Fire cupping uses heated cups placed on the skin to create suction, which supporters say boosts blood flow. Evidence is limited, and burns are a risk.
What it is
Fire cupping is a traditional practice from Chinese and Middle Eastern medicine. A flame heats air in a glass cup, which is placed on the skin. As the air cools, suction forms and pulls the skin into the cup.
Duration
Cups stay on for 5 to 15 minutes.
Claims
Boosts blood flow, relieves muscle pain and removes toxins.
Evidence
Small studies suggest possible short-term pain relief, but quality is low. A 2015 review found limited evidence.
Marks
Round circular bruises last 1 to 2 weeks.
Risks
Burns, bruising, skin infection.
Safety
Avoid with blood thinners, skin conditions, pregnancy, and don’t try it unlicensed.
Alternatives
Massage and heat.
Popularity
Michael Phelps wore cupping marks at the 2016 Olympics.
Procedure
A practitioner places glass, silicone or plastic cups on the skin. Heat from a flame or a pump creates suction. The cups remain for about 5 to 15 minutes, and in a dynamic method they are moved with oil.
Traditional use
Cupping has been used in Chinese, Egyptian and Middle Eastern medicine for thousands of years. It is mentioned in the Ebers Papyrus from about 1550 BC.
Why it leaves marks
The suction pulls blood to the surface and breaks small capillaries, leaving round bruise like marks that last 3 to 10 days. They are not true bruises from injury, but still show tissue effect.
What research says
Reviews of clinical trials report that cupping may reduce chronic neck and back pain, but the quality of evidence is generally low, with small studies and difficulty in blinding. Researchers cannot yet confirm the mechanisms.
Side effects
- Skin discoloration, mild pain and soreness.
- Burns from fire cupping.
- Skin infections if tools are not sterile.
- Rarely, scarring or worsened eczema.
Who should avoid it
People on blood thinners, those with clotting disorders, skin diseases, pregnant women (on the abdomen and lower back) and the very young or old should avoid it or ask a doctor first.
Choosing a practitioner
Use a licensed acupuncturist or trained therapist who uses new or properly sterilized cups. Fire cupping should only be done by a trained professional.
Cost
A session typically costs 40 to 100 dollars in the US, depending on location.
What research says about effectiveness
A 2012 systematic review in PLoS ONE covering 135 trials found some positive results for cupping in pain, but the authors noted that study quality was low, with many trials at high risk of bias. Later reviews reached similar conclusions: evidence for neck and back pain is limited and not strong enough to call cupping an established treatment. Cupping gained wide attention at the 2016 Rio Olympics when swimmer Michael Phelps appeared with circular marks. The marks are not bruises from injury but small areas of broken capillaries (ecchymosis) from the suction, and they fade in about 3 to 10 days. In fire cupping, a flame briefly heats the air inside a glass cup, and as the air cools the cup grips the skin.
Risks and who should avoid it
Fire cupping can cause burns, blisters, skin infections and scarring, and reported adverse events in reviews include these. It should be avoided by people who take anticoagulants, have bleeding disorders or skin infections, and by pregnant women on the abdomen and lower back. Choose a licensed practitioner who uses sterile or single use supplies, and never use flammable liquids near the skin. Sessions often cost about 40 to 100 USD in the US. Talk to a doctor before using cupping in place of treatment for a diagnosed condition.
Based on data from PLoS ONE and the National Center for Complementary and Integrative Health
