Does cupping therapy actually do anything?

The trend: purple circles on Olympic shoulders

Cupping went mainstream the moment Michael Phelps showed up at the 2016 Olympics with a row of perfect purple circles across his back and shoulders. A decade on, the suction-cup treatment is a fixture in physio clinics, spas and sports team rooms, pitched as a way to pull tension and "toxins" out of sore muscles. The marks look dramatic. The evidence is a lot less dramatic.

What the best evidence actually shows

The most thorough recent look at cupping for pain is a 2023 evidence-mapping study in Frontiers in Neurology, which pooled 14 separate meta-analyses covering conditions from knee osteoarthritis to chronic low back pain. Using the standard GRADE system for rating evidence, the authors found no high-quality evidence anywhere in the pool. Most of it was low or very low quality; moderate-quality evidence turned up for only a few conditions, including knee osteoarthritis, neck pain and low back pain.

Where cupping did show a measurable effect, for example a drop of roughly 1.8 points on a 10-point pain scale for knee osteoarthritis when added to standard treatment, the underlying studies were rated weak enough that the authors' own appraisal tool, AMSTAR 2, scored 86% of the pooled meta-analyses as "low" or "critically low" quality. A chronic pain measure in the same analysis showed a sizable average effect, but with so much disagreement between the individual studies feeding into it that the result is hard to trust on its own. [[INLINE]]

Why the quality keeps coming back "low"

The recurring problem is not that cupping never helps, it is that almost nothing in this field controls for the placebo effect. Edzard Ernst, a physician who spent his career specifically researching alternative medicine, reviewed a 2024 systematic review of 11 cupping trials covering 921 low back pain patients and found a short-lived benefit, but only in a body of research that does not separate a real physiological effect from the ritual of the treatment itself. "Most SCAMs help a little with back pain (and similar conditions) because they can have a powerful placebo effect," he wrote, grouping cupping with acupuncture and chiropractic care. None of this means cupping does nothing. It means the research has not ruled out that the relief comes from attention, expectation and a few minutes of lying still, rather than the suction itself.

Dry vs wet cupping: the real safety line

Almost all of the modest evidence applies to dry cupping, where suction alone draws skin into a cup. Wet cupping, which involves small incisions so blood is drawn out along with the suction, carries real risks: infection, scarring and skin damage that dry cupping does not. Ernst's advice, after decades of reviewing alternative therapies, is blunt: skip wet cupping. Dry cupping, by comparison, is low-risk, and in his assessment, "if you insist on SCAM, it is best to use one that is relatively harmless and inexpensive," which is roughly where dry cupping sits next to other alternative options.

Is it worth trying?

If you already have a sore neck or low back and a licensed practitioner offers dry cupping alongside your normal physical therapy, the honest answer is that it probably will not hurt, might give you a few days of relief, and is not a replacement for exercise, physical therapy or medical evaluation of pain that is severe, worsening or paired with other symptoms. Treat the purple marks as a cosmetic side effect, not a sign the treatment "worked," since the bruising is just broken capillaries from suction and carries no diagnostic meaning.

A single dry cupping session at a physical therapy clinic or spa typically costs $40 to $90 in the US, and most of the trials behind the evidence map used a handful of sessions over two to four weeks rather than a one-off treatment. If you try it, judge it the way you would any short-term pain tool: does it make the next day's movement, sleep or workout noticeably easier, not whether the marks look impressive.

Our take

Cupping sits in the same place as a lot of recovery trends covered here, including cold plunges: a real, short-term sensation, a plausible placebo contribution, and no high-quality trial proving a physiological effect beyond that. It is inexpensive and low-risk when done dry, which is more than can be said for a lot of sports recovery gadgets, but treat it as a complement to real treatment, not a substitute for it.

This is general information, not medical advice. Talk to a clinician before changing anything, especially if you are pregnant, nursing, or managing a condition.