Quick Answer: What Is Cupping?
Cupping, known in Chinese as baguan (拔罐, báguàn), creates suction against the skin using a cup. It belongs to medical traditions in China and other regions, including the Middle East.[1]
- Historical images and surviving cups document particular periods and settings.
- Dry versus wet describes whether the skin is pierced; fire versus pump describes how suction is produced.
- Clinical findings depend on the condition, method, comparison and outcome studied.
Cup marks are not proof of successful treatment. This guide explains the practice and its evidence, rather than providing instructions for heating cups or bloodletting.
The circular marks attract attention, but they reveal little about the exact procedure. A useful account starts with the cup, the way it is used and the question being asked. That makes both historical objects and modern research easier to interpret.
Chinese Historical Evidence in Images and Objects
Within traditional Chinese medicine (中医, zhōngyī), cupping has a material and visual history. An illustration from an 1887 Chinese medical book depicts a vessel called huoguan (火罐, huǒguàn), or fire pot. Its historical explanation related the vessel to dispelling cold, reflecting the medical framework of its setting.[2]
A surviving brown ceramic cupping cup provides another witness. Its collection record states that it was collected in Chinanfu, China, in 1897. That date records collection, not a known manufacturing year or the invention of cupping.[3]
Later equipment shows another setting and technology. A dry-cupping set made in Japan in 1980–1990 included graded glass cups connected to a small pump. Its catalogue links it to a British practitioner’s surgery, with an associated date around 1996.[4]
These records document particular objects and movements between settings. They do not support a simple story in which one inventor created every form, or every later practitioner followed one unchanged technique. Historical use and present-day clinical benefit also remain different questions.
Dry or Wet Is Different From Fire or Pump
Dry cupping does not intentionally pierce the skin. Wet cupping includes piercing the skin so that blood can enter the cup.[1]
Fire and pump refer to another distinction: some approaches use heat to create suction, while others use a mechanical suction device. These are ways of producing negative pressure, rather than synonyms for wet and dry.[1]
The two questions should therefore be asked separately. Is the skin being pierced? How is suction generated? A pump does not, by itself, identify every other aspect of a treatment, and dry cupping does not necessarily mean that no heat is used.
The exact method matters for research too. Results from moving dry cups alongside physiotherapy cannot automatically be applied to wet cupping, a different body area or another combination of treatments.
What Modern Studies Actually Compare
Pain is a major research focus, but positive findings against usual care and findings against sham procedures answer different questions. The following examples show why the comparison deserves attention.
| Élément de preuve | Comparison and finding | Limite principale |
|---|---|---|
| 2021 randomized trial: 90 participants | Dry cupping versus sham cupping over eight weeks for chronic nonspecific low-back pain. Pain and other clinical outcomes showed negligible between-group effects. | The finding concerns that dry-cupping protocol and population, rather than every form of cupping.[5] |
| 2024 review: 11 trials, 921 participants | Some pooled analyses favoured cupping for pain or disability, with effects varying by comparison, timing, technique and low-back-pain classification. | Substantial differences among studies complicate certainty and broad conclusions.[6] |
| 2026 small trial: 40 participants | Moving dry cupping plus physiotherapy versus sham cupping plus the same physiotherapy. Primary pain and disability differences were not significant at four or six weeks. | Small numbers and imprecise estimates made the primary findings inconclusive; they did not establish equivalence.[7] |
The 2026 trial also reported an advantage on a secondary physical quality-of-life measure. That should not be substituted for a demonstrated improvement in its primary pain and disability outcomes, or omitted when describing the result.[7]
These distinctions help avoid two shortcuts: treating every positive study as proof for all uses, or treating a nonsignificant result as proof that two treatments are identical. Look for the actual population, procedure, control group, outcome and follow-up before applying a headline to a personal health decision.
Skin Marks, Infection Control and Other Risks
Cupping can leave temporary marks. It can also cause persistent discoloration, scars, burns or infection, and may worsen eczema or psoriasis. Rare serious problems include anaemia after repeated wet cupping.[1]
Blood or other potentially infectious material can contaminate equipment. The risk is not limited to an obviously blood-filled cup: appropriate infection-control procedures and handling of used instruments remain important.[8]
A professional discussion should identify the method, relevant training, skin and health considerations, expected outcomes and alternatives. Ask how equipment is disposed of or properly processed between people, and what symptoms after treatment require medical attention. Familiarity with a cultural practice does not replace those practical questions.
Explain recent cupping marks to healthcare providers so they can interpret them in context. The appearance of a mark is not a validated diagnosis of a toxin, nor a scale showing how much benefit a person received.
For related procedures, see gua sha and acupuncture. Their different techniques call for their own evidence and safety discussions.
FAQs About Cupping
Do darker cup marks mean that treatment worked better?
No. A visible skin response does not measure improvement in pain, function or disease. Judge the agreed health outcome rather than the colour of the marks.
Does all cupping involve fire?
No. Mechanical suction devices are also used. Heat-based suction and pump-based suction are different approaches.[1]
Does no significant difference prove that two treatments are equivalent?
No. An imprecise small trial can leave the question unresolved. The 2026 study explicitly did not establish equivalence between its moving dry-cupping and sham protocols.[7]
Is wet cupping just another form of dry cupping?
The skin-breaching step is a material difference. Wet cupping involves blood collection, so it should not be treated as an interchangeable version of an intact-skin procedure.[1]
Sources
[1] National Center for Complementary and Integrative Health. Cupping
[2] Wellcome Collection. Chinese Woodcut: Medical Instrument—Cupping Vessel, from an 1887 Medical Book
[3] National Museum of American History. Cupping Cup, MG.143017
[4] Science Museum Group. Cupping Set for Dry Cupping Vacuum Therapy, Japan, 1980–1990
[5] Silva HJA, Barbosa GM, Silva RS, et al. Dry Cupping Therapy Is Not Superior to Sham Cupping to Improve Clinical Outcomes in People With Non-Specific Chronic Low Back Pain: A Randomised Trial
[6] Zhang Z, Pasapula M, Wang Z, et al. The Effectiveness of Cupping Therapy on Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Control Trials
[7] Pourahmadi M, Sahebalam M, Ahmadi M, Bagheri R. Dry Cupping Therapy for Non-Specific Chronic Low Back Pain: A Prospective, Randomized, Sham-Controlled, Single-Blind Trial
[8] Nielsen A, Kligler B, Koll BS. Safety Protocols for Gua Sha (Press-Stroking) and Baguan (Cupping)