What Is Cupping Therapy? How It Works, Benefits and Cost

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Health

What is cupping therapy? How it works, types from fire cupping to cupping massage and acupuncture with cupping, benefits, marks and £60 sessions in Chiswick.

What Is Cupping Therapy? How It Works, Benefits and Cost

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Cupping therapy uses suction cups placed on the skin to draw the underlying tissue upward, creating negative pressure rather than the compressive pressure used in massage. It has existed in various forms across several traditional medical systems for centuries, including Traditional Chinese Medicine alongside acupuncture, and has gained wider recognition more recently, partly through visible circular marks seen on some elite athletes.

This guide explains what cupping therapy is, how it works, the different types available, what the evidence supports, how it compares with massage, what it costs, and what to realistically expect.

What is cupping therapy?

Cupping therapy is a treatment in which cups are placed on the skin and the air inside is drawn out, so that suction lifts the skin and the muscle layer beneath it. It is used mainly to ease muscle tension, stiffness and localised pain, most often in the back, neck and shoulders. In the UK it is usually delivered by practitioners of Traditional Chinese Medicine, physiotherapists and sports therapists, and it is commonly combined with acupuncture or massage rather than used alone.

You may also see it called fire cupping, when a flame is used to create the vacuum, or hijama, which refers to the wet form. For a short summary of its main uses, see what cupping is good for.

How does cupping work?

A cup, traditionally glass or bamboo and now often plastic or silicone, is applied to the skin with suction created either by heat, historically using a flame to remove oxygen from a glass cup, or more commonly today using a manual or mechanical pump.

The suction draws the skin and superficial tissue upward into the cup, stretching the fascia and muscle beneath and drawing blood into the area. This is the opposite mechanical action to massage, which compresses tissue, and it is the basis for cupping being described as producing effects that complement rather than duplicate other manual therapies.

Types of cupping

Static (stationary) cupping

Cups are placed and left in position for a set period, typically 5 to 15 minutes, without being moved. This is the type most associated with the circular bruise-like marks sometimes seen afterwards.

Dynamic (moving) cupping, or cupping massage

Often called cupping massage, this is where oil is applied to the skin and the cups are moved across the area while suction is maintained, similar in feel to a massage but working through negative rather than positive pressure. This produces less marking than static cupping.

Dry cupping

The cup alone, with no other intervention. The most common form in an acupuncture or sports therapy setting.

Wet cupping

Involves a small incision before the cup is applied, drawing a small amount of blood. This is a distinct practice with different risk considerations and is not typically what is offered in most Western clinical settings.

Hot cupping and fire cupping

Hot cupping, also called fire cupping, is the traditional method. A flame is held briefly inside a glass cup to heat the air, and the cup is placed on the skin straight away. As the air cools it contracts, creating the suction. The cup itself is not hot when it touches the skin. Most clinics, including ours, now use a hand pump instead, which gives the same suction with finer control and no risk of burns.

Acupuncture with cupping: how cupping is used in acupuncture

In Traditional Chinese Medicine, cupping is often combined with acupuncture in the same session. Needles are placed first, and cups are then applied over the surrounding muscle, usually across the back and shoulders. This combination is the most common way cupping is delivered in UK acupuncture clinics. For how the two compare on their own, see cupping vs acupuncture.

Flash cupping

Rapid repeated application and removal of suction across an area, generally used to stimulate circulation without static marking.

Wet vs dry cupping: what is the difference?

Dry cupping uses suction alone. Nothing breaks the skin, and the cups are either left in place or moved across oiled muscle. It is the form used in most UK acupuncture, physiotherapy and sports therapy clinics.

Wet cupping, widely known as hijama, adds a step. After a first round of suction the practitioner makes small, shallow incisions in the skin and reapplies the cup to draw out a small amount of blood. It has a long history in Islamic and Middle Eastern traditional practice, and many people seek it for religious and cultural reasons as well as for health.

The practical differences are these:

Risk. Because wet cupping breaks the skin, it carries risks of infection and scarring that dry cupping does not. It requires sterile single-use blades and cups, and clinical waste disposal.
Evidence. Neither form has been shown to be clearly better than the other for musculoskeletal pain. Claims that wet cupping removes toxins or "bad blood" are not supported by good evidence.
Suitability. Wet cupping is not appropriate for anyone taking anticoagulant medication or with a bleeding disorder.

Omnia Lifestyle offers dry cupping only, either as a dedicated 30-minute session or within acupuncture treatment. We do not offer wet cupping or hijama. If you are looking for hijama, choose a practitioner who uses sterile single-use equipment and can explain their infection control procedures. More detail is in our answer to is cupping safe.

Why cupping marks the skin

The circular marks that sometimes follow static cupping result from the negative pressure drawing blood into the capillaries near the skin surface. This is a form of bruising, though typically less tender than an impact bruise, and it fades over the following days to two weeks depending on the intensity and duration of suction used.

Marking is not required for cupping to have an effect, and lighter suction or dynamic cupping produces less marking while still delivering the treatment. If visible marking is a concern, for example ahead of an event or photographs, mention this before treatment so the approach can be adjusted.

Does cupping work?

For muscle and joint pain, probably yes, to a modest degree and mostly in the short term. For anything beyond that, the evidence is not there.

Systematic reviews of trials in chronic neck pain and lower back pain find that people who receive cupping report less pain and better function than people who receive no treatment or other control treatments. A 2018 review in BMJ Open, for example, found that cupping reduced neck pain compared with no treatment or active treatment, but rated the evidence as low quality. The weakness is that cupping is very difficult to test blind, and comparisons with sham versions are less consistent: a 2025 review of dry cupping for chronic low back pain found it better than placebo in only one of the trials it included. The US National Center for Complementary and Integrative Health (NCCIH) says most cupping research is of low quality and that cupping may help reduce pain, but the evidence for this is not very strong. That does not make the relief less real for the person who feels it, but it is a reason to be cautious about strong claims. The section below sets out the evidence claim by claim.

Cupping therapy benefits: what the evidence supports

An honest account here matters, since cupping is marketed with more confidence than the evidence currently supports.

Musculoskeletal pain, particularly neck and lower back pain, has the most supportive evidence, with some trials showing benefit over no treatment, though study quality varies and effects compared with credible sham treatment are less consistently demonstrated.

Subjective muscle tension and stiffness is commonly reported to improve by people who have cupping.

Range of motion and function improved in some studies, although, as with pain, the evidence is mostly low quality.

Claims to treat specific internal conditions, detoxify the body, or produce effects beyond the local tissue are not supported by good evidence. NCCIH says there is not enough high-quality research to say whether cupping helps conditions other than pain, and such claims should be treated with the same scepticism applied to similar claims made elsewhere in traditional practice.

The realistic position is that cupping is a reasonable adjunct within an acupuncture-based treatment for musculoskeletal complaints, useful for some people, with a modest and mostly short-term evidence base.

Cupping for back pain

Lower back pain is the most common reason people ask about cupping, and it is the most studied use. Cups are usually placed either side of the spine over the long muscles of the lower back, and often over the glutes or between the shoulder blades as well. They are left in place for five to ten minutes, or moved along the oiled muscle.

Trials in lower back pain report short-term reductions in pain and disability compared with control treatments. A 2017 meta-analysis in the Journal of Back and Musculoskeletal Rehabilitation found lower pain and disability scores with cupping, but noted that high variation between studies and risk of bias limit the findings. A 2024 review in Complementary Therapies in Medicine found improvements in pain at 2 to 8 weeks and called for longer studies, so benefit beyond a few weeks has not been established. Cupping is most likely to help where muscle tightness and guarding are a large part of the problem. It is less likely to help pain driven mainly by an irritated nerve, such as sciatica.

It works best as one part of a plan that also includes movement and strengthening, since the NHS advises people with back pain to stay active and continue their daily activities. At Omnia Lifestyle, cupping for back pain is used within an acupuncture session and combined with physiotherapy or manual therapy where the assessment points that way. Read more about back pain treatment in Chiswick.

Back pain with numbness around the genitals or buttocks, new bladder or bowel problems, weakness in the legs, fever or unexplained weight loss needs urgent medical assessment, not cupping. The NHS lists loss of feeling around the genitals or anus, changes in your bladder or bowels and weakness or numbness in both legs as reasons to call 999 or go to A&E.

What a session involves

Cupping is rarely offered as a standalone treatment in a clinical setting; it is more commonly used as one technique within a broader acupuncture session, sometimes alongside needling and other traditional bodywork.

The area is usually oiled first if dynamic cupping is planned. Cups are applied with a level of suction adjusted to your tolerance, since this varies considerably between individuals and areas of the body. Static application typically lasts a few minutes per position; dynamic cupping continues for as long as suits the treatment.

Most people describe the sensation as a pulling or tight feeling rather than pain, and it should not be sharply uncomfortable. Speak up if it feels too intense.

At Omnia Lifestyle, cupping is delivered by Dr Jialin Zhu as part of acupuncture treatment. You can book an acupuncture session online and mention cupping when you arrive, or ask about it during your assessment.

How often should you have cupping?

There is no fixed schedule, and frequency should follow the assessment rather than a standard package. For an acute musculoskeletal complaint it is common to have cupping incorporated into weekly acupuncture sessions over a short course, then reduce frequency as symptoms settle. For ongoing tension or maintenance, some people find a session every few weeks sufficient.

Two practical limits apply. Any marking from a previous session should have faded before the same area is cupped again, so static cupping on one area is rarely repeated more often than every one to two weeks. And if you notice no change after a reasonable trial, typically three or four sessions, it is more sensible to review the approach than to continue on the assumption that more will help.

Cupping vs deep tissue massage

People often ask whether cupping is a substitute for massage. Mechanically the two are opposites: massage compresses tissue, cupping lifts it. In practice they are used for overlapping problems, chiefly muscle tension, stiffness and localised musculoskeletal pain.

Deep tissue massage works through sustained, direct pressure and is better suited to broad areas of tightness, to people who want a hands-on treatment, and to those who would rather avoid visible marking. It can be booked as a standalone deep tissue or sports massage appointment.

Cupping is usually part of an acupuncture session rather than booked on its own. It can be useful where direct pressure is poorly tolerated, where a practitioner wants to work on a specific area without compressing it, or alongside needling as part of a Traditional Chinese Medicine approach. Static cupping is more likely to leave marks.

Neither has a clearly stronger evidence base than the other for general musculoskeletal pain, and the choice usually comes down to what the assessment suggests and what you prefer.

Cupping for lymphatic drainage

Some therapists use light, moving cupping as a form of lymphatic drainage massage. Small cups with very gentle suction are glided over oiled skin in the direction of the lymph nodes, on the idea that the lifting action helps fluid move through the tissues just under the skin. It feels lighter than standard cupping and leaves little or no marking.

There is very little research on cupping for lymphatic drainage, and it is not a recognised treatment for lymphoedema. The established hands-on approach is manual lymphatic drainage massage, a gentle technique that follows the lymphatic pathways, from £65 for 30 minutes at Omnia. If you have lymphoedema, or swelling after cancer treatment or lymph node surgery, take advice from your specialist team before having cupping on the affected area. Sudden swelling in one leg, especially with pain, warmth or redness, needs urgent medical assessment, as the NHS lists swelling and pain in one leg among the signs of a deep vein thrombosis (DVT).

How much does cupping cost?

At Omnia Lifestyle, a dedicated 30-minute cupping session is £60. Cupping can also be incorporated within a 60-minute acupuncture session at £80 where the assessment suggests it would help, which is usually better value if you need more than cupping alone. Current prices are listed on the acupuncture booking page. For a fuller breakdown, see how much cupping therapy costs in the UK.

Cupping therapy side effects

Most side effects of cupping are mild, short-lived and limited to the treated area.

Common and expected:

Circular marks, from pink to dark purple, that fade over several days to two weeks
Tenderness or a mild ache in the area for a day or two
Feeling tired, or briefly light-headed when getting up after treatment

Uncommon, and usually linked to excessive suction, long application or poor technique:

Small blisters
Skin irritation, or lasting pigmentation change if marked skin is exposed to strong sun
Burns, where fire cupping is performed carelessly
Infection or scarring, which applies to wet cupping rather than dry cupping

NCCIH lists persistent skin discolouration, scars, burns and infections among the possible side effects of cupping, and notes that it may worsen eczema or psoriasis.

Blistering, broken skin, spreading redness, or a mark that is painful rather than tender is not typical and should be reported to your practitioner. For more on risk, see is cupping safe and the section on who should avoid cupping below.

Aftercare

Marking, if it occurs, typically fades over several days to two weeks
The treated area may feel tender for a day or two, similar to after a deep tissue massage
Keeping the area covered from direct sun exposure while marked reduces the chance of pigmentation change
Staying hydrated is generally advised, as with other manual therapies

Who should avoid cupping, or seek advice first

Anyone taking anticoagulant medication or with a bleeding disorder, given the local blood vessel effects
Pregnant women, particularly over the abdomen and lower back
Anyone with a skin condition, infection, or open wound in the area
People with very thin or fragile skin, including some older adults
Anyone with a pacemaker or similar implanted device, where the area should be avoided
Active cancer, which requires specific medical guidance

Cupping questions we hear most

What does cupping therapy do?

Cupping lifts and stretches the skin and muscle, increases local blood flow and is used to ease muscle tension, stiffness and localised pain. The evidence is strongest for neck and lower back pain, in the short term.

Is cupping a massage?

Moving cupping, where oiled cups glide over the muscle, is often called cupping massage. Static cupping, where cups stay in place, is closer to a treatment than a massage. Both can be combined with hands-on massage.

Does cupping hurt?

It should not be sharply painful. Most people describe a pulling or tight sensation, adjustable by the intensity of suction used.

How long do the marks last?

Typically several days to two weeks, depending on the intensity and duration of suction and individual skin response.

How long does a cupping session take?

A dedicated cupping session at Omnia lasts 30 minutes. Static cups are usually left in place for 5 to 15 minutes, and moving cupping continues for as long as the area needs. When cupping is part of a 60-minute acupuncture session, it takes up part of that time alongside needling. Marks from static cupping usually fade within several days to two weeks; see how long cupping marks last.

Can I have cupping alongside acupuncture in the same session?

Commonly, yes. Cupping is often used as one technique within a broader acupuncture session rather than on its own.

Is cupping the same as Chinese medicine cupping?

The technique originates from several traditional systems, including Traditional Chinese Medicine, where it is traditionally used alongside acupuncture. What is offered in most Western clinical settings is typically the dry, mechanical-suction form rather than the more elaborate traditional applications.

Will it help my specific condition?

Evidence is most supportive for musculoskeletal pain and tension. It is not a treatment for internal medical conditions, and any such claim should be treated with scepticism.

Trying dry cupping with Dr Jialin Zhu

Dr Jialin Zhu, a doctor of Traditional Chinese Medicine, gives dry cupping within acupuncture or as a dedicated 30-minute session for £60, and our page on cupping therapy in London explains what to expect. Book a cupping session online or phone 020 4515 0000; the clinic is at 8 to 9 Bedford Corner, The Avenue, Chiswick W4 1LZ.

Sources

This article is general information, not medical advice. If you have a medical condition or take regular medication, mention this before treatment.

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