Cupping therapy can be broadly defined as a technique involving the placement of cups on the skin to create suction through a vacuum, commonly used to generate negative pressure. This treatment has ancient roots and has been employed worldwide throughout history. Around 400 B.C., Herodotus described both wet and dry cupping as effective treatments for various ailments such as indigestion, loss of appetite, and headaches. Hippocrates recommended wet cupping for gynecological complaints, back and extremity diseases, pharyngitis, lung diseases, and ear disorders. The famous Ebers Papyrus in ancient Egypt (1550 B.C.) also mentioned cupping therapy. In China, cupping was documented as a medical treatment in the Mawangdui texts around 168 B.C. Systematic and detailed information about cupping practice, apart from traditional Chinese medicine sources, is found in the records of Muslim societies that have applied this method since the 6th century A.D.

There are two types of cupping therapy: dry and wet. Dry cupping is non-invasive and does not involve bloodletting. Wet cupping (Hijama) is invasive and includes bloodletting through incisions made with a scalpel.

Negative pressure applied to the skin through cupping creates an expansion of blood vessels and increased blood circulation to the treated area. Consequently, oxygen and nutrient flow to the cells in the region are accelerated. The negative high pressure leads to an increase in blood volume, causing the accumulation of filtered fluids and substances in the intercellular spaces. The collected filtered fluid contains substances related to the disease and factors causing pain, such as prostaglandins and inflammatory mediators. The incisions made with a scalpel stimulate inflammatory cell migration and endogenous opioid release, enhancing natural and acquired immunity. This process leads to improved blood flow, toxin elimination, restoration of neuroendocrine balance, increased oxygen levels, and tissue perfusion.

Various anatomical regions can be targeted for cupping therapy, selected based on the treated condition. Areas abundant in muscles, such as the back, chest, abdomen, hips, and legs, are commonly chosen points for cup placement.

Cupping therapy can be applied to both healthy individuals and those with health conditions.

Local discomforts benefiting from cupping therapy include:

  1. Headaches and migraines
  2. Lower back pain
  3. Neck and shoulder pain
  4. Knee pain

Systemic diseases effectively addressed by cupping therapy include:

  1. Hypertension
  2. Rheumatoid arthritis
  3. Diabetes mellitus
  4. Mental disorders
  5. Carpal tunnel syndrome
  6. Asthma
  7. Chronic infections
  8. Psoriasis

Individuals in the following categories should avoid cupping therapy:

  1. Cancer patients
  2. Those with any organ failure
  3. Users of pacemakers
  4. Individuals with blood disorders like hemophilia
  5. Geriatric patients
  6. Pediatric patients
  7. Pregnant and menstruating women

Anatomical contraindications include areas with deep vein thrombosis, open wounds, and bone fractures. Cupping should not be performed directly on nerves, arteries, veins, varicose veins, skin lesions, body openings, lymph nodes, eyes, or areas with skin inflammation. Those taking anticoagulants and individuals with acute infections generally should avoid cupping therapy. It is imperative that cupping therapy is administered by a qualified physician with legal certification.

In Islamic medicine, cupping is recommended during the third quarter of the lunar month, especially on the 17th, 19th, and 21st days. Research on the effects of lunar phases on blood pressure has shown that average arterial blood pressure is higher during the third quarter of the lunar month in individuals with low physical fitness indices. This result is thought to be related to the gravitational force of the moon and its potential impact on cardiovascular function in humans.

Detailed precautions for infection control are crucial. Handwashing and the use of appropriate protective equipment (gloves, mask, protective eyewear, apron) are essential to prevent the risk of infection transmission. Cups, scalpels, and vacuum pumps used during treatment should be disposable.

Cups should not remain on the skin for more than 5-10 minutes. Marks left by cupping, varying from person to person, typically disappear within 1-10 days. The application of St. John’s Wort oil can expedite wound healing.

REFERENCES

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