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Different Varieties of Cup Therapy in one go

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NEW INTEREST IN CUPPING THERAPY

Many Cupping therapy practitioners in the West consider the year 2005 to be the ‘cupping therapy year’! For several months following Friday, 9 July 2005, cupping therapy was the subject of worldwide media attention. This was entirely due to Oscar-winning actress Gwyneth Paltrow, who decided to reveal her newly acquired cupping therapy marks at a film festival in New York by wearing a low-cut dress that revealed the circular marks across her back and shoulders. Newspapers, radio stations and TV networks in the USA and across Europe gave extensive coverage to cupping therapy and speculated wildly about why she was having this treatment! Some cynical comments were made but in general it has been a positive and informative approach. This helped to stimulate a healthy public debate in natural health and complementary medicine circles, simultaneously encouraging many TCM practitioners who were previously reluctant to apply this method of treatment to study further and improve their cupping skills. Social networks like YouTube and Facebook now contain hundreds of cupping sites (some good and some not so good!).

Today, as more people seek complementary and alternative therapies to deal with their health problems, therapies such as acupuncture, cupping, herbal medicine, aromatherapy, reflexology, chiropractic, osteopathy, homoeopathy, Tui Na and massage have become popular. Public awareness and education have also changed, from seeing these as ‘quack’ remedies to more respectable alternative treatments. In both America and Europe the education of the complementary therapist has taken on a new meaning. Here in the West, most acupuncture schools and colleges offer 3–4-year ‘accredited’ acupuncture courses, with optional studies in China. Many alternative therapy organizations have set up self-regulatory bodies, ensuring high educational standards and at the same time seeking better understanding and recognition by the health system and the general public.

Fortunately, most acupuncture school curricula in the West do now include reasonable teaching time for cupping therapy. The first presentation was at the China Medical University hospital in Taichung and the final presentation to the Chang Gung Memorial Hospital, Taipei. Both the students and the doctors were impressed by the variety of cupping therapies offered in my lectures. I am also very pleased to see a genuine enthusiasm towards cupping therapy practice among the new generation of TCM practitioners as well as the contemporary massage therapists and physiotherapists. In parallel with this newly found interest, quite a number of websites are also offering online cupping therapy information. It is estimated that over 100 000 acupuncture practitioners today work outside China, practising Chinese medicine as a whole. It is clear that cupping therapy taught and used properly on its own, or alongside various tactile therapies, can positively influence and speed up the body’s natural healing process.

Cupping Therapy Evidence-Based Research

Treatment Protocol
Cupping therapy was given every other day. Blood analysis from specimens was taken on three occasions: before the cupping treatment commenced, after 7 days (halfway through the treatment) and finally on the 15th day of the trial following the last cupping treatment. Because of limited funds and my timescale on the island where the research was done (North Cyprus),

At the end of each full blood analysis, 22 different values were recorded, but only 7 of these were monitored as the rest were considered irrelevant to our trial or did not show any changes at all. The seven values were: uric acid, erythrocyte sedimentation rate (ESR), pH, rheumatoid factor (RF), white blood count (WBC), red blood count (RBC) and haemoglobin (Hgb).

Cosmetic Cupping Therapy

Facelift
Is cupping therapy facial application a facelift? I think this terminology is not the most correct term to describe cupping treatment applied to the face. My preferred description for the facial cupping procedure is as a ‘facial energizing’ or ‘facial rejuvenation’ programme, because this is exactly what is happening during the cupping treatment: oxygen-rich blood is forced to the face, fluid circulation is encouraged and, most importantly, the lymphatic system is activated resulting in healthier and livelier looking skin. The skin is literally energized and rejuvenated through the power of cupping therapy. Also, during cupping the production of collagen and elastin may be stimulated, resulting in firmer skin texture, erasure of fine lines and reduction of deeper lines. Cupping also promotes Qi and Blood circulation; this increased circulation nourishes the skin, which helps it look fresher and younger. In the cosmetic field the facial rejuvenation programme is by far the most popular cosmetic treatment demanded by patients / clients, particularly female clients. Cupping therapy to the face is very effective and the result can be seen around the sixth visit (one course of treatment is ten sessions), which is a relatively short time when compared with other hands-on techniques, but of course for some not quick enough!

Cupping on the face needs particular attention. This is because the facial skin is the thinnest and finest particularly around the eyes (0.1 mm) and can be sensitive to external stimulation and manipulation. Prepare the patient and apply cups as directed in the above section. For a facial cupping treatment, silicon, rubber or the more recent Perspex suction cups are more suitable. Working in harmony with the facial contour, apply between five and seven long strokes, starting from the forehead, then on each side of the face, under the eyes, the sides of the nose, around the mouth / lips, the front of the ear (jaw bone) and, finally, behind the ear, over and under the chin, neck and the upper chest (décolletage).

Cupping Therapy on Children and Adults

CUPPING THERAPY ON ADULTS
When cupping therapy is employed on adults it is extremely difficult to categorize and select the treatment modality using age alone as a guide. I cannot think of a general formula that could be put into practice according to age. Therefore, almost always, observation, listening, tongue and pulse diagnosis should be used to determine the correct cupping method and duration for each particular patient. No matter how strong or healthy the patient may appear to be, the above precautions will ensure the correct cupping application. In this way the patient receives the full benefit, instead of their existing Qi possibly being depleted as a result of the wrong method being chosen. Avoid performing unnecessarily long sessions of cupping, especially during the first and second visits, as this can also deplete Qi. Also, during the first and second visits, use Weak to Medium methods in preference to the more draining methods.

A ‘dizzy’ or ‘light-headed’ feeling after treatment is a common complaint among patients over 60 years of age. To prevent this, help the patient to get up from the couch when the session is over, and a few minutes before they need to get dressed. Generally speaking, patients under the age of 60 tolerate cupping quite well. Once or twice weekly treatment can safely be administered (with the exception of Bleeding cupping). When treating patients over the age of 60, and in particular over the age of 70, more attention has to be directed towards the skin condition. This is the age where skin becomes dehydrated and subcutaneous fat content much reduced, causing the skin to become emaciated and fragile. It is also common to observe bruising marks under the skin, sometimes caused by a knock or the medication patients are on. Avoid direct cupping therapy on such bruises. Never, ever, apply Strong or Moving cupping over such dehydrated skin. Cupping marks will also take longer to dissipate and vanish completely.

What to Expect During and after Cupping Therapy

INTRODUCTION
The primary object of cupping therapy is to move Blood and Qi, remove Wind and Cold pathogens as well as Heat pathogens and eliminate stagnation of any kind from the body (and not to ‘remove the evil spirit’ as was claimed by one untrained therapist, leading to a police investigation in England in July 2005). To achieve this, different cupping techniques can be employed (there are 12 different cupping methods). Almost without exception, in every case where cupping is performed for the first time there will be slight reddening or a ring mark caused by the edge of the cup at the site of the treatment . The extent of the cupping mark depends very much on the length of treatment time and the strength of the suction achieved. To reduce the risk of severe marking, always start with empty, light or medium strength suction, increasing the strength and duration on subsequent visits. The patient should experience a warm, pulling or stretching sensation on the skin, but not pain. If the patient complains of pain at any time during treatment, remove the cups immediately and reapply using reduced technique. The skin of some patients is very sensitive and their pain threshold extremely low, especially children under 16 years old, the elderly, North Americans, Scandinavians and northern Europeans including the UK patients. On several occasions heavy unsightly cupping marks that are caused by over-eager or inexperienced cupping practitioners.

Normally the ring or cupping mark will fade away within 10 days. In some cases a blister may appear on the skin inside the cup. This is an indication of both excessive duration and strength of suction. When this happens, remove the cup without delay and pierce the blister with a sharp sterilized instrument, such as an acupuncture needle, to release the fluid. Do not reapply cups at the site of the blister until it has completely healed. Elderly and very young patients are particularly susceptible to severe marking and blistering. This is another reason for monitoring the patient during treatment. If the blister is not noticed at an early stage, it may result in an unnecessary large, open wound.

During the holiday season, cupping treatment should be terminated a week before the patient goes away (unless the patient does not mind showing off the marks) or the marks may draw attention from onlookers at the beach or the pool. The cupping marks usually appear worst of all after the first application, because of stagnation of Blood and Qi; follow-up treatments to the same point will result in much less marking, as the circulation improves and the stagnation is removed. The fine capillaries under the skin fill and empty freely and, as a result of improved metabolism following treatment, a sense of warmth and wellbeing pervades the patient’s body, sometimes accompanied by a feeling of light-headedness and a slight thirst.

When the cupping session is over there is a short period of tenderness at the points where the cups have been applied. Using massage oil, the area can be massaged gently and, time permitting, the patient can be covered with a blanket for a few minutes’ rest before leaving the clinic. Blood pressure may vary by a few points owing to the unfamiliar suction and its effects on the circulation. As patients with low blood pressure are particularly susceptible to these fluctuations, care must be taken not to send patients away too soon following treatment. Patients coming for cupping therapy should also be advised to eat a light meal at least 2 hours before the treatment commences. Do not administer cupping therapy when the stomach is full or when it is completely empty, and particularly when the patient is fasting. In both situations the Qi is either ‘stagnant’ or ‘empty’, in which case it may contribute to the patient feeling unwell.

During the cupping days or weeks ask the patient to refrain from eating rich and greasy foods. Light, warm meals in winter and salads in the summer are preferred. The fluid intake should also be increased at least 20% during this period, which will help with the metabolism and the detoxification process. A warm feeling throughout the body, some perspiration and a sense of relaxation normally follow the treatment owing to improved circulation and muscle relaxation. Should the patient feel cold, shivery or extremely tired after the treatment, a warm drink and up to 30 minutes of rest are highly recommended before the patient leaves the clinic.

Like many other therapies, cupping therapy isn’t a ‘magic cure’ for all ailments. The full benefits of cupping therapy are usually achieved after between 5 and 10 visits. Sometimes the benefits are noticed immediately but are short lived, in particular when dealing with emotional complaints or longstanding chronic problems. Ten sessions are considered to be one course of treatment. Patients less than 16 years of age normally require less treatment.

Cupping Therapy in the Treatment of Common Disorders

Explanation
Empty / Flash cupping on children is quite easy especially when you don a playful approach to cupping therapy! As indicated earlier on, demonstrate the technique on the parent’s arm first and then on to the child. On each application make sure that the suction strength is never strong but always a Weak or a Medium strength. Repeated Flash cupping to the above points cools the Blood, regulates the flow the Qi, brings the Blood from the deeper levels to the more superficial level. Also dredges the Governing Vessel and the Bladder channel helping to eliminate the internal Wind.

CUPPING
Cupping belongs to the oldest therapeutic methods and was known in all ancient civilizations. In the modern world, it is still among the most popular home treatments. The suction cups were originally made from animal horns or bamboo, and later were made of glass; this allowed observation of the skin undergoing treatment. Reflexive physical medicine utilizes only the so-called dry cupping; there are no skin cuts under the cup, unlike so-called wet cupping, which is used mainly to suck out something such as snake or insect toxins.

Cupping therapy mechanically stimulates skin nervous receptors in a way similar to reflexive massage; instead of pressure, however, it uses a vacuum effect. This can be achieved either by heating the air inside the cup with a flame or using a vacuum pump connected to the cup via flexible pipes with a manometer to control the pressure.

In the case of hot cupping, a burning, spirit-imbibed swab should be inserted inside the cup for three seconds, and then the cup should be quickly placed on the chosen skin area, this kind of treatment also includes a thermal stimulation, to some extent. In the case of cold cupping, the pressure inside the cup should be established at about 0.2 atmosphere. Four to 10 cups are usually used simultaneously. Skin areas chosen for cupping therapy should be even; they are usually above large muscles, in order to insure good fixation of the cup. Only tender skin areas, with OED readings of “Acute’’/“Subacute’’ should be stimulated. Prior to treatment, the skin should be cleaned with water, soap, and high-percentage alcohol and covered with petroleum jelly. The typical duration of the cupping treatment varies from 15 to 25 minutes. Treatments can be done on a daily basis for acute problems and every other day for more chronic conditions.

Cupping is among the most effective physical therapies within its range of indications, which traditionally include pneumonia, acute bronchitis, bronchial asthma, back pains, and neuralgias.

Dr Bilal Ahmad Wani
M.D Ayurveda
Panchakarma and Hijama Therapist.

Eid Mubarak
May Almighty Allah keep us Healthy