What do singer Lady Gaga, actress Gwyneth Paltrow, fashion mogul Victoria Beckham and Olympic swimmer Michael Phelps have in common apart from being famous? All four are fans of cupping, a form of traditional Chinese medicine (TCM) therapy. Cupping is believed to stimulate the flow of qi, the vital energy or “life force” that, according to TCM, circulates through our bodies. TCM practitioners believe that when our qi is disrupted or disturbed, “blockages” or imbalances can occur in the body. The purpose of cupping is to remove these blockages and restore the flow of this vital energy. How cupping works First, a vacuum is created inside the cup, either by burning the oxygen inside a glass cup or by sucking the air out from the top of a plastic cup, says Master Ruth Lee, a TCM practitioner who has her own clinic in Hong Kong. The cup is then quickly placed on selected acupuncture points on the patient’s skin, and the vacuum draws the skin up into the cup. The low pressure inside the cup mobilises the free flow of qi and blood around the body through channels known as meridians. This process facilitates the removal of toxins, and ultimately restores balance in the body. Lee considers cupping to be minimally invasive. The suction effect breaks the tiny blood vessels underneath the skin, resulting in slight discolouration in the area. When the brain picks up signals of this minor injury, it triggers the body’s self-healing process, leading to an increase in blood circulation, improved lymphatic flow and the release of built-up fluid. Hong Kong’s Chu among Olympic athletes embracing cupping “When combined with acupuncture or tui na massage, cupping works well to enhance the flow of qi,” Lee says. “Many physiotherapists and chiropractors incorporate cupping therapy into their protocols, and even foot massage shops now offer cupping as a service add-on.” Types of cupping There are several types of cupping, says Dr Troy Sing, a TCM practitioner from Health Wise Chinese Medicine Consultancy in Hong Kong’s Central district. Dry or fire cupping involves the use of a flame to create negative pressure inside the cup; the cup is then left on the skin for three to 15 minutes. This type is the most commonly used in Chinese clinics. Today, a handheld pump may be used to create the vacuum instead; some practitioners also use silicon press cups. The second type, called wet or bleed cupping , comprises three steps: first, the practitioner creates a mild suction by leaving the cups on the skin for three minutes. He or she then pricks the skin using a triangular-tipped needle or plum blossom needle. How gua sha scrapes away the pains of working from home The cup is applied to the skin for the second time to draw out a small quantity of “toxic” blood. Another type is move or slide cupping , which involves the practitioner applying the cup to the skin before slowly moving it in one direction in a specific area. Sing adds: “Other types include empty cupping , which sees the cups being removed from the skin immediately after suction; needle cupping , which involves acupuncture followed by the application of the cups over the needles; medicinal or herbal cupping , which uses bamboo cups that have been boiled with herbs; and water cupping , which involves filling a glass or bamboo cup one-thirds-full with warm water and then quickly applying it to the skin.” A brief history of cupping The earliest records of cupping were found in The Mawangdui Silk Texts , an ancient book written on silk that was discovered in 1973, in an ancient tomb dating back to China’s Han dynasty (202BC-220AD). The use of cupping therapy can be traced back to early Jin dynasty doctor Ge Hong, who lived between 283 and 343AD and was a well-known herbalist and alchemist. How traditional Chinese medicine – TCM – is used to treat Covid-19 Back then the cups were made of bull horn or bamboo, unlike the glass or plastic cups used today, says Lee. Practitioners used these cups to draw out pus or toxins from their patients’ wounds. They created suction by sucking the air out of the horn or by boiling the bamboo cups. Glass and plastic cups only came in during the Industrial Revolution, and it was after this period that cupping became more widely available. What cupping helps with According to Lee, many people use cupping regularly as a muscle-relaxing treatment. She says the therapy works on a range of issues, including: Pain in the neck, shoulders, lower back and legs; The common cold, flu or cough; Gastrointestinal problems like diarrhoea and constipation; Facial paralysis and stroke; Respiratory conditions such as allergic rhinitis and asthma; Skin diseases like eczema , acne , shingles and hives; Gynaecological issues such as period pain and infertility ; Depression ; Weight loss, and; Sleep disorders. Cupping is not for everyone. Sing warns that pregnant women, children, the elderly, people on blood-thinning medication, and people with certain health conditions such as cancer, organ failure, haemophilia, oedema, blood disorders, and some types of heart disease should not get cupping. Risks and side effects Cupping is fairly safe as long as it’s done by a trained practitioner. The treatment often leaves behind suction marks, which disappear within 24 hours in healthy individuals, according to Sing. Stop the treatment immediately if you experience side effects in the area where the cups touch your skin, These include: Sweating; Dizziness or lightheadedness; Fainting; Nausea or vomiting; Mild discomfort; Swelling; Burns (if you received fire cupping); Bruises; Skin pigmentation changes, and; Skin infections (if you received wet cupping). “Cupping also shouldn’t be done on areas where the skin is broken, irritated or inflamed, over arteries, veins or lymph nodes, or on the eyes, orifices or fractures,” Sing says. Like what you read? Follow SCMP Lifestyle on Facebook , Twitter and Instagram . You can also sign up for our eNewsletter here .