lternative medicine is not very popular in Sri Lanka where I live. However, the indigenous system of medicine, namely ayurveda which has existed for many centuries and which was smothered by the advent of western medicine when the British colonised the then Ceylon is gradually surfacing in popularity although it still has a long way to go before it attains its former stature of many centuries back. 

But other alternative therapies are virtually unheard of or not well known or accepted. Cupping therapy is virtually unheard of in Sri Lanka. There are only a handful of practitioners…….about less than five to my knowledge in a population of 20 million.  

Patients used to popping pain killers for long periods of time with attendant side effects find this therapy fascinating. And………..when they find relief through this drugless therapy after a few sessions they are astonished at what some simple cups can do! Here are five such cases: 
CASE 1 

A lady in her mid sixties found it extremely difficult to do meditation in the temple as she could not maintain posture for some time without suffering from severe pain down the back of both her thighs accompanied with cramps of the calves. She has been suffering for about two years and only strong analgesics provided temporary relief. But taking such analgesics precipitated severe gastritis so much so she was between the devil and the deep blue sea! She looked so forlorn that she could not meditate anymore with success as the pain creeps in to her meditative state and disturbs the tranquility she otherwise experiences.  

She was asked to lie face down (prone position) with her hands crossed and her forehead placed on the dorsum of her hands. Sesame oil was applied from the area below the gluteal crease up to the popliteal crease. A medium size cup was applied just below the gluteal crease and suction and negative pressure exerted by means of a pistol grip. 

When the cup was gently moved down she complained of severe pain. It meant that though chronic characterises her condition her present predicament was acute. The pressure was released and a less strong suction was made – one she could put up with. 

Movement elicited complains of pain at various sites and it corresponded to muscle knots (myofascial trigger points) that can be felt in the hand when moving the cup. An overall examination revealed that the posterior-medial aspect of both thighs had many hard muscle knots. 

Gentle cupping massage was then initiated over the course of these hard muscle knots in soft tissue – back and forth a few times. This was done to break up the tension in the tissues. Subsequently, average sized cups were placed over the knobby areas and stationary cupping done for 20 minutes. 

The same method was applied to the calves and here too muscle knots were identified and stationary cupping initiated. A cup was placed over acu-point UB-57 with moderate suction after needling it with a one inch, 32 gauge, filiform needle. 

She also complained of a pain radiating from both buttocks down the posterior aspect of the thighs. Acu-point GB-30 over both buttocks were deeply palpated by a jimmy and sharp tenderness elicited which indicated she suffered from bilateral sciatica……which also could contribute to her discomfort when she assumed the pose for meditation (seated on the ground with legs crossed over – lotus position). 

Long filiform needles (5 inches-32 gauge) were inserted over GB-30 of both buttocks and large cups were thereafter placed over the needles, suctioned and acu-cupping initiated.  

When the cups from the thighs/calves were removed the interior was misty (coated with water vapor) which was clearly indicative of the prevalence of damp in the sites cupped. ‘Damp pathogen’ as it is sometimes called always manifests in the type of pain and discomfort and muscle knots the patient suffered from. 

Immediately after the cupping session the patient complained of a sense of soreness and stiffness. She did not look happy. After she went home she made a phone call and said she felt more sore and stiff. I reassured her that these sensations would soon subside.  

Some patients do feel such post-cupping discomfort which eventually subsides. A strong suction (particularly on the elderly and children must be avoided) would often precipitate such post-cupping conditions. Even a moderate suction (as in this case) sometimes would elicit such discomfort if the condition is acute (though chronic over time). Therefore, it is best to tell the patient that ‘only’ sometimes some post-cupping discomfort may be felt when/after returning home but that it would soon dissipate and give over to relief.

When the patient came for the second session she said the sense of soreness and stiffness disappeared after some hours and a sense of relaxation crept in. She felt more confident of the treatment. Four more cupping sessions later she was virtually relieved of her suffering totally. And now she does meditate for many hours without any pain or discomfort. She was so happy that she could meditate in peace that she donated a 12 piece cupping set to the clinic!!

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SOME CASES OF CUPPING THERAPY- Dr Mass R. Usuf-Cupping Hijama Magazine -Vol 1- Page 18-Jan 2010