America’s Reaction To Cupping Reveals Cultural Health Bias

The recent Olympic games in Rio piqued Snow Quach’s interest, especially as she watched Michael Phelps, American swimmer and winner of 23 Olympic gold medals, on TV with dark, circular marks on his shoulder and back. The rest of the world was watching, too. Many major news organizations soon followed up with explanations of cupping therapy, calling it a fad, probably harmless, probably psychological, and just as weird as expected.

So how could Phelps, the most decorated Olympic athlete of all time, believe in a medical practice that “might look a little ridiculous,” as USA Today described it?

Although Snow, 59, is not a medical professional, she has a simple answer. This was the first time that Snow saw the international spotlight put on cupping therapy, a form of Chinese traditional medicine that her family uses to treat sickness and pain.

You can’t argue with results, Snow says; when Michael Phelps does cupping, he gets a gold medal and people go crazy. “They go wow, he’s so powerful,” she explains.

She believes that Phelps wanted to enhance his performance without doping, so he chose cupping for pain relief and recovery after intensive swim practices and competition. This form of treatment is external and does not require ingestion of medicine that could be perceived as performance enhancers.

Cupping is thought to cause capillaries to rupture right beneath the skin’s surface, drawing blood to the area. The treatment pulls the skin up a tiny bit from the muscles and creates a circular mark that looks like a bruise, the New York Times explained. Snow believes that cupping and coining work because when someone is very sick or in pain, the treatment produces deep red marks on the skin, which means there is an increased presence of toxins in the body. As Snow applies a menthol lubricant on her arm and rubs the coin on herself, she talks about how redness occurs from the process.

Cupping derives from “coining,” and both should only be used when people are sick or feeling pain, according to Snow. She does not recommend this treatment for wellness, similar to how people should not take a Tylenol unless they need it.

Snow explains the process of coining: Vaporub or a similar mentholated cream is applied to the back, neck, shoulders, and chest, and then a coin is applied at about a 45-degree angle and rubbed up and down the skin repeatedly.

She believes that it works because she recovered every time she felt sick and coined herself. She says that coining is “poor people’s medicine.” It’s low-cost, and anyone can coin if they learn the proper technique.

It was also the only form of medicine available to Snow and millions of others who were displaced as refugees in Southeast Asia. Medical doctors weren’t available when they became ill, whether they were at refugee camps or the jungle.

Snow, who identifies as Chinese by ethnicity and Cambodian by cultural identity, had to flee at 22 years old from Cambodia to Thailand in 1978 to escape violence and war because of the Khmer Rouge.

After experiencing several disruptive and temporary resettlements, she moved to the United States in 1984, leaving behind the “Pol Pot days” and bringing along her knowledge of coining and cupping.

Between the two types of cupping that she is familiar with, rubber pump cupping, which Phelps and other high-profile athletes utilize, is a less painful form of treatment compared to fire cupping. Rubber pump cupping involves a pump that sucks out the air from the glass. But Snow prefers fire cupping because it creates a more powerful vacuum inside the cup.

Fire cupping sounds dangerous, but Snow says that it would be safe when administered properly. Snow demonstrates by putting a tiny short red candle on a coin, balancing it on her leg. Then she lights the candle and hovers a small glass cup over it, but not covering it completely. She waits until the fire warms the cup, then cups it to her leg. The fire extinguishes, producing a suction effect on the skin.

In Cambodia, Snow says, her purse had a small, empty glass bottle; when she had a headache, she’d light a fire. But in America, she says, people kept looking at her, causing her to stop.

But Snow’s niece, Jean Quach, acknowledges there could be risks of injury associated with fire cupping. “We had a live flame on someone’s back, and we put the cup on top. And I was like, this is scary as F,” Jean says.

Jean, 29, learned at a young age how to coin and fire cup from older family members when they could not self-administer on their back, the same reason that Snow had to learn from her grandfather.

The cultural misunderstanding of traditional Chinese medicine, which stopped Snow from cupping when she first came to the United States, surfaced again after Jean was approached sometime in elementary school to explain the reddish marks on her body. A social worker visited their home almost every month that year, deciding that it was best to investigate thoroughly if it was a case of child abuse.

Marks from cupping and coining have been perceived as bruises, causing ethnic minority parents to be mistaken as child abusers, according to a law review.

One time, a social worker watched the family demonstrate coining. “After that, they [were] gone,” Snow says.

Cultural awareness of treatments like coining and cupping may be useful for people who work with immigrant communities. A 2011 research study suggests there should be an increase in ethnic and cultural consideration within medical curriculum because it would help improve health outcomes, and a large proportion of Asians utilize these folk remedies anyway.

Evidence-based medicine is not the only treatment option available for pain and sickness. A 2010 literature review and 2011 study published in the journal Evidence-Based Complementary and Alternative Medicine both reported that although there isn’t enough high-quality research to allow recommendation of cupping for clinical use at the moment, research using randomized control trials has improved over the decades, and this trend should continue.

But given the option, Snow would choose to use cupping or coining to relieve pain over a painkiller tablet. It’s a not a placebo for Snow and her family. It’s a real treatment.

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Lead image: Bentevb at English Wikipedia