Therapeutic Cupping, Part 9- What not to do

Precautions and Contraindications of Cupping Therapy:

Cupping is a therapy that can have great benefit and is relatively safe to do.  The following precautions should be followed to best avoid injury and undue pain.  This list also has contraindications for patients on whom  you should not do any cupping unless you really understand the pathology and physiology of the condition you are treating or trying to help.

  1. Hemophiliacs and those with thrombocytopenia: These people may have bleeding that will not stop, or undue bruising.  This can be more uncomfortable for them; it can possibly cause more problems, as well.


  1. Anyone who is dehydrated. You will likely find poor results, which can be frustrating.  Someone that is very dehydrated can have a good initial result.  However, cupping can cause trouble with the kidneys and make them feel temporarily worse.


  1. Skin allergies, Psoriasis, Vitiligo, eczema: You may make some of these conditions worse, at least in the short term.  Best advice is to avoid any skin that you would not consider ‘normal’.


  1. Any broken skin: Cuts, abrasions, holes, lacerations etc.  These just hurt and we never want to hurt people.  Infections or oozing areas are not a good idea either.


  1. Other skin changes: Raised moles, warts, local tumors, scabbed areas.  You can cause bleeding at these points.  When in doubt, cup elsewhere.


  1. Areas with large vessels, or lymph nodes: Arm pits (axillary), Cervical areas (the front of the neck), in the groin (inguinal), wrists, anterior of the forearm, back of the knee.  These places are usually considered too ‘Yin’ for cupping.  Some techniques can be used; we can discuss these later.  Cupping in these areas can cause severe pain and may damage the vessels or nodes.


  1. Deep vein thrombosis. Although there is little chance of causing more trouble, it is best to get a clearance from a primary provider before continuing.


  1. Genitals, nipples, lips: anywhere there is a mucous membrane. Mucous membranes are those places that open to the outside that have moisture.  Also the umbilicus (belly button).


  1. On the face. Use special technique… and really small cups…


  1. On or around the eye. This can cause exophthalmos, or an avulsion or prolapse of the tissues.  Avoid the eye area.  It would likely hurt a lot, too.


  1. On the tongue or mouth.  Although a part of a recent fad for young people, you can burst blood vessels as these are areas of very thin tissue.


  1. During the menstrual period as this can cause a disruption in the energy flow and increase discomfort, especially if many cups are used, or cupping is done near the uterus or pelvic area. This is a traditional statement really, and I have not found any significant difference in a person’s feelings after cupping.


  1. Women who are pregnant, ESPECIALLY no cupping on the pregnant belly. In fact there are areas on the ankle that are considered completely forbidden during pregnancy, as they can cause uterine contractions and therefore spontaneous abortion or delivery at the wrong time.  This point is generally not easily cupped anyway; it is located on the inner ankle about three thumb widths up from the ankle bone.  I know of no research or actual cases of this, but better to be safe than sorry.  Cupping on the shoulder and back should be fine as long as it is light and done with care.


  1. Any active disease process that weakens the person. Here, refer to comfort and get advice from an advanced provider who understands what cupping is and does.  This would include:  tuberculosis, anemia, respiratory conditions (COPD, Emphysema, Asthma), cardiovascular issues that are not under control, including hypertension and congestive heart failure.  People who suffer from these ailments may not like or do as well with stronger cupping, so use flash or light cupping.  Remember, healing is a timed process.


  1. Anyone under the age of five, (traditionally it is three years old) I have found it impossible to get one so young to sit still long enough…


  1. Bug bites, animal bites; even though you can remove the toxins or poisons, it’s best to let the body do its own work and not irritate it any more.



  1. Anywhere there are sutures or stitches. Any place there has been recent surgery.  Sometimes glue is used to close wounds.  It’s best to wait until healing is complete; a good rule of thumb is six weeks or so after the sutures have been removed.  A good idea is to check with the surgeon first.



  1. Fresh scar tissue. There are some good techniques to get scar tissue to change, but that is a bit advanced.  Using different sized cups is useful here.  Along with herbs and other salves, it can show good results.


  1. Any burn areas, new or old. A sunburn is a terrible place to have cupping.  It will aggravate the issue and the patient can have massive problems with energy flow.  This can cause fever and chills and make them susceptible to other problems.  Wait until the skin has properly healed and no sloughing of skin is occurring. With sunburn, especially sunburn that covers a large area, avoid cupping it.


  1. Other burns, if someone has scar tissue from a burn, it is best not to do cupping on those areas. The skin is no longer normal. There  are significant challenges to the way cupping would have to be applied and how the scarred skin may react.  Get an OK from the primary if possible.


  1. Someone that does not want cupping. This would include someone that is not feeling up to it or is overly skeptical.  They will tend to focus on the discomfort.  As luck would have it, that is when injury is likely to occur.  Best to wait or offer some other treatment.


  1. Someone who has over eaten, is drunk, or drank a lot the night before. You can re-distribute the toxins and make them feel more ill.  Their energy and fluids are needed to transport and help in the digestion or metabolism process.


  1. Severe fatigue:  This is an option really.  Flash cupping can help them actually feel better.  More ‘fresh’ or effervescent…   This of course depends on the type of fatigue and how much time they have for recovery.  As long as they have the proper follow up, there should not be a  real problem.


  1. The palms or soles of the feet. These areas have different skin and it can be overly irritating.   It is also difficult to get the cups to stay.


  1. After strenuous exercise. The release of that reserve energy can cause the patient  to feel even more tired and fatigued.


  1. Be cautious with people who are overly nervous or restless. Some people with severe emotional disturbance cannot tolerate the therapy and should wait until they are feeling more stable. Occasionally, people can experience sudden and sometimes disturbing emotional releases.


  1. A chronic disease process you do not understand well, including complex disorders that you should first discuss with a practitioner who understands cupping, as well as the condition of the person receiving cupping.


  1. Thin skin, very papery skin. This is common in the very old or frail and you should be cautious with this.  Ok to do lighter technique but be gentle and take time.  It may take many visits to see the desired results.


  1. People on certain medications such as Warfarin, Coumadin, have taken a lot of Aspirin, or blood thinners. People that are taking large amounts of fish oils (omegas), DHEA, Vitamin E, or Gingko Biloba.  They may have markings from cupping that will last a very long time.


  1. People that are under treatment for cancer or diabetes. Make sure you get authorization from their primary care provider.  Although there are no research articles or studies that show cupping doing any harm other than the skin discolorations in people with diabetes or cancer, most Western medical practitioners caution that somehow it can help spread the disease.  There is no basis in fact with this as people have had all sorts of other treatments that were once forbidden for cancer patients, massage being one of them.  Remember, cupping is moving fluids within the tissues.  The body’s natural response is to clean and maintain homeostasis.  The cupping treatment stimulates that to continue more vigorously, thereby removing toxins that would otherwise have a harder time being released and properly dealt with.


  1. Other areas as diagramed below. Elbows, knees, ears, feet and hands are not a real contraindication, it is just too difficult to get any cups to stay and there is little benefit from using them there.

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