Reviewed by Tyler Tice, PT, DPT, OCS, ATC
Cupping therapy is a traditional healing method that has been used by practitioners around the world for centuries. Across the world the method used to perform cupping and the theory behind the practice is quite varied however the basics are relatively the same, a vacuum is created using a small cup to pull the skin up into the cup. This suction is believed to bring blood with nutrients to the area or in eastern medicine they believe that it brings “bad blood” to the surface.
There are different methods used for cupping including dry cupping, wet cupping, fire cupping, and dynamic cupping. The two that are used by physical therapists are the dry and dynamic cupping methods. There is little understanding of what it is actually doing to the body but has been shown to greatly help patients with pain management and improve range of motion. There are many theories to explain the effects of cupping, some believe that the suction and pressure stimulate nerve fibers that interrupt pain signals to the brain. Others believe that the discomfort distracts the brain from the pain. Many also believe that cupping boosts circulation and nutrient delivery to the area allowing for the body to heal more efficiently.
What is the difference between dry cupping and dynamic cupping? Dry cupping is the most common method used, where multiple suction cups are placed over the muscle belly and left in one place for 5-10 minutes. Dynamic cupping is where the therapist or practitioner uses the suction cup to go back and forth across the muscle belly to bring the suction effects to the entire area and then many times are left in one spot to gain the same effects of dry cupping. While there is not a lot of research to explain why to use one method or the other, there is a main school of thought. Dry cupping is used for small muscles and deep muscles to improve blood flow and primarily for specific targeted pain modulation. This makes this option great for patients who have chronic pain or an old deeper injury.
Dynamic cupping is beneficial to be used over larger muscle areas such as the back, shoulders, or thighs. The movement of the cup is to help loosen tight muscles and fascia more evenly. The benefit of dynamic over traditional cupping is that it is believed to help increase range of motion by increasing flexibility and mobility of the soft tissues. This makes it more desirable for athletes and those who are struggling with muscle stiffness. It is also less intense and more tolerable by patients as it feels more like a deep tissue massage, leads to less bruising, and breaks up adhesions to relieve knots in the muscles.
When done properly, cupping is a very safe modality to be used in a physical therapy session for pain modulation and range of motion. It is expected for the patient to experience mild redness, bruising, soreness, and fatigue following the use of cupping. Patients are not candidates for cupping if they have active infections, skin wounds, deep vein thrombosis (DVT), blood disorder, cancer, organ failure, are pregnant, or are on blood thinners. Cups should be cleaned after use and between patients, practitioners should wear PPE, and the treatment area should be disinfected to prevent the spread of diseases.
- Furhad S. Cupping therapy. StatPearls [Internet]. October 30, 2023. Accessed June 15, 2025. https://www.ncbi.nlm.nih.gov/books/NBK538253/.