, scars, burns and infections, and may make eczema or psoriasis worse.
• Rare severe effects. These have included bleeding inside the skull after cupping on the scalp, and anaemia from blood loss after repeated wet cupping.
• Blood-borne infection. Cups can become contaminated with blood, on purpose in wet cupping or by accident in dry cupping. Reusing equipment on another person without sterilising it between people can therefore spread blood-borne infections such as hepatitis B and C.

Infection control and fire safety

The infection rules follow from a simple principle in the national guidelines the Board relies on: intact skin is a natural defence against infection, and breaks in the skin can let infection in and can also pass it to others. The Board's guidelines for registered practitioners set out, among other things, that:

• cups and other equipment that have touched blood or broken skin, for example cups placed where the skin has been pricked with a dermal hammer, must either be reprocessed to the relevant Australian standard or treated as single-use and discarded
• cups that have touched only intact skin can be cleaned and disinfected
• bamboo cups cannot be properly cleaned, disinfected or sterilised, so they must be used once only and thrown away
• single-use gloves should be worn for procedures that may involve contact with blood, such as cupping after dermal hammering
• flames for cupping should be lit well away from alcohol swabs and other alcohol products, and alcohol-based hand rub must be completely dry before any procedure that involves a naked flame.

Related modalities

• Acupuncture
• Massage
• Shiatsu

Further reading

• Chinese Medicine Board of Australia. Guidelines on infection prevention and control for acupuncture and related practices. Ahpra, 2023.
• Choi, Tae Young, et al. "Evidence Map of Cupping Therapy". Journal of Clinical Medicine, 2021.
• National Center for Complementary and Integrative Health. "Cupping". US National Institutes of Health, 2018.
• Wang, Liaoyao, et al. "Efficacy of cupping therapy on pain outcomes: an evidence-mapping study". Frontiers in Neurology, 2023.