Nazar Bondarchuk
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Companion page to the book · Cupping Therapy

Glossary & Bibliography

All terms used in the book, explained in plain language, and the full list of scientific sources the book is based on.

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Cupping Therapy
Nazar BondarchukNazar Bondarchuk

A

Adverse Event

An undesirable reaction or event that occurs during or after a procedure. In cupping therapy these may include severe pain, a burn, a blister, skin damage, bleeding, infection, dizziness, and other reactions.

Allocation Concealment

A method of reducing bias in a clinical trial: the person enrolling a participant must not know in advance which group the participant will be placed in.

Anticoagulants

Medications that reduce the ability of the blood to form clots. They are especially important in cupping therapy because of the risk of hemorrhage, and above all in wet cupping.

Antiplatelet Drugs

Medications that reduce the ability of platelets to stick together. They may increase the tendency to bruising and bleeding.

Ashi Points

A traditional Chinese medicine term for individually painful or tender areas. Unlike a fixed acupuncture point, an ashi point is determined by the response of the particular person.

B

Baseline

The state or measurement before the intervention. For example: pain of 7/10, limited movement, or a particular functional task before the procedure.

Bias

A systematic distortion of a study's result that can lead to overestimating or underestimating an effect.

Biomarker

A measurable biological indicator, for example the concentration of a substance in the blood or a measure of blood flow. A change in a biomarker does not necessarily mean clinical improvement.

Blinding (masking)

A method of reducing bias in which the participant, the practitioner, the outcome assessor, or the analyst does not know the group allocation, where this is possible.

Blister

Damage to the skin with the formation of a fluid-filled cavity. After cupping therapy it is not a necessary sign of "cleansing" and should not be the goal of the procedure.

Blood Stagnation (xue yu)

A traditional term that has different meanings in different medical systems. It should not be automatically equated with deep vein thrombosis, chronic venous insufficiency, or any other modern vascular diagnosis.

Bloodborne Infection

An infection that can be transmitted through contact with blood. Especially important for wet cupping, sharps, and reusable equipment.

C

Clinical Significance

The practical importance of a change for a person's condition and life. A statistically significant result is not necessarily clinically significant.

Co-intervention

Another treatment or action a person receives at the same time as the method being studied: medications, exercise, physical therapy, and so on. It can make it harder to assess the independent effect of cupping therapy.

Comparator (control intervention)

What the studied procedure is compared with: no treatment, usual care, a sham procedure, another treatment, or a combination of methods.

Confidence Interval (CI)

A range of values compatible with the obtained data under the chosen statistical model. A very wide CI indicates low precision of the estimate.

Cupping Massage

A technique in which the cup, after a moderate vacuum has been created, glides over the skin. Also: sliding cupping, moving cupping, massage cupping.

Cupping Therapy

The general name of the method. In this book it is used as an umbrella term for dry, wet, retained, sliding, and other variants.

D

Deep Vein Thrombosis (DVT)

The formation of a blood clot in the deep veins. Suspected DVT is a reason to decline elective cupping therapy on the affected limb and to seek medical evaluation.

Disinfection

Treatment that destroys many or most pathogenic microorganisms on objects, but not necessarily all bacterial spores. It is not the same as sterilization.

Dose

In cupping therapy, the combination of procedure parameters: suction pressure, duration, size and number of cups, area treated, frequency of sessions, and technique.

Dry Cupping

Cupping therapy in which negative pressure is applied over unbroken skin without deliberate bloodletting.

E

Ecchymosis

Subcutaneous hemorrhage caused by blood escaping from damaged small vessels. Many dark marks after intensive cupping therapy are ecchymoses.

Effect Size

A quantitative estimate of a difference or change. A p-value alone does not show how large or clinically important an effect is.

Erythema

Redness of the skin caused by a local vascular response. It can occur without significant damage to the capillaries.

F

Fascia

The connective tissue system that surrounds, separates, and binds muscles and other structures. It takes part in transmitting mechanical load and in the gliding of tissues.

Femoral Triangle (trigonum femorale)

An anatomical area in the upper anteromedial part of the thigh through which large neurovascular structures pass. In this book it is among the zones requiring special caution.

Fire Cupping

A technique in which negative pressure is created by heating the air inside the cup before it is placed. It adds a risk of burns.

Flash Cupping

A technique in which the cup is placed for a short time and removed at once, with the placement repeated many times on the same area.

G

H

Hematoma

A collection of blood in the tissues after damage to blood vessels. A larger formation than an ordinary superficial ecchymosis.

Heterogeneity

Differences between studies in participants, technique, dose, control intervention, outcomes, or results. High heterogeneity limits simple pooling of data.

Hijama

A term widely used in the Islamic and Middle Eastern tradition for a form of wet cupping. In the scientific literature it usually refers to wet cupping.

Hyperemia

An increase in the blood supply of a tissue. Local redness after cupping therapy may be related to a vascular response.

I

Intention-to-Treat Analysis (ITT)

A principle of analysis in randomized controlled trials in which participants are analyzed in the groups to which they were assigned at randomization, regardless of how fully they adhered to the assigned intervention.

Interstitial Fluid

The fluid between tissue cells that takes part in exchange among capillaries, cells, and the lymphatic system.

I² Statistic

A statistical measure of heterogeneity in a meta-analysis. It should be interpreted together with clinical differences and the number of studies.

L

Lymphedema

Chronic swelling caused by impaired lymphatic transport. Any temporary puffiness should not automatically be called lymphedema.

M

Manual Lymphatic Drainage (MLD)

A specialized gentle manual technique used as part of the treatment of lymphedema. Sliding cupping and MLD are not the same procedure.

Meta-Analysis

A statistical pooling of the results of several sufficiently comparable studies.

Microcirculation

The movement of blood through arterioles, capillaries, and venules. Cupping therapy can temporarily change local skin and tissue blood flow.

Minimal Clinically Important Difference (MCID)

The smallest change in a measure that is regarded as clinically important. There is no universal MCID for all chronic pain: it depends on the baseline state, the method of calculation, and the clinical context.

N

Natural History

How a condition changes over time without the intervention being studied. Improvement after a procedure does not always mean that the procedure was the only cause of the improvement.

Negative Pressure

Pressure inside the cup that is lower than the surrounding atmospheric pressure. The main physical principle of cupping therapy.

Nocebo Effect

An intensification of a symptom or of unpleasant sensations linked to negative expectations, learning, or context.

Nociception

The processes by which the nervous system detects and transmits signals about a potentially damaging stimulus. Put simply, it is the work of the nerves that notice possible tissue damage and send a signal to the brain. Nociception and subjective pain are related but not identical: a signal may travel without any sensation of pain, and pain may arise without such a signal.

Nociceptor

A nerve ending that responds to a potentially damaging stimulus (strong pressure, stretching, heat, cold, chemical irritation) and triggers a nociceptive signal.

O

Outcome

A predefined result that is measured: pain, function, range of motion, quality of life, adverse events, and so on.

P

P-Value

A statistical measure that is not an effect size and does not automatically show the clinical importance of a result.

Paravertebral Area

The soft tissues to the right and left of the spine. It does not mean placing cups directly on the spinous processes.

Petechiae

Small pinpoint hemorrhages in the skin. After strong suction they can look like many red or dark red dots.

Placebo Effect

A psychobiological effect linked to expectations, learning, the context of treatment, and interaction with the practitioner. It does not mean that the symptom is "made up."

Popliteal Fossa (fossa poplitea)

The anatomical hollow behind the knee joint through which large vessels and nerves pass. In the charts in this book the central zone is left free.

Publication Bias

A distortion of the published literature that arises when positive results are published more often than negative or inconclusive ones.

R

Randomized Controlled Trial (RCT)

A study in which participants are randomly assigned to groups in order to reduce the influence of systematic differences and to better estimate the causal effect of an intervention.

Reactive Hyperemia

A temporary increase in blood flow after a change in mechanical or vascular conditions. It is not evidence that a pathological "stagnation" existed before the procedure.

Referred Pain

Pain felt somewhere other than the site of the original source of the signal. Treating a painful surface area does not prove that an internal source of the symptom is being treated.

Regression to the Mean

A statistical phenomenon in which an especially pronounced symptom, when measured again, often moves closer to its usual level even without a specific intervention.

Risk of Bias

The risk of systematic distortion of a study's result due to features of randomization, deviations from the assigned intervention, missing data, measurement of outcomes, or selective reporting of results.

S

Sham Procedure (sham cupping)

A simulation of cupping therapy used as a control intervention (also called a placebo procedure). It should resemble the real procedure as closely as possible while reducing or eliminating the presumed specific component.

Sharps

Needles, lancets, and other objects that can puncture or cut the skin. After use they require safe handling and a special disposal container.

Standard Precautions

Basic infection-control measures for work with blood and potentially contaminated materials: hand hygiene, PPE according to risk, safe handling of sharps, cleaning, disinfection or sterilization, and so on.

Sterilization

The process of destroying all forms of viable microorganisms, including bacterial spores. It is not the same as ordinary cleaning or disinfection.

STRICTOC

The international standard for describing clinical trials of cupping therapy (Standards for Reporting Interventions in Clinical Trials of Cupping, 2019). It tells researchers what to include in a paper about the intervention, and it is not a rule of practice.

Surrogate Outcome

An indirect measure, for example a biomarker or skin blood flow, that may be related to health but is not directly equal to an improvement in well-being, function, or prognosis.

Systematic Review

A review of the literature with a predefined method for searching, selecting, appraising, and synthesizing studies.

T

Trigger Point

A clinical term for a painful or tender area in a muscle or related tissue. It should not be automatically identified with an ashi point.

V

Vacuum

In the context of this book, a relative reduction of pressure inside the cup compared with the surrounding atmosphere; it does not mean an absolute physical vacuum.

Venous Stasis

A slowing of venous blood flow in a specific medical context. It should not be automatically equated with the everyday sensation of "stagnation."

Viscerosomatic Interaction

A connection between visceral and somatic signals in the nervous system that can take part in referred pain and other segmental responses.

W

Wet Cupping

An invasive form of cupping therapy in which negative pressure is combined with deliberate breaking of the skin and the collection of blood. Also called blood cupping.

Working Zone

In this book, a surface that is anatomically and, given the condition of the skin, potentially suitable for cupping therapy after a safety check. The term does not mean proven effectiveness for any particular disease.

Nothing found.

This page is educational. It is not medical advice and does not replace a consultation with a doctor. Wet cupping and work near blood vessels require training and medical clearance.