Cupping Therapy: An Overview from a Modern Medicine Perspective

Cupping therapy, popularly known in Brazil as "ventosas" and in other countries as "cupping," is a millennia-old practice of traditional medicine that has been gaining prominence in the modern medical world. This ancient technique involves the application of special cups over specific points on the skin, creating a suction pressure that can be produced by heat or by vacuum equipment. Historical documents, including the Ebers papyrus from Ancient Egypt dating to 1550 B.C., already mentioned this practice, which later spread across various cultures, including Chinese, Greek, Arab, and Islamic medicine. The Greek physician Hippocrates, considered the father of medicine, described in detail different types of cupping and their specific applications, demonstrating the historical importance of this therapeutic technique.

This review study, conducted by researchers from the National Center for Complementary and Alternative Medicine of Saudi Arabia, had as its main objective to provide a comprehensive view of cupping therapy from a modern medicine perspective. The authors conducted a detailed analysis of the available scientific literature, examining different aspects of the practice, from its mechanisms of action to its current clinical applications. The methodology involved systematic review of scientific studies, historical documents, and clinical evidence, with the purpose of creating updated and standardized classifications for different aspects of cupping therapy. The study also proposed to establish clear guidelines on indications, contraindications, and safety measures necessary for the safe practice of this therapy.

Although the exact mechanism of action of cupping therapy is not yet fully elucidated, the researchers identified several promising theories. The main hypothesis involves the effects of the subatmospheric pressure created by the cups, which promotes peripheral blood circulation and improves the local immune response. Studies have demonstrated that the therapy can increase blood flow in the skin, modify the biomechanical properties of tissues, raise the pain threshold, improve local anaerobic metabolism, reduce inflammation, and modulate the cellular immune system. The study also presented a new updated classification of cupping therapy types, organizing them into six main categories: technical types, suction intensity, suction method, additional therapies, conditions, and treated areas.

This more detailed classification allows better understanding and standardization of clinical practice.

For patients, the results show that cupping therapy presents promising evidence in the treatment of various conditions, especially those related to pain. Research has demonstrated significant benefits for low back pain, neck and shoulder pain, headaches and migraines, knee pain, facial paralysis, carpal tunnel syndrome, hypertension, diabetes mellitus, rheumatoid arthritis, and asthma. It is important to highlight that the therapy proved to be relatively safe when performed by qualified professionals, with adverse effects generally mild to moderate. For healthcare professionals, the study offers important guidelines on contraindications, including situations where therapy should be absolutely avoided, such as in patients with cancer, organ failure, pacemaker use, or coagulation disorders.

The work also establishes relative contraindications, such as acute infections, anticoagulant use, pregnancy, and anemia.

The study acknowledges some important limitations that should be considered. The main one is the lack of complete understanding of the mechanisms of action of cupping therapy, which indicates the need for more basic and clinical research to clarify exactly how the therapy produces its beneficial effects. In addition, although there is promising evidence for various conditions, the authors emphasize that more controlled and randomized clinical studies are needed to definitively establish the efficacy of cupping therapy in different medical situations. The work also highlights the crucial importance of following rigorous infection control measures, including the use of disposable equipment, adequate disinfection, and personal protective equipment.

For patients interested in this therapy, it is essential to seek properly trained and certified professionals, who can adequately assess individual indications and contraindications. Cupping therapy should not be viewed as a substitute for conventional medical treatments, but rather as a complementary therapy that can offer additional benefits when integrated into a comprehensive treatment plan.