Send to:

Choose Destination
See comment in PubMed Commons below
Complement Ther Med. 2014 Feb;22(1):148-58. doi: 10.1016/j.ctim.2013.12.013. Epub 2014 Jan 7.

Mode of action of cupping--local metabolism and pain thresholds in neck pain patients and healthy subjects.

Author information

  • 1Center for Complementary Medicine, Department of Environmental Health Sciences, University Medical Center, 79106 Freiburg, Germany.
  • 2Department Psychosomatic Medicine, University Medical Center, 79106 Freiburg, Germany.
  • 3Department Child and Youth Psychiatry, University Medical Center, 79106 Freiburg, Germany.
  • 4Karl und Veronica Carstens-Foundation, 45276 Essen, Germany.
  • 5Center for Complementary Medicine, Department of Environmental Health Sciences, University Medical Center, 79106 Freiburg, Germany. Electronic address:



Cupping worldwide has been part of traditional medicine systems and is in the western world used as CAM therapy mainly for treating pain syndromes. The mode of action is up to now unclear. In order to investigate its mechanism we measured in parallel metabolic changes in the tissue under the cupping glass and pressure pain thresholds.


In 12 volunteers (6 healthy subjects and 6 patients with chronic neck pain) a microdialysis system was implanted subcutaneously on both sides (left and right) above the trapezius muscle. After baseline measures cupping was performed at one randomly selected side (left or right), the other side served as control. Every 20 min during baseline measures and for 280 min after cupping, microdialysis probes for detection of lactate, pyruvate, glucose and glycerin were taken. In addition, pain thresholds were measured before and after cupping with algometry.


Cupping resulted in a strong increase of lactate (beginning 160 min after cupping until the end of the measurements) and the lactate/pyruvate ratio, indicating an anaerobe metabolism in the surrounding tissue. Baseline pain thresholds were non-significantly lower in neck pain patients compared to healthy controls and slightly increased immediately after cupping (p<0.05 compared to baseline close to the area of cupping in healthy subjects and on the foot in neck pain patients). After 280 min no more significant changes of pain thresholds were detected.


Cupping induces >280 min lasting anaerobe metabolism in the subcutaneous tissue and increases immediate pressure pain thresholds in some areas.

Copyright © 2014 Elsevier Ltd. All rights reserved.


Adenosin; Algometry; Lactate; Microdialysis; Subcutaneous tissue; Ultrasound

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk