Does Cupping Therapy Actually Work for Pain? What the Science Says

By Dr. Jeffrey Peng, MD · Published March 04, 2026 · 8 min read

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Cupping therapy has gained significant attention in recent years, particularly after high-profile athletes like Michael Phelps appeared at the Olympics sporting those distinctive circular marks. But for patients dealing with chronic musculoskeletal pain, the real question isn't about celebrity endorsements — it's whether this ancient practice actually delivers measurable results. In this post, I'll walk through the current scientific evidence on cupping therapy for pain relief, inflammation, and recovery, and share my own clinical perspective on when it may be worth considering.

What Is Cupping Therapy?

Cupping therapy has roots in traditional Chinese medicine dating back thousands of years, though it has evolved into various forms practiced worldwide. At its core, cupping involves placing cups on the skin to create a vacuum or suction effect. This suction lifts the skin and underlying tissues, and depending on the method used, can serve different therapeutic goals.

There are two primary techniques used today. Wet cupping combines suction with controlled bloodletting — very shallow incisions are made on the skin, and cups are placed over them to draw out a small amount of blood. Practitioners believe this process helps remove toxins and improve overall health. Dry cupping, on the other hand, relies solely on suction without any skin incisions. The cups can remain stationary or be moved across the skin's surface depending on the treatment area and therapeutic goals.

How Does Cupping Therapy Work?

The exact mechanisms of action for cupping therapy are still being researched, but several theories attempt to explain its potential benefits. One of the primary hypotheses is that the suction generated by the cups enhances blood circulation to the targeted area. This increased blood flow may help deliver oxygen and nutrients to tissues, facilitate the removal of metabolic waste products, and support the body's natural healing processes.

Cupping is also believed to alleviate muscle tension and tightness. The suction force can potentially loosen restrictions and adhesions in the muscles and fascia, which may improve range of motion and decrease pain. These proposed mechanisms make cupping an appealing option in sports medicine and rehabilitation settings, though the strength of evidence varies by condition.

Does Cupping Help Knee Osteoarthritis?

For patients with knee osteoarthritis, there is some evidence suggesting that cupping therapy may improve pain and physical function. A systematic review and meta-analysis by Li et al. (2017) examined seven randomized controlled trials and found that patients receiving dry cupping plus conventional Western medicine showed significantly greater improvements in WOMAC pain, stiffness, and physical function scores compared to Western medicine alone. However, the authors noted that most included studies were of low methodological quality, and they concluded that only weak evidence supports cupping's effectiveness for knee osteoarthritis.

Can Cupping Reduce Neck and Low Back Pain?

Neck and low back pain are among the most common reasons patients seek cupping therapy. A systematic review by Wood et al. (2020) evaluated 21 randomized controlled trials involving 1,049 participants and found that dry cupping had a significant effect on pain reduction for both chronic neck pain and low back pain. The review also found moderate-quality evidence that cupping improved functional status in patients with chronic neck pain.

However, not all studies agree. A well-designed randomized trial by Almeida Silva et al. (2021) compared dry cupping to sham cupping in 90 patients with chronic low back pain over eight weeks and found negligible differences between groups for pain, physical function, mobility, and quality of life. This suggests that at least some of cupping's perceived benefits may be attributable to a placebo effect.

A broader meta-analysis by Cramer et al. (2020) examined 18 trials with 1,172 participants and found large short-term effects of cupping on pain intensity compared to no treatment, but no significant effects when compared to sham cupping or other active treatments. This pattern — positive results versus no treatment, but equivocal results versus sham — is a recurring theme in the cupping literature.

Does Cupping Have Anti-Inflammatory and Systemic Effects?

Beyond musculoskeletal pain, some research explores cupping's potential anti-inflammatory and systemic effects. An editorial review by Abbasi and Najafi (2021) discussed emerging evidence that cupping may stimulate the release of anti-inflammatory cytokines and reduce the production of pro-inflammatory molecules, which could contribute to decreased inflammation and associated pain relief.

In terms of cardiovascular and metabolic outcomes, a randomized controlled trial by Aleyeidi et al. (2015) found that wet cupping provided an immediate reduction in systolic blood pressure in hypertensive patients, with effects lasting up to four weeks. Additionally, a systematic review and meta-analysis by Wu et al. (2023) found that cupping therapy significantly reduced waist circumference, body weight, BMI, and LDL cholesterol in patients with metabolic syndrome when used as a complementary intervention.

Is Cupping Therapy Safe?

One of cupping's strongest selling points is its relatively favorable safety profile. While some data suggests that cupping treatments are associated with higher rates of adverse events compared to no treatment, most of these are mild, skin-related conditions such as irritation, bruising, soreness, or superficial burns. The most recognizable side effect is the distinctive circular bruise marks, which are typically benign and temporary.

Wet cupping carries additional risks due to the skin incisions involved, which can increase the likelihood of infections. Patients on anticoagulants or those with bleeding disorders should exercise particular caution. However, when performed by a trained practitioner, serious complications are rare.

Should You Try Cupping Therapy?

In my practice, patient feedback on cupping therapy has been mixed. Some patients report significant benefit and find it more effective than massage or other soft tissue techniques. Many competitive athletes tell me that cupping helps relax their muscles and promotes recovery more effectively than alternatives like TENS units or foam rolling. Others, however, report limited to no improvement.

It's important to recognize that Western medicine has only recently begun conducting rigorous clinical trials on cupping, and a significant critique of the existing literature is the generally small sample sizes and high risk of bias. The absence of strong clinical trial evidence does not necessarily mean cupping is ineffective — its long-standing use over thousands of years across different cultures suggests enduring relevance and potential benefits.

The real advantage of cupping is that it offers a modality that can potentially alleviate pain while reducing reliance on medications like ibuprofen or naproxen, which carry their own side effect profiles. Cupping is probably best utilized as an adjunctive treatment alongside standard care — including physical therapy and other evidence-based interventions — rather than as a standalone therapy.

Is cupping right for everyone? Probably not. The novelty of the treatment and the distinctive circular bruises it leaves may deter some patients. But if you are struggling with chronic pain and looking for additional options, cupping may be worth a conversation with your healthcare provider.

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References

1. Li JQ, Guo W, Sun ZG, et al. Cupping therapy for treating knee osteoarthritis: The evidence from systematic review and meta-analysis. Complement Ther Clin Pract. 2017;28:152-160. doi:10.1016/j.ctcp.2017.06.003

2. Wood S, Fryer G, Tan LLF, Cleary C. Dry cupping for musculoskeletal pain and range of motion: A systematic review and meta-analysis. J Bodyw Mov Ther. 2020;24(4):503-518. doi:10.1016/j.jbmt.2020.06.024

3. Almeida Silva HJ, Barbosa GM, Scattone Silva R, et al. Dry cupping therapy is not superior to sham cupping to improve clinical outcomes in people with non-specific chronic low back pain: a randomised trial. J Physiother. 2021;67(2):132-139. doi:10.1016/j.jphys.2021.02.013

4. Abbasi N, Najafi R. Cupping therapy as an anti-inflammation therapy and immunomodulator in cancer patients. J Gastrointest Cancer. 2023;54(1):3-5. doi:10.1007/s12029-021-00701-2

5. Aleyeidi NA, Aseri KS, Matbouli SM, Sulaiamani AA, Kobeisy SA. Effects of wet-cupping on blood pressure in hypertensive patients: a randomized controlled trial. J Integr Med. 2015;13(6):391-399. doi:10.1016/S2095-4964(15)60197-2

6. Wu LK, Chen YC, Hung CS, et al. The efficacy and safety of cupping as complementary and alternative therapy for metabolic syndrome: A systematic review and meta-analysis. Medicine (Baltimore). 2023;102(13):e33341. doi:10.1097/MD.0000000000033341

7. Cramer H, Klose P, Teut M, et al. Cupping for patients with chronic pain: A systematic review and meta-analysis. J Pain. 2020;21(9-10):943-956. doi:10.1016/j.jpain.2020.01.002

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Medical Disclaimer: This content is for educational purposes only and does not substitute for the medical advice of a physician. Always consult your healthcare provider before beginning any new treatment program. The information presented reflects the opinion of Dr. Jeffrey Peng and does not represent the views of his employers or affiliated hospital systems.