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Thanks to Olympics, ‘cupping’ gets its 15 minutes of fame–again

Joy Victory is deputy managing editor of HealthNewsReview.org. She tweets as @thejoyvictory.

Cupping therapy, woman doctor removes cup from the patient's backFrom The New York Times to CBS News to TIME to CNN to NPR–and on and on and on–many major news outlets were breathless this week to report that swimmer Michael Phelps had circular red welts on his skin, a sign that he was “cupping.” The same characteristic marks also were seen on gymnast Alex Naddour and a handful of other athletes.

Some true believers make health claims about cupping, which involves using suction to pull a glob of skin and underlying tissue into small glass cups. Because it causes visible (and eyebrow-raising) bruising of the skin, it’s hard to miss on scantily-clad swimmers and gymnasts.

From time to time, it pops up in the news, when a celebrity or athlete espouses its pain relieving and injury recovery benefits–even though there’s not a lot of evidence to support these claims.

How did the coverage fare?

Given the flurry of cupping stories this week, we were curious: Was the news media appropriately cautious about its effectiveness?

Fortunately, nearly every story we looked at (about a dozen) included at least one critical statement or quote about cupping. The most in-depth criticism we came across was served up by VICE Motherboard, which used the topic as a springboard to look at other trendy questionable practices in Why the Olympics Are an ‘International Festival of Sports Pseudoscience.’”

And we were pleased to see the placebo effect discussed in depth in a handful of articles, especially this Well blog post from the New York Times, where a source explains “a placebo effect is present in all treatments, and I am sure that it is substantial in the case of cupping as well. A patient can feel the treatment and has marks after it, and this can contribute to a placebo effect.”

On the other end of the spectrum, a USA Today sports story included only one tiny line of skepticism–and it was buried on the third page of a graphic slideshow, where we learn “medical authorities are divided over the treatment’s effectiveness.”

Evidence discussion–it’s OK to weave it in earlier into your story

Over and over, we noticed that journalists saved the evidence discussion for the end, making it likely to be missed by many readers.

One exception: CBS News, which after two quick paragraphs tells us “when it comes to the science behind the ancient Chinese practice, the answers are vague.” Later, the story follows up on this theme several times, including unequivocal quotes like this: “There’s no scientific evidence. There are multiple trials out there but no quality evidence.” (However, the on-air version on last night’s CBS Evening News was not nearly as good. It offered a graphic of “how cupping works” — wrong on two counts: It’s not known how or if cupping works. And it ended with a throwaway line at the end about a lack of good scientific evidence, followed by a final line about the Olympics’ true believers who “swear by it.”)

We’d love to see more stories using the lack of evidence as a way to start the story (i.e., “Despite little medical evidence in its favor, a physical therapy technique called cupping is all the rage right now…”) Why? This better guarantees that readers are left with an accurate explanation of the treatment, even if they don’t read right down to the last paragraph (or watch the full video).

Half-baked presentations of the evidence: TIME coverage

And while it’s great to include the findings from meta-analyses and systematic reviews, it’s important to do so accurately. Which, unfortunately, TIME didn’t do:

In Why Michael Phelps Is Gaga for Cupping, we’re told:

Some doctors say there isn’t enough evidence that cupping therapy works, but as TIME reported earlier, it has been thoroughly studied by some researchers: “A 2010 review of 550 clinical studies … concluded that the ‘majority of studies show potential benefit on pain conditions, herpes zoster and other diseases.’ None of the studies reported serious bad health outcomes from the practice.”

Except this summary is wrong. The reality? That 2010 review concluded quite the opposite (see the last two paragraphs of the review):

This review suggests that there is insufficient high-quality evidence to support the use of cupping therapy on relevant diseases. Although quite a number of clinical studies reported that cupping therapy may have effect on pain conditions, herpes zoster, symptoms of cough and asthma, acne, common cold, or other common diseases. The current evidence is not sufficient to allow recommendation for clinical use of cupping therapy for the treatment of above diseases of any etiology in people of any age group.”  

Not many gold medals to be given out for news coverage of this pop health fad. 

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Comments (3)

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Janet Borges

August 15, 2016 at 11:43 am

Oh, so very sad. “Pop health fad.” Really? How about those thousands of years of cupping being practiced across multiple traditions, including traditional Chinese medicine, and even co-opted by physical therapists as “myofascial decompression?” Sure, must be just a fad. This is a disappointing presentation from your organization, which I have previously held in high regard.

    Stephen Cox, MD

    August 30, 2016 at 2:42 pm

    “thousands of years:” does not equate to effective, honest or credible in any way. Penicillin, anticoagulants and angioplasty have not been around for hundreds of years but are effective. Snake oils, traditional Chinese and Egyptian medicine and other forms of magic and deception have fooled the gullible for many years and continue to do so. Just because you are convinced it works does not mean it did or will in a significant number of people.

Stephen Cox, MD

August 22, 2016 at 3:36 pm

This worthless alternative fake therapy has caused serious complications as local and systemic infection, ulceration, scarring as well the potential for severe bleeding in patients with clotting disorders or on anticoagulants,etc., which is a concern for gullible viewers of famed athletes and celebrities. (as Phelps and the quack promoter Gwyneth Paltrow).