Cupping is a therapy in which cups are placed on the skin to create suction, pulling the skin and underlying tissue upward. The suction dilates blood vessels, increases blood flow to the area, and can help relieve muscle tension and pain. You’ve likely seen the telltale circular marks on athletes, celebrities, or someone at the gym. Those marks are the most visible sign of a practice that dates back thousands of years and is still widely used today for pain management, injury recovery, and general wellness.
How Cupping Works
A practitioner places a cup, typically made of glass, silicone, or bamboo, onto the skin and creates a vacuum inside it. The negative pressure pulls skin and soft tissue upward into the cup, stretching the tissue and dilating tiny blood vessels called capillaries. This triggers several responses in the body: blood flow to the area increases significantly, tight fascia and connective tissue loosen, and the local immune system activates through a controlled, mild inflammatory response.
The biological chain reaction is fairly well understood. Blood vessels in the treated area release chemical signals, including histamine and nitric oxide, that widen the vessels further and draw more blood in. This enhanced circulation brings oxygen and nutrients while flushing out metabolic waste products that contribute to soreness and stiffness. At the same time, the suction stimulates peripheral nerves in the skin, which can raise your pain threshold in that area.
Types of Cupping
The main technical types are dry cupping, wet cupping, flash cupping, and massage cupping. Each uses the same basic principle of suction but differs in execution and intensity.
Dry cupping is the most common form. Cups are placed on the skin and left stationary for 5 to 15 minutes. In fire cupping, a flame briefly heats the air inside a glass cup before it’s placed on the skin. As the air cools, it contracts and creates the vacuum. Modern practitioners often use silicone cups that can be squeezed to create suction without any heat, or pump-style cups with a hand valve.
Wet cupping, known as hijama in Arabic medicine, adds a second step. After a brief round of dry cupping to draw blood to the surface, the practitioner makes small, shallow incisions in the skin and reapplies the cups. The suction draws out a small amount of blood. This method has deep roots in Middle Eastern and Islamic medical traditions and is still practiced widely in parts of Asia and the Middle East.
Massage cupping uses oil on the skin so that cups can be slid across muscle groups rather than left in one spot. Flash cupping involves rapidly applying and removing cups in succession to stimulate an area without leaving them on long enough to create deep marks.
What Cupping Treats
Cupping is used most often for musculoskeletal pain, particularly in the back, neck, and shoulders. Clinical trials have tested it against standard treatments with some promising results. In one randomized trial, patients with nonspecific low back pain who received dry cupping for 11 days saw significantly greater pain reduction than a group taking anti-inflammatory medication, with a mean difference of nearly 23 points on a 100-point pain scale. Another trial found that wet cupping plus usual care reduced low back pain by about 2.2 points on a 6-point scale compared to usual care alone.
For neck pain, two German trials tested wet cupping against heat pads and standard care. Both found statistically significant reductions in pain for the cupping groups. One reported a mean improvement of roughly 23 points on a 100-point scale for overall brachial (arm and shoulder) pain, and about 13 points specifically for neck pain.
Beyond back and neck pain, cupping is commonly used for migraines, tension headaches, arthritis, and nerve pain. It has also carved out a niche in sports recovery. Many athletes use it to speed muscle recovery after intense training, and sports-specific cupping protocols target areas prone to overuse injuries. Other applications include facial cupping for cosmetic purposes and abdominal cupping for digestive complaints, though the evidence base for these uses is thinner.
What Those Circular Marks Mean
The round marks left by cupping are not bruises in the traditional sense. A bruise forms when an impact damages blood vessels, causing blood to leak into surrounding tissue. Cupping marks form because the suction pulls blood into the capillaries near the skin’s surface and causes tiny blood vessels to expand beyond their normal capacity. This creates redness, small red dots called petechiae, and sometimes deeper discoloration that looks like bruising.
The marks generally disappear within one to two weeks. Their color can vary from light pink to deep purple depending on how much suction was applied, how long the cups stayed on, and how much stagnation or tension existed in the tissue beforehand. Darker marks in a specific area often indicate that the tissue there had more restricted blood flow prior to treatment. The marks are not typically painful to the touch, though the skin may feel tender for a day or two.
What a Session Looks Like
A full cupping session typically lasts 30 to 45 minutes, including preparation and aftercare guidance. The cups themselves stay on for 5 to 15 minutes depending on the technique and the area being treated. You’ll lie face down or in whatever position gives the practitioner access to the target area. Most people describe the sensation as a deep pulling or tugging, not sharp pain. Some find it immediately relaxing, similar to a deep-tissue massage.
For acute conditions like a recent muscle strain or flare-up of back pain, weekly sessions are common. Chronic pain management and general wellness typically call for biweekly or monthly sessions. Your practitioner will adjust the frequency based on how your body responds.
Safety and Side Effects
Dry cupping is generally considered low-risk. The most common side effects are the circular skin marks, mild soreness at the treatment site, and occasional light-headedness during or immediately after a session. Some people experience temporary skin sensitivity or itching as blood flow increases to the area.
Wet cupping carries additional risks because it involves breaking the skin. Infection is the primary concern if proper sterilization protocols aren’t followed. People on blood-thinning medications, those with bleeding disorders, or anyone with active skin infections or open wounds in the treatment area should avoid cupping. Cupping is also generally not recommended over sunburned skin, varicose veins, or bony prominences where there isn’t enough soft tissue to safely create suction.
Historical Roots
Cupping is one of the oldest documented medical practices. Its exact origin is debated, but descriptions appear in both ancient Egyptian and Chinese medical texts. The Ebers Papyrus, one of the oldest known medical documents from Egypt, references cupping-like techniques. In traditional Chinese medicine, cupping was used to move stagnant qi (energy) and blood. The practice also has a long, unbroken tradition in Middle Eastern medicine, where it’s called hijama and holds cultural and religious significance. Today, cupping is practiced on every continent and has been integrated into physical therapy, chiropractic care, sports medicine, and acupuncture clinics.