HEAT AND SUCTION CUPPING THERAPIES
The acupuncture nodes have been described since ancient times as amenable to non-specific stimulation, including not only needling but also heat, pressure application (massage, acupressure) or reduction (suction cupping), and topical use of therapeutic herbal preparations. The ability of acupuncture nodes to transmit and transduce signals from a wide variety of stimuli is borne out by modern basic research into the characteristics of the nodal/vessel system (Kendall 2002; Shang 2002).
Moxibustion Therapy
The classic method of heat therapy in Chinese medicine is known as "moxibustion." Moxibustion refers to the combustion of "moxa:" preparations of dried medicinal herbs, principally Artemesia vulgaris (mugwort). Focused local heat is delivered via ignition of wand-shaped moxa rolls held above the skin, or by small cones of moxa placed over a protective medium. Regional heating is accomplished through placement of ignited moxa in protective chambers that are held or placed over larger body areas. Moxibustion is normally applied for 5-10 minutes only, and in all cases precautions are taken to ensure that overheating or burning does not occur.
The high resin content of moxa makes for high-temperature combustion and deep penetration of heat. The clinical effects of moxibustion are similar to those of other heat therapies (such as the increased cellular metabolism, vascular flow, and relaxation of contractile tissue, etc. that is observed with hot packs, therapeutic ultrasound, infrared heat, etc.). In addition, the signature wavelength spectrum emitted by moxibustion may account for ancient use in Chinese medicine.
The earliest Chinese medical texts describe heating of nodes and vessels through moxibustion as equal in importance and effectiveness to needle therapy for the treatment of certain diseases, especially arthritic, neurological, myofascial, and soft-tissue traumatologic conditions, as well as upper respiratory tract infections and asthma; digestive and OBGYN disorders, and endogenous hypofunction disorders (e.g. hypothyroidism).
The clinical efficacy of moxibustion therapy has been demonstrated in recent powerful studies such as "Moxibustion for Correction of Breech Presentation: A Randomized Controlled Trial" (Cardini, 1998), in which 75.4% of 130 fetuses in the intervention group were cephalic at birth vs. 62.3% of the 130 fetuses in the control group who received manual version (P = .02; RR, 1.21; 95% CI, 1.02-1.43.
Contemporary Heat Therapies
While moxibustion remains a useful clinical modality, the advent of newer equipment allows for more precise temperature control and safety. Hot packs, infrared lamps, contrast and paraffin baths, and ultrasound devices are in common use in acupuncture clinics in present-day China, Japan, Europe, and the United States.
Suction Cupping Therapy
Cupping involves creating a vacuum in a suction cup over various parts of the body for therapeutic effects. The classical method of cupping was to briefly heating the air in an inverted cup, which then produces a vacuum when the air cools after the cup is quickly applied to the skin. The resultant low pressure under the cup causes a localized expansion of tissue, which produces a profound vasodilatation reaction.
Suction cupping is used therapeutically to draw blood flow to areas of ischemic pain, thus flushing capillary beds and re-supplying vital nutrients. Suction also mobilizes and stretches soft tissue by pulling it up and away from underlying structures, thus loosening areas of adhesion or restriction and activating muscle spindle reflexes that relax contractile tissue.
Suction cups are typically placed locally over disease/injury sites, and retained or manipulated for 5-10 minutes. Topical application of an oil-based lubricant to the skin just prior to cup application facilitates a tight seal, and allows for sliding cups around in the treatment area.
Cups are now available that can be mechanically evacuated using a small hand-operated pump. Cups of all sizes are employed to treat a wide range of disorders. Small cups may be applied to the face to treat facial paralysis, whereas larger cups placed in the lumbar region are used to treat lumbago. Cupping is frequently applied over nodal sites, but can be used in non-nodal regions as well.
Enhancement of acupuncture effects through heat and suction cupping.
Heat and suction cupping therapies may be used alone, or to enhance the effects of acupuncture. Heat and reduction of ambient pressure both lower the threshold for generation of propriospinal reflexes through needle stimulation of muscle spindles. The activation of such reflexes is signaled through the inducement of propagated sensation (see "Acupuncture Mechanisms of Action"). Heat and suction cupping may thus be used synergistically with needling to evoke the propriospinal responses that facilitate muscle relaxation.
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Health Care Network 2003
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