If you’ve been watching the Olympics this year, you may have spotted some strange-looking purplish circles on the skin of athletes, including gold medal swimmer Michael Phelps. These unusual marks appear to be a result of some of the athletes turning to cupping for back pain and other pain during competition. What’s cupping? Let’s take a look.


Cupping is a traditional technique for natural pain relief that has likely caught the attention of Olympic athletes wary of using pharmaceuticals, natural or otherwise, during the Rio games. Cupping is traditionally used to help activate chi (qi) – a person’s life force or energy.

The technique takes just 5-10 minutes and involves the use of plastic or glass cups to create a vacuum on the skin. The practitioner places cups on the skin over the painful area. They might heat the cups or use a pump to create suction, drawing the skin into the cup and pulling blood with it. The degree of suction can burst blood vessels, which is what causes the hematomas seen on Phelps’s skin and on other athletes. Essentially, cupping results in love bites or hickeys that will fade over time.


Practitioners most commonly use cupping therapy for conditions such as:

  • Herpes zoster
  • Facial paralysis (Bell palsy)
  • Cough and dyspnea
  • Acne
  • Lumbar disc herniation
  • Cervical spondylosis.

Lumbar disc herniation and cervical spondylosis can result in lower back pain and neck pain, respectively.


Practitioners claim that cupping stimulates the flow of blood, helping to draw out toxins and help eliminate these from the body. This would, in theory, lead to healthier cellular metabolism and decrease pain from ongoing tissue damage caused by such toxins.

The use of cupping for back pain or other types of pain is controversial. There’s little evidence that the technique is actively harmful, but there’s also very little good evidence of benefits.


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In one recent study, cupping was used to relieve symptoms and improve function in patients with cervicogenic periarthritis of the shoulder (Yuan and Wang, 2015). Cupping was combined with red-hot needle therapy, and compared with routine acupuncture therapy. The patients were treated once daily and once every other day for a period of two weeks.

Researchers found that the cupping and needling group had more significant relief and improvement in daily function than those in the acupuncture group. The study failed to compare either therapy to a placebo, or to administer cupping alone, however. The results cannot, therefore, be taken as quality evidence of benefits linked to cupping itself.

Some other studies also suggest benefits, but, again, the methodology of the studies tended to be unsound.

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A review by Cao and colleagues, for example, looked at data from 135 studies involving cupping. They found that much of the data was of low quality due to poor study design. This makes it difficult to evaluate the benefits of cupping for back pain or other health issues.

Most of the clinical trials looking at cupping for back pain related to cervical spondylosis used wet cupping combined with acupuncture, traction, or other treatments. Trial data showed that combining cupping and other treatments was more effective than other treatments alone. One trial noted that wet cupping was comparable to flunarizine for improving symptoms or cervical spondylosis.

Trials concerning disc herniation and back pain could not be analysed due to variations in methodology. More research needs to be carried out, therefore, in order to assess how useful cupping is for discogenic pain.

Many trials included in this review failed to have a placebo-control. Admittedly, it is difficult to figure out a placebo control for techniques such as cupping and acupuncture. Nevertheless, the placebo effect may account for some or all of the benefits observed, with little good evidence of the efficacy of cupping for back pain.


Cao, H., Li, X., & Liu, J. (2012). An Updated Review of the Efficacy of Cupping Therapy. PLoS ONE, 7(2), e31793.

Yuan, T., & Wang, F. (2015). Clinical Trial of Treatment of Cervicogenic Scapulohumeral Periarthritis by Red-hot Needle Therapy Combined with Cupping. Zhen Ci Yan Jiu, Oct;40(5):415-8.