Cupping Therapy: What It Is and What the Evidence Says

If you have seen photos of swimmers or athletes with round purple circles on their backs, you have already seen cupping. It is one of the oldest hands-on practices in the world, and it has become popular again in recent years. If you are curious about it, you probably have two simple questions: what actually happens during a session, and does it work? This guide walks through both, honestly, including the parts where the science is thin.

What cupping is

Cupping uses cups placed on the skin to create suction. A practitioner may use glass, ceramic, bamboo, or plastic cups. The suction is made in one of two ways: by briefly heating the air inside a cup with a flame before placing it, or by using a pump that draws the air out. Either way, the skin and the soft tissue underneath get gently pulled up into the cup.

The cups may be left in one spot for a few minutes, or oiled and slid across the skin in what some call "moving cupping." A session often uses several cups at once. Many people describe the feeling as a tight tug or pinch rather than pain.

Cupping comes from traditional medicine systems and is sometimes offered alongside massage or acupuncture. In Canada it is not a regulated profession on its own, so it may be provided by a range of practitioners. If you are booking through a massage clinic, it can help to understand what massage therapy and an RMT credential mean before you go.

Dry cupping versus wet cupping

There are two main types, and the difference matters for both comfort and safety.

Dry cupping uses suction only. The skin is never broken. This is the more common form in Western clinics, partly because it avoids contact with blood and other body fluids.

Wet cupping adds a step. The practitioner makes very small, shallow scratches or pricks in the skin, then applies the cup so that a little blood is drawn out. Because wet cupping breaks the skin, it carries risks that dry cupping does not, including the risk of infection. We will come back to that in the safety section.

The marks

The round marks are the thing people ask about most. During suction, tiny blood vessels near the surface can release a small amount of blood into the surrounding tissue. That leaves a circular mark, ranging from light pink to deep purple depending on your skin and how strong the suction was.

These marks are essentially bruising, and with dry cupping they are an expected result, not a sign that something went wrong. According to a StatPearls medical reference, cupping marks "typically fade over time and gradually disappear within 1 to 10 days after treatment." They are not usually painful, though the area can feel tender.

What the evidence says

Here is the honest part. Cupping has been studied, but the research is mostly small and of low quality, so firm conclusions are hard to reach.

The U.S. National Center for Complementary and Integrative Health (NCCIH), a government research body, puts it plainly. On pain, it states that "cupping may help reduce pain, but the evidence for this isn't very strong." For other health conditions, it says there is "not enough high-quality research to allow conclusions to be reached about whether cupping is helpful." And on the research overall, it notes that "there's been some research on cupping, but most of it is of low quality."

Reviews that pool many studies tell a similar story. An evidence-mapping study of cupping for pain found that low-to-moderate quality evidence suggested possible benefit for some pain problems, such as low back pain, neck pain, and knee osteoarthritis, while stressing that more and better research is needed. In other words, some signals point toward help with certain kinds of pain, but the studies behind those signals are not strong enough to be sure.

A key question researchers ask is whether cupping beats a fake ("sham") version, where a cup is applied without real suction. This helps separate a true effect from the boost people often get simply from receiving attention and care. A 2025 systematic review in JOSPT Open looked at dry cupping compared with placebo cupping for muscle and joint complaints and did not find clear evidence that dry cupping was better than the placebo. Findings like this are why many clinicians treat cupping as an add-on, if it is used at all, rather than a main treatment.

The picture for wet versus dry is also mixed. A review of self-managed cupping for low back pain reported more promising pain results for wet cupping than for dry cupping, but the authors again cautioned that the studies were limited and varied widely in how they were done. Because protocols differ so much from study to study, results are hard to compare.

We share this as a curator, not a cheerleader. Cupping is a contested therapy: some people report feeling better, and some studies hint at modest benefit, but the overall evidence is low-certainty and mixed. We are not able to say it treats, cures, or prevents any disease.

Safety: what to know before you try it

For most healthy adults, dry cupping is generally considered low-risk, but it is not risk-free.

• Marks and skin effects. Bruise-like marks are expected. Less commonly, NCCIH notes cupping can cause "persistent skin discoloration, scars, burns" (from the flame method), "and infections, and may worsen eczema or psoriasis."
• Wet cupping and infection. Because wet cupping breaks the skin, it carries a real infection risk. Equipment should be sterile and single-use, and blades and cups should never be shared. NCCIH warns that unsterilized equipment can spread bloodborne diseases such as hepatitis B and C. Repeated wet cupping has also been linked in rare cases to anemia from blood loss.
• Who should be cautious or avoid it. Medical references advise avoiding cupping over open wounds, and using extra caution for people with bleeding disorders or hemophilia, those taking blood thinners, people with cancer, and those with a pacemaker. Extra care is also urged for people who are pregnant, menstruating, elderly, or very young. Skin over veins, arteries, and nerves is generally avoided.

None of this is a diagnosis, and we cannot tell you whether cupping is right for your body. If you have a health condition or take medication, ask your doctor or a regulated health professional first.

Making a sensible choice

If you decide to try cupping, ask the practitioner about their training and how they clean or dispose of equipment. Choose dry cupping if you want to avoid the infection risk that comes with broken skin. Expect the marks, and know they usually fade within a week and a half. And treat cupping as one possible comfort measure among many, not a replacement for care with stronger evidence behind it, such as exercise and guided rehabilitation.

Many people first meet cupping at a massage clinic, so it can help to know what to expect at a first massage therapy appointment and to compare it with other types of massage and hands-on options. When you are ready to look for someone near you, you can browse registered massage therapists in our directory.

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