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Not medical advice. The Atlas is not a substitute for a clinician who can examine you.

Cupping Therapy

The Suction Cups That Crossed Every Ancient World

Evidence grade 1 of 5, Untested. Read how the Atlas grades evidence.

Evidence is limited and generally low-quality. Some small trials and reviews suggest cupping may offer short-term relief for certain musculoskeletal and neck/back pain, but studies are often poorly controlled and blinding is nearly impossible (the marks give it away), so a large ritual/expectation component is likely. There is no good evidence it "detoxifies" or treats internal disease. The honest verdict is "traditional-use with weak, mixed support for short-term pain", a practice that may help people feel better, with mechanisms that are mostly non-specific.

Reference only. Not medical advice.

What can go wrong

Dry cupping is generally low-risk and leaves characteristic circular bruises, not injuries, that fade over roughly one to ten days. Fire cupping adds a burn risk from the flame and hot rim. Wet cupping (hijama), which involves small skin incisions, carries real infection and bleeding risk and demands strict hygiene with disinfection, sterile single-use equipment, and safe waste handling. Documented case reports include disseminated Staphylococcus aureus infection with organ injury after wet cupping (BMC Complementary Medicine and Therapies, 2023) and a fatal necrotizing fasciitis case (Cureus, 2021). NCCIH also notes rare serious harms including bleeding inside the skull after scalp cupping and anemia from repeated wet cupping. It is inadvisable for people on blood thinners or with bleeding, clotting, or other serious medical conditions. Anyone who is pregnant, managing a chronic illness, or considering wet cupping should consult a qualified healthcare provider first, and cupping should never replace effective treatment for a serious condition.

Cupping is one of the most widely shared healing practices in recorded history. The same basic act, applying suction to the skin to draw something toward the surface, shows up in ancient Egyptian and Greek medicine, across the Islamic world as hijama with religious significance, in Chinese medicine, and in folk traditions from Finland to Latin America. That near-universality is the genuinely interesting part, an idea intuitive enough that many peoples arrived at it. The modern evidence is thin. A handful of small trials suggest short-term relief of musculoskeletal pain, but the effect tends to vanish once treatments are compared against a sham, and blinding is close to impossible because real cupping leaves round marks. There is no credible support for the claim that cupping removes toxins or treats internal disease. Dry cupping is generally low-risk and leaves bruises that fade in days. Wet cupping, which involves small skin incisions, carries real infection and bleeding risk and has been linked in case reports to serious harm.

Suction cups used for healing from ancient Egypt to Greek, Islamic, and Chinese medicine, weak modern evidence for short-term pain, but a remarkable story of a practice nearly every culture reached.

How it is supposed to work

Proposed mechanisms include increased local blood flow, connective-tissue and fascial effects, mild counter-irritation and pain-gate modulation, and a substantial relaxation and ritual (meaning) component. The traditional rationale, drawing out "stagnation," "bad blood," or imbalanced humors, reflects each culture's theory rather than a demonstrated mechanism.

What people get wrong

  • Often saidThe circular marks are toxins being pulled out of the body.

    ActuallyThe marks are bruising, broken capillaries near the skin caused by suction, not toxins. NCCIH and the American Cancer Society state the evidence does not support detox claims, and Wikipedia's medical summary notes that assertions cupping removes unspecified toxins are unsupported.

  • Often saidCupping is a single tradition, essentially just Chinese medicine.

    ActuallyCupping is one of the most widely shared therapies in history, documented in Egyptian, Greek and Roman, Islamic (hijama), Chinese, and European and Latin American folk medicine. It is a genuinely cross-cultural practice rather than the property of one lineage.

  • Often saidTrials prove cupping relieves pain.

    ActuallyThe trials that show benefit are almost all unblinded, and a treatment that leaves round marks is very hard to blind. In the placebo-controlled trials that exist, such as Lauche et al. 2016 in fibromyalgia and a 2025 knee osteoarthritis trial, real cupping performed no better than sham, which points to a large expectation and ritual component.

Who profits, and who pushes back

  • Cupping-trial reviewers

    mixedSystematic reviewers

    Find low-quality evidence of possible short-term relief for some musculoskeletal pain, limited by poor blinding and a likely large non-specific (ritual) effect.

  • Medical historians

    endorsesHistory-of-medicine scholars

    Document cupping across Egyptian, Greek, Islamic, and Chinese medicine, one of the most broadly shared therapies in the human record.

  • Hijama practitioners

    endorsesTraditional/religious cupping

    Value wet cupping for its cultural and spiritual meaning as well as perceived relief, emphasizing hygienic practice.

  • Infection-control clinicians

    cautionsSafety view on wet cupping

    Warn that wet cupping involves skin incisions with real infection and bleeding risks and is inadvisable for those on blood thinners or with clotting disorders.

Where the research comes from

Most of the published research on this comes from one place. 100% of it is from Practiced across many cultures, ancient to modern. Findings that no unrelated group has reproduced are weaker than the study count makes them look.

Share of published research by country of origin.
PlaceShare of published research
Practiced across many cultures, ancient to modern100%

How we got here

Cupping appears in some of the oldest surviving medical records. Ancient Egyptian texts including the Ebers Papyrus, dated around 1550 BCE, describe cupping for fever, pain, and other complaints, and Egyptians are often credited with passing the method to the Greeks. Hippocrates and later Galen used it in Greek and Roman medicine, frequently paired with bloodletting. In China the Taoist physician Ge Hong, in the third to fourth century CE, is associated with early cupping, which became a fixture of traditional Chinese medicine. Across the Islamic world it developed as hijama, recommended in hadith attributed to the Prophet Muhammad and detailed by Ibn Sina, known in the West as Avicenna, in his Canon of Medicine, which gave it lasting religious and clinical standing. It persisted in European folk practice, including Finnish sauna cupping with horn cups and Eastern European Jewish communities, and in Latin American folk medicine. It faded from Western biomedicine, then returned to popular attention in the 2010s through athletes.

  1. c. 1550 BCEEbers Papyrus and other Egyptian texts describe cupping for fever and pain
  2. c. 400 BCEHippocrates uses cupping in Greek medicine; later adopted by Galen and Roman surgeons, often with bloodletting
  3. 3rd-4th c. CEChinese physician Ge Hong associated with early cupping; it becomes central to traditional Chinese medicine
  4. 7th c. CE onwardDevelops across the Islamic world as hijama, recommended in hadith attributed to the Prophet Muhammad
  5. c. 1025 CEIbn Sina (Avicenna) documents cupping in the Canon of Medicine, cementing its clinical and religious role
  6. 15th c.Wet cupping documented in Finland, traditionally performed in saunas with valved cattle-horn cups
  7. Late 19th-early 20th c.Recedes in Western biomedicine while persisting in folk and traditional practice worldwide
  8. 2016Cupping marks on Michael Phelps and other Rio Olympic athletes bring it renewed popular attention and study

How it is understood

Cupping, placing heated or suction cups on the skin to draw blood to the surface (and sometimes, in "wet" cupping/hijama, to draw small amounts of blood), is one of humanity's most widely shared therapies. It is documented in ancient Egypt, in Greek Hippocratic medicine, across the Islamic world as hijama (where it carries religious as well as medical significance), in Chinese medicine, and in folk practice from Finland to Latin America. The round marks it leaves became globally familiar when modern athletes appeared covered in them.

At a glance

Forms
Dry cupping; wet cupping (hijama)
Found in
Egypt, Greece, China, Islamic world, folk Europe
Best (weak) evidence
Short-term musculoskeletal pain
The marks
Bruises, not injuries; fade in days

What this entry does not yet cover

What follows is unfinished work on our side, not a finding about Cupping Therapy. A short entry is not a safe entry.

  • Cost and market. We have not documented what it sells for or who sells it.
  • Supply chain. We have not mapped where it is made.
  • Who uses it. We have not documented the user groups.
  • What could change. No forward-looking summary yet.
  • How it compares. We have not set it against the alternatives.
  • Children and teenagers. We have not checked what is known about younger people.
  • What people take it for. We have not catalogued the claims made for it.

Sources