Dry cupping may give some people short-term relief from muscle pain and stiffness, but the evidence that it works better than a placebo is very uncertain. A 2026 review that compared real cupping with fake (sham) cupping found the effects on pain were "very uncertain at all timepoints", and recommended trying better-proven treatments first. Cupping is generally safe and some people like how it feels, so it's best used, if at all, as an optional add-on to exercise-based treatment, never as the main event.
Key takeaways
- What it is: cups create suction on the skin, lifting the tissue underneath. "Dry" cupping doesn't involve any cuts.
- Compared with fake cupping, real cupping's effect on pain is very uncertain (2026 review of 5 trials).
- Compared with no treatment, cupping can reduce pain a little in the short term, but those studies can't separate a real effect from expectation.
- The claim that cupping "reduces inflammation" or "draws out toxins" isn't supported by good evidence.
- It's low risk: the round marks are bruising from the suction and fade within days.
What is dry cupping?
Cups made of glass, silicone or plastic are placed on the skin, and air is removed to create suction. The cups may be left in place for a few minutes, or moved over the skin with oil. It's most often used on the back, neck, shoulders and thighs.
The round marks it leaves are caused by small blood vessels under the skin breaking under suction, much like a bruise. They're harmless and usually fade within a few days to a week.
What are the claims, and what does the evidence say?
Cupping is often promoted as "increasing blood flow", "releasing fascia", "drawing out toxins" or "reducing inflammation". It's worth separating what's plausible from what's proven.
Cupping vs fake cupping: the most important question is whether cupping does anything beyond the experience of having a treatment. A 2026 systematic review (JOSPT Open) found 5 trials (281 people) comparing dry cupping with placebo cupping for musculoskeletal pain:
- Short term: very-low-certainty evidence ranging from trivially harmful to meaningfully beneficial. In other words, we can't tell.
- Medium term: one trial suggested a possibly meaningful benefit, but with very low certainty.
- Long term: one small trial, very uncertain.
- 4 of the 5 trials were at high risk of bias.
The authors concluded the effects were very uncertain and that treatments with higher-certainty evidence should be tried first.
Cupping vs no treatment or other treatments: a 2023 review of cupping in musculoskeletal and sports rehab found moderate evidence that it improves soft tissue flexibility in the short term, low-to-moderate evidence for reducing low back and neck pain, and very low-to-low evidence for other conditions. Side effects were very rare. But most of these studies compared cupping with doing nothing, so some of the benefit may come from expectation, attention and the relaxing nature of the treatment.
The myth: "Cupping reduces inflammation and draws out toxins"
These claims are common on clinic websites. But there isn't good evidence that cupping reduces inflammation in muscles or joints, or that it removes "toxins". The marks are bruises from suction, not toxins coming to the surface.
A fair summary: cupping may help some people feel looser or less sore for a while, which can make it easier to move and exercise. That's a reasonable, modest role. It shouldn't replace treatments with stronger evidence.
What has better evidence for muscle and joint pain?
| Treatment | Strength of evidence | Example |
|---|---|---|
| Progressive exercise and strengthening | Strong for many conditions | NICE recommends exercise for osteoarthritis and chronic primary pain |
| Education and staying active | Moderate to strong | Understanding pain, gradually returning to activity |
| Hands-on therapy, including massage | Short-term relief, best combined with exercise | Recommended by NICE only as part of a package with exercise for low back pain |
| Cupping | Very uncertain vs placebo | An optional extra for people who find it helpful |
When might cupping be worth trying?
- You're already doing an exercise-based plan and want something to ease muscle soreness or stiffness.
- You've tried it before, found it helpful, and understand the evidence is uncertain.
- You don't have any reasons to avoid it (below).
Avoid cupping if you:
- take blood thinners or have a bleeding disorder
- have broken, sunburnt or fragile skin, or a skin infection in the area
- are pregnant, unless your midwife or doctor agrees
- have a deep vein thrombosis or varicose veins in the area
When to see a physio or GP
See your GP promptly if muscle or joint pain comes with fever, unexplained weight loss, night pain that doesn't change with position, or new numbness or weakness.
Get urgent help (999 or A&E) if back pain comes with numbness around your genitals or bottom, or new problems with bladder or bowel control.
See a physio if pain has lasted more than 2–3 weeks or keeps coming back, so you can get a diagnosis and a plan with the best evidence behind it.
Our approach at Athos Physio
Our clinic is inside F45 Manchester NQ, at 77 Piccadilly in Manchester city centre. We'll assess the cause of your pain, explain your options honestly, and build a custom rehab and strengthening plan. Hands-on treatment, including sports and deep tissue massage and, if you'd like it, cupping, can be part of that, but the long-term change comes from what you do between sessions. You don't need a GP referral, and we work with Bupa, WPA, Vitality and Aviva. Book an appointment.
FAQs
Does cupping actually work?
The honest answer is that we don't know. Compared with fake cupping, its effect on pain is very uncertain. Some people feel short-term relief and looser muscles, which can help them move more. Treatments like exercise have much stronger evidence.
Are cupping marks bruises?
Yes. The suction breaks small blood vessels under the skin, leaving round marks that usually fade within a few days to a week. They're not toxins.
Is cupping safe?
For most people, yes. Serious side effects are very rare. Avoid it if you take blood thinners, have a bleeding disorder, or have broken or fragile skin in the area.
What's the difference between dry and wet cupping?
Dry cupping uses suction only. Wet cupping also involves small cuts in the skin to draw blood. This article is about dry cupping.
This article is general information, not a substitute for an individual assessment.
Sources
- Jenkins LC, et al. The efficacy of dry cupping compared to placebo cupping for people with musculoskeletal complaints: a systematic review with meta-analysis. JOSPT Open 2026;4(1):23–35. https://doi.org/10.2519/josptopen.2025.0159
- Mohamed AA, et al. Evidence-based and adverse-effects analyses of cupping therapy in musculoskeletal and sports rehabilitation: a systematic and evidence-based review. J Back Musculoskelet Rehabil 2023;36(1):3–19. https://doi.org/10.3233/BMR-210242
- NICE. Low back pain and sciatica in over 16s: assessment and management (NG59). https://www.nice.org.uk/guidance/ng59
- NICE. Chronic pain (primary and secondary) in over 16s (NG193), 2021. https://www.nice.org.uk/guidance/ng193
Related: Sports and deep tissue massage · Benefits of sports massage · Active rehabilitation · Chronic pain · All conditions we treat
Reviewed by Nick Chatziviltsos, PgDip, HCPC-registered physiotherapist (PH114351).