Cupping therapy can be performed by several types of licensed healthcare professionals, including acupuncturists, chiropractors, physical therapists, massage therapists (in most U.S. states), physicians, and naturopaths. There is no standalone “cupping license” in the United States. Instead, cupping falls within the scope of practice of various existing healthcare licenses, and the rules vary significantly by state and country.
Licensed Acupuncturists
Acupuncturists are the professionals most traditionally associated with cupping. In California, the state’s Business and Professions Code explicitly defines cupping as part of acupuncture practice, and the California Acupuncture Board is the sole licensing authority. Applicants must pass the California Acupuncture Licensing Exam to practice. Minnesota law similarly lists cupping as a named treatment technique within the acupuncture scope of practice and requires practitioners to hold current certification from the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).
Because acupuncturists study cupping as part of their formal training in traditional Chinese medicine, they typically have the most extensive background in the technique’s traditional applications, including point selection and treatment planning based on Eastern medical theory.
Physical Therapists and Athletic Trainers
Physical therapists increasingly use cupping, sometimes calling it “myofascial decompression,” to treat musculoskeletal pain and movement restrictions. In this context, cupping is applied as a manual therapy tool alongside exercises and other rehabilitation techniques. Athletic trainers and sports therapists also use dry cupping for similar purposes, particularly for muscle recovery and soft tissue mobility. If you’re seeing a physical therapist for an injury or chronic pain, cupping may be offered as one component of a broader treatment plan rather than a standalone session.
Chiropractors and Osteopaths
Chiropractors in many jurisdictions can perform cupping as an adjunctive therapy. The specific authorization depends on your state’s chiropractic board and how broadly it defines the chiropractic scope of practice. Osteopathic physicians, who hold full medical licenses, can also perform cupping without additional certification. If you’re considering cupping from a chiropractor, it’s worth confirming that your state’s licensing board includes it in their permitted techniques, as this varies.
Massage Therapists
This is where regulations get complicated. In many U.S. states, massage therapists can perform cupping as part of their bodywork practice, and continuing education courses in cupping are widely available. However, the rules are not universal. In British Columbia, Canada, the College of Massage Therapists issued a formal notice stating that cupping in any form does not fall within the scope of practice for registered massage therapists. Practitioners there who perform or bill for cupping are considered in violation of their professional standards.
If you’re booking cupping with a massage therapist, ask whether they’ve completed specific training in the technique and whether your state or province permits it under their license. Some states, like Ohio, don’t even require continuing education for massage license renewal, meaning there’s no formal mechanism ensuring a therapist has trained in cupping before offering it.
Physicians and Naturopaths
Medical doctors and osteopathic physicians can legally perform cupping under their broad medical licenses, though few do in general practice. Naturopathic doctors also include cupping within their scope of practice in states where they are licensed. You’re most likely to encounter cupping from these providers in integrative medicine clinics or practices that blend conventional and traditional approaches.
How Regulations Differ by Country
Outside the United States, the regulatory picture varies widely. In the United Kingdom, cupping (particularly wet cupping, known as hijama) operates under a system of voluntary self-regulation rather than government-mandated licensing. Organizations like the General Regulatory Council for Complementary Therapies maintain registers of practitioners, but these are not statutory bodies with enforcement power comparable to medical licensing boards. Multiple competing registers exist for hijama practitioners alone, which means the public has limited guidance on which credential is most rigorous. A 2017 analysis published in the Journal of Muslim Minority Affairs concluded that the UK’s voluntary regulation system has failed to provide adequate safeguards for either practitioners or patients.
In countries where cupping has deep cultural roots, such as China, South Korea, and several Middle Eastern nations, there are typically more structured regulatory frameworks tied to traditional medicine licensing systems.
Dry Cupping vs. Wet Cupping
The type of cupping matters when considering who should perform it. Dry cupping uses suction alone and carries lower risk. Wet cupping involves small incisions in the skin to draw blood, which introduces significantly more safety concerns. Equipment contaminated with blood, whether from intentional wet cupping or accidental skin breaks during dry cupping, can transmit bloodborne diseases like hepatitis B and C if not properly sterilized between patients.
Wet cupping should only be performed by practitioners with medical training or by those operating under direct medical supervision. The risk of infection, scarring, and excessive blood loss is real. The National Institutes of Health notes rare but severe side effects, including bleeding inside the skull after cupping on the scalp and anemia from repeated wet cupping sessions.
What to Look for in a Practitioner
Regardless of which type of provider you choose, a few things signal a competent cupping practitioner. They should hold an active license in their profession that you can verify through your state’s licensing board. They should ask about your health history before treatment, since cupping can worsen skin conditions like eczema and psoriasis and may be inappropriate for people on blood thinners or those with certain circulatory conditions.
Equipment hygiene is non-negotiable. Cups should either be single-use or sterilized between patients. If a practitioner uses the same cups on multiple people without proper cleaning, the risk of transmitting bloodborne infections is significant.
One practical note: cupping leaves temporary circular marks on the skin that can look alarming. A good practitioner will explain this beforehand, and the NIH specifically recommends that patients tell other healthcare providers about the marks so they aren’t mistaken for signs of physical abuse.
Can You Do Cupping at Home?
Silicone cupping sets are widely sold for home use, and many people use them for muscle soreness or relaxation. Home cupping with silicone cups carries relatively low risk because the suction is gentler and easier to control than traditional glass fire cups. Stick to large muscle groups like the back, thighs, and shoulders. Avoid cupping over the scalp, face, or areas with thin skin, broken skin, or varicose veins.
Wet cupping should never be attempted at home. The risk of infection, uncontrolled bleeding, and scarring is too high without proper training and sterile technique. Even with dry cupping, leaving cups on too long or using excessive suction can cause burns, blisters, or lasting skin discoloration.