Cupping in orthopedics

What is cupping?

During cupping, special suction glasses or silicone cups are placed on the skin and held in place using negative pressure. The suction slightly lifts the superficial tissue layers, increasing local blood flow and tissue fluid. In Traditional Chinese Medicine (TCM), the flow of Qi and blood is supposed to be harmonized; From a modern perspective, it is primarily a mechanical stimulation therapy for the skin, connective tissue and muscles.

• Goal: Relieve muscular tension and myofascial pain
• Methods: dry (without blood sampling), moist (with minimal blood sampling), dynamic (moving cupping massage)
• Area of ​​application: in addition to conservative orthopedic treatment

Areas of application in orthopedics

Cupping can relieve discomfort caused by muscular imbalances, overload or myofascial trigger points. It does not replace a medical diagnosis and is not a panacea; It is particularly useful as part of a structured, conservative treatment plan.

• Neck and shoulder tension (e.g. trapezius-related tension headaches)
• Non-specific back pain and fascial back problems
• Myofascial pain in thighs, buttocks, calves
• Overuse syndromes in sports (e.g. muscular shortening, trigger points)
• Accompanying functional elbow or knee pain (e.g. lower quadriceps insertion, iliotibial band, flexor/extensor forearm)

In the case of acute structural injuries, severe nerve pain, infections, open wounds or unexplained severe symptoms, cupping is not suitable and medical warning signs should first be clarified by a doctor.

How does cupping work? Modern explanatory models

From today's perspective, the effectiveness of cupping can be explained primarily in biomechanical and neurophysiological terms. Negative pressure lifts and stretches the skin, fascia and superficial muscle parts. This stimulates mechanosensitive receptors, promotes microcirculation and can modulate pain perception via segmental and supraspinal mechanisms.

• Blood circulation: short-term increase in local perfusion and lymphatic drainage
• Fascia: Shearing forces can loosen adhesions and improve lubrication
• Pain modulation: Gate control mechanisms and altered trigger point activity may contribute to relief
• Vegetative effects: some patients report pleasant warmth and relaxation

Variants of cupping

In our practice we differentiate between different forms of application. Which variant is suitable is decided individually based on the examination, symptoms and safety criteria.

• Dry cupping: Cups are placed on defined points/segments and remain on the skin for a few minutes.
• Dynamic cupping (cupping massage): Cups are moved over oiled skin with lower negative pressure in order to treat myofascial structures over a large area.
• Moist cupping: After careful indication and explanation, the smallest cuts in the skin are made to allow a small amount of blood to be drawn from congestion zones. This is more invasive and not always necessary.

Technically, glass cups with a vacuum pump, rarely fire cupping, and silicone cups are used. The selection depends on region, skin condition and target tissue.

• Further information: Dry cupping
• Further information: Dynamic cupping
• Further information: Wet cupping

Process in our practice in Hamburg

You can find us at Dorotheenstraße 48, 22301 Hamburg. Appointments can be requested unbureaucratically via Doctolib or by email.

Combination with other conservative procedures

Cupping unfolds its potential especially in combination with established conservative measures. The aim is to transform short-term relaxation into sustainable stability and function.

• Active therapy: targeted strengthening, mobility, stretching, breathing and posture work
• Manual therapy/chiropractic: gentle joint mobilization and soft tissue techniques
• TCM procedures: acupuncture, moxibustion, Tuina, TDP lamp; in individual cases TCM herbal medicine
• Everyday life and ergonomics: paused sitting, monitor height, backpack instead of a one-sided bag, sleeping positions

Benefits and evidence

Studies suggest that cupping may provide short-term relief for some patients with muscular and myofascial pain. However, the data situation is heterogeneous: the methodological quality and comparability of the studies vary, and high-quality long-term data are often missing.

• Possible benefit: short-term pain reduction, improved mobility, subjective relaxation
• Quality of evidence: predominantly small to moderate, partly contradictory; Cupping is usually not listed in guidelines as a standard, but rather as a supplementary option
• Implication: sensible option with appropriate indication and patient preference, always embedded in active, conservative therapy

We provide you with transparent advice on opportunities and limitations and only recommend cupping if it is medically justifiable and fits your goals.

Safety, side effects and contraindications

Cupping is generally well tolerated, but requires care and hygiene. Hematomas are common, expected reactions and usually resolve within 1-2 weeks.

• Common: redness, pressure, hematomas, temporary tenderness
• Uncommon: dizziness, tiredness, headache on the day of treatment
• Rare: Blistering, skin irritation, infections (especially during wet cupping) - special hygiene and indication testing are required here

Absolute contraindications: active skin infections in the area, open wounds, severe coagulation disorders. Relative contraindications or caution: anticoagulation/blood thinners, pronounced varicosis, sensitive skin, diabetes with neuropathy, pregnancy (no cupping over the abdomen/lumbar), known tendency to keloids.

Please inform us in advance about medications, skin diseases and relevant previous illnesses. If there are warning signs such as increasing pain, fever, severe dizziness or persistent skin reactions, consult a doctor.

Preparation and aftercare

• Before the session: drink enough, eat a light meal, do not apply any highly irritating creams/lotions
• On the day of treatment: loose clothing, allow access to the target area
• After the session: warmth and rest, drink plenty of fluids, avoid heavy physical exertion and sauna on the same day
• Skin care: mild care as needed; do not scratch until hematomas have subsided

It is important to actively continue the exercise and posture programs in order to convert short-term relaxation into sustainable resilience.

Common complaints that can be addressed

• Cervico-thoracic tension (office work, screen work)
• Lumbar myofascial pain without red flags
• Myofascial trigger points in the shoulder girdle (infraspinatus, levator scapulae)
• Attachment irritation with muscular involvement (e.g. lateral elbow, proximal iliotibial band)
• Calf and thigh tension after running

After an examination, we will determine whether cupping makes sense in your specific case. The method is not indicated for structural causes (e.g. fractures, acute disc protrusions with failures, infections).

Costs and reimbursement

Cupping is an individual health service. Reimbursement depends on your insurance status and plan. Private insurers sometimes cover costs by agreement, while those with statutory health insurance usually pay themselves. We will inform you transparently in advance; there are no hidden obligations.

Further information on cupping techniques

• Dry cupping – detailed indications, process, safety
• Wet cupping – indications, hygiene, risks
• Dynamic cupping – cupping massage for fascia and muscles