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Author: Anita Shannon, L.M.T.
Photo Courtesy of Anita Shannon

Cupping therapy, or vacuum therapy, can be used for a variety of applications, from head to toe. One special focus is the head, neck and face, as these are often areas of pain and dysfunction. Headaches, sinusitis, temporomandibular joint (TMJ) disorders, lymphatic issues, chronic inflammation, and surgical preparation and recovery are common concerns for many people who come to see massage therapists.

Massage to Facilitate Drainage

Many traditional and effective massage techniques gently traction the neck and necessitate upward movement to the occipital ridge. Integrating downward movements into massage of the head, neck and face can enable the drainage of cranial lymph and add an enormous benefit to soft tissue work.

Drainage of the head and neck moves down the cervical spine and travels around to the anterior neck, superior to the clavicle and toward the central clavicular notch. Anterior drainage moves down along the sternocleidomastoid and joins the drainage chain superior to the clavicle. Look around one day and observe how many people have a puffy face and neck. Some have congestion only above the clavicle, and a few have more severe congestion that has affected the upper thoracic area.

How Cupping Therapy Can Help

Vacuum therapies provide a wonderful approach to lymphatic liquefaction and drainage, as well as soft tissue release. Liquefaction is the process of turning something into liquid. Congestion of the face and body can be areas of thickened lymph, which blocks drainage and creates more congestion, much like a blockage on the highway results in mile after mile of trapped cars.

As congestion builds, the body’s drainage and filtration system is overwhelmed and slows down, and this dense layer of thickened lymph blocks the elimination of deep inflammation via the blood vessels in the skin. Vacuum therapy lifts and separates the layers of the skin and underlying tissue to enable movement of the congestion, and liquefaction can be achieved if deeper heat is brought to the skin surface.

Application of heat before vacuum therapies can also help soften very thick, old congestion. A warm towel wrap or steam on the face and neck prior to treatment works well to begin both liquefaction of lymph and vasodilation of blood vessels in the skin—and it feels great, too.

Either manual cups or a machine can be used on the face and neck. Low-suction vacuum machines have been part of basic esthetic equipment for decades, and lymphatic drainage is the foundation of many facial treatments and facial massage movements. Massage therapists are now incorporating vacuum therapies into bodywork, and working on the face during the session will quickly become a client favorite.


It is common for those with thyroiditis to have a thick layer of congestion around the base of the neck, and that area may take a few treatments to clear before the upper neck and face will be able to drain. (There is no sense in bringing more cars onto a backed-up highway.)

TMJ Dysfunction

TMJ dysfunction can create severe congestion at the angle of the jaw and around the ears, and vacuum drainage under or along the jaw line and down the neck can help relieve this pain and pressure. There is a chance of leaving a mark due to the history of micro-tears in the jaw muscles, so watch the tissue closely as you work.

Two cups can be used simultaneously to gently traction the soft tissue of the TMJ; this is effective at releasing these tight muscles, and is excellent preparation for any intra-oral techniques that may be needed. Most TMJ dysfunction is also related to cervical soft-tissue issues and resulting structural distortion, so treatment of the posterior neck tissues is an important part of the session.


Headaches are a common complaint brought to our massage tables, and vacuum therapy soft tissue release techniques and vacuum drainage combine well to address the myriad of causes. Observe the tissue inside and around the cup to detect adhesions or discolorations, using deeper suction for muscular tension and lighter suction and pumping for drainage.


Another common complaint from clients and therapists alike is sinusitis from allergies and seasonal colds. To help bring relief, do a complete drainage and soft tissue treatment for the neck and face, with special focus over the sinuses located on both sides of the nose and just above the eyebrows.

Pumping movements over the sinuses and gliding movements to drain the neck and face can relieve swelling and discomfort, especially if done twice per week. Use a very small cup to work closely around the eyes to drain puffiness from allergies and sinus issues.


before cupping therapySurgical Preparation and Recovery

A favorite application for vacuum therapies is surgical preparation and recovery. So many people are having surgical procedures, and the process can be enhanced by the addition of vacuum therapies. Preoperative drainage can improve recovery time and decrease the postsurgical discoloration and swelling that can be very noticeable from procedures such as rhinoplasty, melanoma or cancer removal, and full or partial face lifts.

after cupping therapy

Top: Surgical scar before cupping therapy Bottom: The scar after cupping therapy | Photos by Mike Krizek

Vacuum therapies have been successfully used for postsurgical applications that include scar reduction, skin graft integration, and releasing restrictions that can inhibit normal lymphatic and soft tissue function. The incredible results have gotten the attention of the medical field, and some surgeons are beginning to recommend cupping therapy for their patients by referring them to trained vacuum therapy practitioners.

Integrating Vacuum Therapy into Your Practice

The face, head and neck constitute one of the most complex areas of the body, and are naturally prone to dysfunction due to lifestyle habits and events. Integrating vacuum therapies into treatments quickly produces substantial results, and special treatment series for any of the conditions mentioned above are a great addition to any service menu.

Start with 30-minute sessions twice per week for six to eight treatments and chart each client’s progress. Be sure to document facial scars, lymphatic congestion, sagging skin and other visible conditions with photos. You and your client will enjoy seeing the progress, and you will also have the case study to show potential referring health care professionals.

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