A Different Kind of ‘Ring’ Spotted at the Olympics

The Olympic games have brought the traditional Chinese medicine therapy of cupping into the spotlight.

The Olympic games have brought the  traditional Chinese medicine therapy of cupping into the spotlight, with many Team U.S. athletes participating with visible circular lesions on their bodies – cupping’s personal calling-card – but just how effective is the treatment?

The treatment consists of placing heated round glass cups on the skin; after the cup is placed, cooling of the air creates a vacuum. Although the exact mechanism of action of cupping is unknown, research suggests that placement of the cups on the skin increases blood circulation and rids the body of congested blood and waste.

A recent study1 by researchers in Turkey tested the efficacy of wet cupping therapy (wet cupping lacerates the skin and draws blood into the cup, whereas dry cupping involves no laceration) on 61 participants with nonspecific neck and upper shoulder pain. Neck and upper shoulder pain scores, as measured by the Numeric Rating Scale (NRS) were significantly reduced (P<0.05) from 7.02 (SD=1.8) before therapy and 3.70 (SD=2.2) after cupping therapy.  The researchers hypothesized that “stimulating the peripheral nervous system, removing oxidants and decreasing oxidative stress, and excreting toxic heavy metals” may be the three mechanisms by which the therapy is providing pain relief. In addition, sleep quality may improve as well, with the authors suggesting that this improvement may be secondary to a decrease in pain. They concluded that wet cupping may be considered as acomplementary treatment for neck and shoulder pain, although the results of the trial need to be supported by randomized and placebo controlled trials.

A 2012 review2 of 108 randomized controlled trials (RTCs) compared cupping therapy (wet and dry) with no treatment, placebo, or conventional medicine. The review found that cupping was used to treat a number of ailments, the six most common being herpes zoster (17 trials), facial paralysis (Bell palsy) (17 trials), cough and dyspnea (8 trials), acne (6 trials), lumbar disc herniation (6 trials) and cervical spondylosis (6 trials). The researchers found that cupping therapy was most effective in treating herpes zoster, acne, facial paralysis, and cervical spondylosis. However, the authors cautioned that nearly all trials in the study were considered to have a high risk of bias. They proposed that more trials be conducted to reach a definitive conclusion on the efficacy of treatment for these various diseases/conditions.

Judging from their photos, it appears that the Olympic cupping adherents are practicing the dry method. Alexander Naddour, the U.S. gymnast competing in Rio, said that “[Cupping’s] been the secret that I have had through this year that keeps me healthy.”

No serious adverse events were noted in any of the trails included in the 2012 review, however the circular areas of erythema could become edematous and ecchymotic as a result of blood vessel breakage in the papillary dermis.3


1. Yunus Emre Mahallesi, Takdir Caddesi. The effect of traditional wet cupping on shoulder pain and neck pain: A pilot study. Complementary Therapies in Clinical Practice. 2016; 30-33.

2. Huijuan Cao, Xun Li, Jianping Liu. An Updated Review of the Efficacy of Cupping Therapy. Plos one. 2012. DOI: 10.1371