In recent years, cupping therapy has been increasingly employed for lymphatic drainage due to its potential benefits in promoting the flow of lymphatic fluid.
Cupping therapy has been used for centuries as a therapeutic modality in traditional medicine systems worldwide. Its use has evolved over time, and today, it is gaining popularity in various health care practices, including massage therapy.
In this article, we will explore the technical aspects of cupping for lymphatics, including its history, techniques, indications and contraindications.
Cupping, a Remedy for Many Ailments
Cupping therapy, with a history dating back thousands of years, is one of the oldest-known healing practices. Its origins can be traced to ancient civilizations in Egypt, Greece, China and the Middle East.
The earliest records of cupping can be found in the Ebers Papyrus, an ancient Egyptian medical text from around 1550 BCE. Cupping was also mentioned in the famous Chinese medical text, “The Yellow Emperor’s Classic of Internal Medicine,” written over 2,000 years ago.
Throughout history, cupping has been used as a remedy for many ailments, ranging from pain relief to respiratory issues. Over time, various cultures and regions have developed unique cupping techniques and applications.
Today, cupping therapy has evolved into a popular and widely practiced form of complementary medicine worldwide, embraced for its potential to alleviate pain, promote healing and support overall well-being.
How Cupping Encourages Movement of Lymphatic Fluid
Cupping therapy involves the application of cups to skin and the use of suction. Cups are typically made of glass, plastic or silicone. Suction can be created manually with the use of a hand pump, or in the case of silicone cups by squeezing them, or automatically by using an electric pump.
Some of these automatic pumps are quite sophisticated, using computer control boards to create exact amounts of suction and being able to vary suction over time. Others are just a pump that has an on or off switch.
When placed on skin, the suction effect draws skin and underlying tissues into the cup, increasing blood perfusion in the local capillary bed, promoting adaptation of the nervous system in setting muscular tone or perceiving pain, and encouraging the movement of lymphatic fluid.
The amount of suction used, the length of time a cup is kept in place, and the amount of shearing force created by moving the cup or the tissue underneath a cup are variables a trained therapist will manipulate in order to have the intended outcome of a cupping intervention.
Cupping for Lymphatic Drainage
Not all cupping techniques work for addressing the lymphatic system; however, several basic cupping techniques, including flash cupping, fast cupping and massage (also known as dynamic) cupping, can be used for this purpose.
These techniques have a few things in common; namely, light suction, very low retention times and a small amount of shearing force. These techniques are also rhythmic in their application.
Flash cupping involves placing a cup on the area being treated and removing it almost immediately, then putting it back on and taking it off repeatedly for the treatment time. This technique is done with very light suction and the cup is removed quickly, which creates a popping sound.
Fast cupping is a technique where a few cups are put on the body close together, usually in a line, and then the first one applied is removed and is leap-frogged over the others along the line being treated. The strength of the suction is light to medium.
Massage cupping entails gliding cups along skin to mobilize lymphatic fluid. Normally in cupping for lymphatics, this is done with relatively light pressure, usually moving fairly slowly and with short stroke lengths. (Watch examples of this type of cupping in our video presentation for MASSAGE Magazine at youtube.com/watch?v=dmSIrLhuuwQ.)
Cupping for Various Lymphatic-Related Conditions
Cupping therapy can be beneficial for individuals with various lymphatic-related conditions, including lipedema, lymphedema, swelling from injury, post-operative swelling and compromised lymphatic circulation.
Cupping is useful in treatment of chronic pain where there is an inflammatory component. There are some case studies of cupping for lymphatics being used with athletes looking to recover from heavy workouts or recovering from competitions.
Cupping can be helpful in cases of chronic edema where cupping for lymphatics seems to perform better than manual lymph drainage. It is hypothesized that this result is because of the tissue provocation brought on by the suction of cupping that is not present around typical manual lymph drainage techniques.
Cupping therapy can be used in conjunction with other lymphatic drainage techniques to enhance treatment outcomes. These other techniques include manual lymph drainage, kinesiology taping, combined decongestive therapies, exercises or dry-brushing.
Often cupping is combined with manual lymph drainage techniques where the volume of edema is so much the skin has become fragile. Manual techniques are better equipped to deal with this, so manual lymph drainage may be used on fragile skin and cupping for lymphatics used where the skin is healthier.
Movement is often added to these treatments and as home-care for clients with swelling, as movement can be done passively within a treatment session and active movement can be given to the client to do at home to extend treatment results.
Contraindications & Safety Considerations
While cupping therapy can be beneficial for many individuals, there are certain contraindications to consider. Cupping should not be applied to areas with open wounds or broken skin.
In general, cupping is not usually applied to areas that are swollen or inflamed; however, in cupping for lymphatics the cups are used only with light-to-medium suction and never left stationary for long—so with these modifications, cupping is safe to do in these areas.
Cupping should be avoided over varicose veins and areas with thin, fragile or sensitive skin. People with bleeding disorders, skin conditions or a history of blood clotting issues should also avoid cupping therapy or seek advice from a qualified medical professional before undergoing treatment.
Caution should be used in cases of anemia and with pregnancy. The client’s medications must also be looked at, as many medications can lead to easier bruising and that is something to be avoided.
Research on Cupping for Lymphatic Drainage
There is not an abundance of research available for cupping for lymphatics, but there are some studies that show promise:
Weber stated that negative pressure therapies could be useful in treating post-operative swelling.1 In this study, negative pressure therapy had a better outcome around pain control than the manual lymph drainage treatments that were the control for the study.
This finding was also found in a study by Vuorinen, et al. in 2013 where they found that a negative pressure device gave better results than regular manual lymph drainage treatment in limb volume changes and in tissue stiffness measurements and in quality of life (as tested in the experiment).2 Other studies reinforce these results. And such results seem to be consistent no matter the type of swelling—from lymphedema to traumatic-injury swelling and post-operative swelling.3,4,5
Most of these studies are done with a negative-pressure machine programmed to use light-to-medium suction in several different settings specific to treating the lymphatic system in various scenarios. This is not difficult to simulate using cups manually, so it is comparable to a cupping for lymphatics treatment.
The results of using this machine are compared to traditional cupping in the discussion in a study by Rodríguez-Huguet,6 noting that the results of using the machine are comparable to the results of cupping therapy.
Cupping Supports Clients’ Lymphatic Health
Cupping therapy is a time-honored therapeutic technique that offers numerous benefits for lymphatic drainage. With its long history of use and growing body of evidence, cupping therapy has gained recognition as a valuable modality in supporting lymphatic health and overall well-being.
In a clinical setting, cupping for lymphatics is typically incorporated into a comprehensive treatment plan based on desired outcome, current health history, and indications and contraindications present for that client. The therapist begins by assessing the client’s overall health and their lymphatic system. With that information, the therapist can then determine the appropriate cupping techniques based on the client’s condition and medical history.
The therapist may use a combination of flash, fast and massage cupping techniques to address specific areas of concern. Cupping therapy is often combined with other manual lymphatic drainage techniques, such as light massage and gentle movement, to optimize treatment results.
As with any treatment, it is essential to approach cupping for lymphatics with a thorough understanding of techniques, indications and contraindications to ensure safe and effective outcomes for clients. Courses that teach cupping often focus on pain relief and range of motion, only making passing mention of how to apply cupping for lymphatics. Therapists interested in this modality should seek out courses that focus on the lymphatic system.
With the right knowledge and skill, massage therapists can harness the power of cupping therapy to enhance lymphatic circulation and support their clients’ health and wellness journey.
1. Weber M, Rahn J, Hackl M, Leschinger T, Dresing K, Müller LP, Wegmann K, Harbrecht A. “Postoperative swelling after elbow surgery: influence of a negative pressure application in comparison to manual lymphatic drainage-a randomized controlled trial.” Archives of orthopaedic and trauma surgery, 2023. 10.1007/s00402-023-04954-3. Advance online publication. doi.org/10.1007/s00402-023-04954-3. Accessed August 16, 2023.
2. Vuorinen VP, Iivarinen J, Jurvelin J, Airaksinen O. “Lymphatic therapy using negative pressure, A clinical study with the LymphaTouch Device.” TEKES (the Finnish Cunding Agency for Technology and Innovation). 2013. 5320003/221. bodyanalyse.no/gammel/studier/lymphatic_therapy.pdf. Accessed Aug. 16, 2023.
3. Dresing K, Fischer AC, Lehmann W, Saul D, Spering C. “Perioperative and posttraumatic anti-edematous decongestive device-based negative pressure treatment for anti-edematous swelling treatment of the lower extremity—a prospective quality study.” International journal of burns and trauma, 2021. 11(3), 145–155.
4. Saul D, Fischer AC, Lehmann W, Dresing K. “Reduction of postoperative swelling with a negative pressure treatment—a prospective study.” Journal of orthopaedic surgery (Hong Kong). 2020. 28(2), 2309499020929166. https://doi.org/10.1177/2309499020929166. Accessed Aug. 16, 2023.
5. Whitaker J. “The Effects of a Hand-Held Negative Pressure Lymph Drainage (NPLD) Device on 2 Primary Lymphoedema Patients of Different Durations.” 8th International Lymphoedema Framework Conference. June 6-9, 2018, Rotterdam, Netherlands.
6 Rodríguez-Huguet M, Rodríguez-Huguet P, Lomas-Vega R, Ibáñez-Vera AJ, Rodríguez-Almagro D. “Vacuum myofascial therapy device for non-specific neck pain. A single blind randomized clinical trial. 2020. Complementary Therapies in Medicine. Volume 52, 2020, 102449, ISSN 0965-2299, doi.org/10.1016/j.ctim.2020.102449. Accessed August 16, 2023.
About the Author
Paul Kohlmeier, LMT, creates and teaches continuing education courses for various health care professionals across Canada and the U.S. and beyond. He is the co-owner and head instructor for Cupping Canada and Cupping USA, and he also hosts the Cup, Scrape, Tape Symposium, to be held Nov. 11-12, 2023, and the 60 Minute Series, both online conferences.