Chinese cupping therapy Báguàn: understanding the basics

In the West, cupping is often considered a form of deep-tissue massage and is mostly used as a treatment for tight, tired, and sore muscles. Since muscle spasms are quite common among athletes, this therapy is becoming increasingly popular among people who participate in sports.

In East Asia, especially in China, the clinical applications of cupping therapy are much wider. Suction Cups in conjunction with acupuncture and moxibustion have been used for thousands of years to remedy chronic diseases. There is a Chinese saying that goes: “Cupping and acupuncture cure more than half of illnesses.” In fact, these three ancient medical practices once were established across hospitals in China as the official principal treatment for arthritis, asthma, the common cold, chronic cough, indigestion problems, and some skin conditions.

Chinese cupping, known as Báguàn (拔罐), is an integral part of Traditional Chinese medicine (TCM). Along with the mentioned elements, TCM also includes Tuina massage, Herbal remedies, food therapy, and physical and concentration exercises such as Qigong. All these parts are thought of as the branches of TCM, whereas acupuncture is the root.

The philosophy behind Сhinese Cupping

The basic concept of Traditional Chinese medicine is that a vital life force, called “Qi“, flows through every body part, tissue, and organ along the meridian lines of the body. Qi keeps one’s spiritual, mental, and physical health in the balance of Yin and Yang, which are the opposite but interconnected forces. When the energetic channels are blocked, the Qi is disrupted, which leads to congestion, stagnation, and other imbalances in the body and causes disease and illness.

Applying suction cups to create a vacuum restores a consistent circulation of vital energy, blood, lymph, and phlegm in the treated area, and stimulates the body’s self-healing process. Yes, the suction also breaks tiny blood vessels under the skin and dredges toxic substances, but nevertheless, its primary purpose is to balance Yin and Yang. That’s why the cups are usually placed on one’s back – because the five most important meridians are up there!

What are the different types of cupping?

Depending on the treatment goals and the acupuncturist’s approach, Suction Cups can be used at rest (Stationary style) or while moving (Sliding style). Next, stationary cupping can be “Dry” (without blood-letting) or “Wet” (with blood-letting). The classic Chinese cupping technique Baguan Zi, where “Zi” means “itself”, is “Dry”.

Dry cupping

Dry cupping is also known as static cupping or retained cupping. This is the most commonly seen type of treatment, which uses single or multiple cups placed on the affected area or the acupuncture points along the energy meridians and retained without movement for 5 to 15 minutes. The suction force inside the cups is commonly generated by putting a flaming ball of cotton wool in the cup. So this type is also called Fire cupping.

In recent years, many kinds of special manually operated vacuum pumps appeared on the market in China. These cupping pumps are gaining more popularity as they allow laymen to carry out the procedure by themselves while controlling the amount of suction used. That said, most traditional practitioners believe that extra heat does a better job of stimulating energy circulation and extracting dampness from the body.

There is a variety of Dry cupping called “Flash” or “Quick”. It is mostly used to treat minor, elderly, deficient, and weakened patients. The cups are applied to the skin just for a few seconds, with a minimum retention period, and then quickly removed. Also, Flash cupping is typically recommended for the rapid relief of acute pain and swelling, whereas “normal” Dry cupping is said to be more effective against chronic pain.

The acupuncture, herbal medicine, and massage additions

Báguàn therapy might be carried out separately, but Traditional Chinese medicine takes a holistic approach to a person’s health, hence it favors maximum involvement of all its therapeutic modalities in treatment. In doing so, acupuncture, herbal medicine, and acupressure procedures are used both before and after cupping, as well as combined techniques occur.

Acupuncture cupping

Acupuncture involves the insertion of fine needles into specific points along the body’s meridians to activate the flow of Qi vital energy and strengthen the body’s natural ability to self-heal. As noted above, cupping therapy is commonly used in conjunction with this branch of Chinese medicine, as both healing modalities affect the same energetic pathways and thus amplify one another’s impacts.

Moreover, most qualified Baguan practitioners are actually acupuncturists first, so to get safe and effective Chinese сupping treatment with little to no side effects, one should look for a qualified acupuncturist to do the job.

When Dry cupping therapy is combined with acupuncture into a single therapeutic procedure, the heated cups are placed over embedded acupuncture needles. This double procedure is widely used in Chinese traditional medicine to treat a number of diseases. It is believed though that topical suction may be better able to cope with external issues, whereas acupuncture is more effective with systemic disorders in the body, helping to encourage healing at the root level.

Herbal cupping

Herbal cupping is also known as medicinal cupping. In this type, bamboo cups have been filled and boiled with a mixture of medicinal herbs, such as ginger, cinnamon, eucalyptus, camphor, lavender, chamomile and so long, known for their anti-inflammatory and analgesic properties. To avoid skin burns, the cups are left for one minute to cool down before applying them to the treated area. This kind of cupping is often used to promote relaxation, unwind, and detox.

Wet cupping

Wet cupping is also known as full cupping, bloodletting cupping, and bleeding cupping. Specific areas of the skin are pricked using a specialized lancet to promote mild bleeding. The cups are then applied to these places for 3-5 minutes to suck a small amount of “toxic” blood. This method is similar to an Islamic bloodletting technique Hijama – however, Traditional Chinese medicine practitioners focus more on the acupuncture points along the meridian channels.

Slide cupping

This type of Baguan therapy, called Sliding or Moving cupping, is performed in a meridian massage manner. A lubricant is applied onto the skin prior to the cups being placed, which allows the therapist to glide these cups easily across the area in an up-down, circular, or zig-zag motion. Slide cupping is traditionally performed on large muscle groups of the back and thigh to treat pain and muscle spasms but also can be used to treat digestive problems.

Besides, “Cupping with rotation” can be considered an intermediate option between Stationary and Moving techniques. It involves applying cups to the body and then gently shaking/rotating them in a static position to provide a form of deep tissue massage.

To enhance the flow of Qi, TCM practitioners often go further and provide the combined procedure composed both of cupping therapy and Tuina or Gua Sha massage sessions… and so do we (Thai massage), but that’s for another article:

Cupping massage in Chiang Mai: what to expect during a session

How is cupping performed?

In all types of cupping, the therapist firmly places one or several inverted cups made of glass, bamboo, ceramic, or plastic over the preferred location on the patient’s body. Typically, this would be the back, but it may also be the chest, stomach, buttocks, arms, legs, or even the face.

Traditionally, cupping therapy is done in sets of four, six, ten, or twelve cups. They might come in different sizes: the smaller ones are used for point massage, while the larger ones with consistent suction are used for trigger muscle release.

Every cup has a rolled rim to ensure tight contact with the skin to preserve the negative pressure, created by heat or by a manual pump. This negative pressure fixes the cup onto the skin and creates a suction force that pulls the skin upward into the cup and expands the blood vessels.

Every cup is held for up to three minutes to one hour (in rare cases), depending on the skin reaction and one’s symptoms. In any case, cups should not be left on the skin for too long as they can cause blistering if there is too much suction, or even burns if alcohol condenses in the cups. The number and frequency of cupping sessions also depend on individual conditions. For those experiencing acute issues, it can be performed daily, whereas patients with more severe and chronic conditions may receive treatment every other day.

What conditions does cupping treat?

It is proven by research studies and clinical practice that the following indications really respond to cupping therapy: common colds, respiratory diseases like chronic cough, dyspnea, bronchitis, pleurisy, pneumonia, and asthma; migraine, acute and chronic pain in the neck, shoulder, and back caused by radiculitis, neuralgia, sciatica, and arthritis; muscular tension and congestion, sport injures; fatigue, anemia, and low energy levels; anxiety, depression, and insomnia; digestive issues and vomiting.

Chinese cupping has been employed for centuries by healthy individuals as a means of preventing various diseases and improving their quality of life. Modern Western medicine also confirms its ability to boost the body’s natural healing and explains this in such a way: the suction created by the cups not only promotes a sense of calmness and increases the production of endorphins, which are the body’s natural “feel-good” chemicals, but it is also triggering the Parasympathetic Nervous System (PSNS). PSNS is responsible for the body’s “Rest and Digest” response that tells the body it is safe to focus on recovery and involves lowering blood pressure, breathing rate, and heart rate as well as launching other processes like digestion.

In short, every time someone gets the cupping procedure, it’s like flipping on the switch that tells their body to relax and focus on recovery!