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𝐍𝐨𝐰 𝐚𝐜𝐜𝐞𝐩𝐭𝐢𝐧𝐠 𝐜𝐥𝐢𝐞𝐧𝐭𝐬 𝐭𝐡𝐫𝐨𝐮𝐠𝐡𝐨𝐮𝐭 𝐭𝐡𝐞 𝐡𝐨𝐥𝐢𝐝𝐚𝐲 𝐬𝐞𝐚𝐬𝐨𝐧!

I am a licensed massage therapist, and I travel to you! Whether you’re looking to relax or recover from your favorite sport, planning a date night with your partner, hosting a house party, or staying at an Airbnb, hotel, or resort, I bring the spa experience to you.

𝑃𝑙𝑒𝑎𝑠𝑒 𝑛𝑜𝑡𝑒: 𝐴 𝑚𝑖𝑙𝑒𝑎𝑔𝑒 𝑓𝑒𝑒 𝑚𝑎𝑦 𝑎𝑝𝑝𝑙𝑦 𝑑𝑒𝑝𝑒𝑛𝑑𝑖𝑛𝑔 𝑜𝑛 𝑡ℎ𝑒 𝑑𝑖𝑠𝑡𝑎𝑛𝑐𝑒 𝑎𝑛𝑑 𝑡𝑟𝑎𝑣𝑒𝑙 𝑡𝑖𝑚𝑒.

For more information:
716-544-7601 (call or text)

When someone says “studies show,” or "studies prove", the next question should be: What kind of studies? Study design matters, but the type of study is only part of the picture. You also have to look at how well it was conducted.

For questions about whether a treatment causes a benefit or harm, a well-designed randomized controlled trial (RCT) will usually carry more weight than an observational study because randomization helps reduce confounding—differences between groups that may otherwise explain an outcome. Cohort and case-control studies can still be valuable, particularly for long-term outcomes, rare harms, prognosis, or questions that cannot ethically or practically be randomized. However, when estimating treatment effects, observational studies are generally more vulnerable to confounding and selection bias than a well-conducted RCT.

A useful broad hierarchy for treatment-effect questions is:

• Systematic reviews and meta-analyses of well-conducted, sufficiently similar RCTs.

• Individual well-designed RCTs.

• Cohort and case-control studies, depending on the research question and methodological quality.

• Case reports, case series, mechanistic studies, expert opinion, and anecdote.

Think of this as a general guide, not a shortcut for deciding whether a study is automatically good or bad. A small, poorly designed, selectively reported, inadequately randomized, or highly biased RCT may be less informative than a large, well-conducted cohort study. Likewise, a case-control study may be the most practical and informative design for studying a rare disease or outcome, while a cohort study is often better suited to measuring incidence and following outcomes over time.

Not all systematic reviews are created equal, either. “Junk studies in, junk studies out” is a useful rule of thumb. If a review pools a group of underpowered, biased, poorly controlled, or highly inconsistent RCTs, the result is not automatically strong evidence simply because it is called a systematic review or meta-analysis.

A good systematic review should:

• Use clear, pre-specified inclusion criteria.

• Search broadly enough to reduce cherry-picking.

• Evaluate the risk of bias in the included studies.

• Consider whether the studies are similar enough to combine.

• Account for inconsistency, imprecision, indirectness, and publication bias.

• Be transparent about uncertainty rather than treating a pooled statistic as definitive.

A meta-analysis can produce a precise-looking number without producing a reliable answer. The quality of the evidence being pooled—and the quality of the review itself—matters at least as much as the fact that studies were combined. Frameworks such as GRADE assess certainty across a body of evidence by considering risk of bias, inconsistency, indirectness, imprecision, and publication bias. Randomized evidence can be downgraded substantially when these problems are present.

Also, studies are not automatically “outdated” after five years. The more important questions are:

• Has better or more relevant evidence been published since then?

• Has the intervention, technology, diagnostic criteria, or standard of care changed?

• Does the study still apply to the population and question being discussed?

• Have newer systematic reviews, large trials, safety data, or guidelines changed the overall conclusion?

An older study can still be useful if the question and evidence base have not changed much. A newer study can still be small, biased, poorly designed, unreplicated, or inconsistent with the broader literature. Some research suggests that clinical guidelines may need reassessment after roughly 5–7 years on average. This does not mean that individual studies suddenly become irrelevant once they are five years old.

When looking at any study, the better questions are:

• Is it well designed for the question being asked?

• How large and precise is it?

• Was it conducted and reported transparently?

• Does it agree with other high-quality research?

• How confident should we be that the result reflects a real, clinically meaningful effect?

Anyone can post a link to a study. The harder part is figuring out whether it was well done and whether its findings hold up against the rest of the research.

Many people think of pain procedures as treatments designed to provide relief. In reality, some procedures are performed primarily to answer a question.

Diagnostic procedures can help determine whether a specific nerve, joint, or other structure is contributing to pain, providing information that may help guide future treatment decisions. Other procedures are therapeutic, aiming to reduce pain, improve function, or target specific pain-signaling pathways.

Join us for the next Stanford Pain Science Lecture Series on Monday, October 5, at 5:30 PM PST, where Daniel Gessner, MD, will provide an overview of common pain procedures, including medication-based treatments, energy-based interventions, and implantable devices. The lecture will explore how these approaches are used in clinical practice, the goals they are designed to achieve, and considerations for patient selection and shared decision-making.

Registration is free. https://bit.ly/4hDchXY

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I have some availability in Ellicotteville this Monday (10/06/26) after 2:30 PM.

Call or text for more info.
716-544-7601
https://www.AlexandersMobileMassage.com

Alexander West LMT Alexander’s Mobile Massage brings Swedish, Therapeutic, Deep Tissue, Sports, Medical, Pregnancy, and Chocolate massage directly to your home, hotel, or Airbnb anywhere in Western New York — serving Buffalo, Niagara Falls, Amherst, Cheektowaga, and surrounding towns within a 75+ mile radius.

SPECT, short for single-photon emission computed tomography, is a form of nuclear medicine imaging rooted in early work on emission tomography in the 1960s. In a brain SPECT scan, a patient receives an injection containing a radioactive tracer. Once the tracer reaches the brain, it emits gamma rays that are detected by a camera rotating around the head. A computer then reconstructs those signals into a three-dimensional map of tracer distribution and regional blood-flow patterns—an indirect proxy for brain function.

Unlike MRI or CT, SPECT is generally considered functional rather than structural imaging. An MRI following a concussion, for example, can show the physical structure of the brain: the “layout of the house.” A SPECT image is intended to show where activity may be concentrated within that structure, more like a map of where guests are clustering during a party. In that sense, it functions somewhat like a heat map.

SPECT does have established medical uses. It is widely used in cardiology and can contribute to selected neurological evaluations, including investigations of suspected dementia, cerebrovascular disease, and seizure foci in appropriate cases. The controversy arises when it is promoted as a routine tool for diagnosing common psychiatric disorders from apparent differences in cerebral blood flow. That is the central distinction between conventional uses of SPECT and the approach associated with Dr. Daniel Amen.

Amen has stated that his clinics have conducted nearly 300,000 SPECT scans in patients from 155 countries. At his U.S. clinics, patients may undergo one scan while resting and another on a separate day while completing a concentration task. He says the images are considered alongside a conventional psychiatric assessment when forming a diagnosis.

However, his diagnostic framework does not closely follow the Diagnostic and Statistical Manual of Mental Disorders (DSM), the standard classification system used in psychiatry. Amen has claimed that SPECT imaging identifies six subtypes of anxiety and depression—which he groups together—along with seven forms of ADHD and five forms of obesity. These proposed categories include labels such as “temporal lobe anxiety and depression” and “ring of fire ADD.” His clinics also market SPECT-informed evaluations and treatment approaches for a broad range of concerns, including body-image concerns and relationship problems.

The central evidentiary question is not whether SPECT can identify average differences between groups of people. It is whether Amen’s scan-based classifications improve diagnostic accuracy, treatment selection, or patient outcomes beyond what a careful clinical assessment can achieve. Robust blinded trials demonstrating that added clinical value have not been established.
In research studies, investigators may compare SPECT images from people diagnosed with a particular psychiatric condition against images from people without that diagnosis. On average, the two groups may differ. But a group-level difference does not automatically create a reliable diagnostic test for an individual patient.

A useful way to picture this is as two overlapping clusters rather than two clearly separate categories. Some people with a diagnosis may have scans that look typical of the comparison group, while some people without the diagnosis may show patterns described as abnormal. A finding can distinguish groups statistically while still lacking the accuracy needed to determine whether one particular person does or does not have a condition.

There is also the issue of symptom overlap. Difficulty concentrating, for instance, can occur in ADHD, depression, anxiety disorders, sleep deprivation, trauma-related conditions, substance use, and many other circumstances. Even if a brain-imaging pattern were associated with impaired concentration, it would not necessarily establish why that person was struggling to concentrate. A study comparing people with “condition X” against healthy controls does not resolve the more clinically relevant question: among several plausible explanations, which diagnosis best accounts for this patient’s symptoms?

For these reasons, routine neuroimaging for the diagnosis of common psychiatric disorders remains unproven. Brain imaging can be useful in research and in selected clinical contexts, but it should not be mistaken for a stand-alone psychiatric diagnostic test. When an image is presented as though it can reveal a person’s diagnosis directly, it can create an impression of precision that exceeds what the evidence supports.



Δhttps://www.mcgill.ca/oss/article/health-and-nutrition-pseudoscience/everyone-else-wrong-dr-amen-story

If cupping feels good, helps you relax, or you enjoy it, that is a valid personal experience. Feeling better afterward is meaningful, but it cannot tell us on its own whether cupping was the reason for the improvement.

People can feel better for many reasons: relaxation, expectation, attention from a practitioner, the treatment setting, normal symptom fluctuation, regression to the mean, or simply the passage of time. A personal experience can tell us that someone improved; it cannot, by itself, tell us why they improved.

That is why testimonials cannot, by themselves, establish that cupping works better than placebo or usual care, establish a proposed mechanism, or demonstrate that the same effect will reliably occur in a broader population.

Cupping can create local suction and visible circular marks, but those marks are not evidence that toxins were removed or that circulation was improved in a clinically meaningful way. If a treatment is said to “remove toxins,” the questions should be: Which toxin? Removed from where? In what amount? By what mechanism?

The same standard applies to the idea that cupping “fixes fascia.” There would need to be evidence that it produces a meaningful and lasting change that improves symptoms or function.

More broadly, personal testimony cannot establish that cupping detoxes the body, removes toxins, meaningfully improves circulation, changes fascia in a clinically relevant way, or treats disease. Those claims require evidence beyond anecdote. Research on cupping has focused mainly on pain, and the evidence remains limited by low-quality and inconsistent studies rather than supporting broad health or mechanistic claims.

A claim becomes pseudoscientific when it relies on unsupported explanations, ignores contrary evidence, or makes itself impossible to test. Someone may still enjoy a treatment or report feeling better after it, but personal benefit does not validate a specific explanation for why it supposedly works.

𝐂𝐮𝐩𝐩𝐢𝐧𝐠 𝐓𝐡𝐞𝐫𝐚𝐩𝐲: 𝐒𝐞𝐩𝐚𝐫𝐚𝐭𝐢𝐧𝐠 𝐒𝐜𝐢𝐞𝐧𝐜𝐞 𝐅𝐫𝐨𝐦 𝐏𝐬𝐞𝐮𝐝𝐨𝐬𝐜𝐢𝐞𝐧𝐜𝐞

Cupping is a real physical intervention, but the most dramatic claims made about it are not supported by reliable clinical evidence. Suction can pull on the skin and superficial tissues, produce local vascular changes, and leave temporary red or purple marks. Those effects show that the skin experienced suction; they do not show that toxins, “stagnant blood,” inflammation, or disease were removed.

A useful way to evaluate cupping is to separate what the intervention physically does from what someone claims those effects accomplish medically. A physiological effect is not automatically a therapeutic effect, and a therapeutic effect is not automatically evidence for the mechanism being proposed. The strongest conclusions should come from the overall weight of evidence, giving greater consideration to well-designed randomized trials, systematic reviews, meta-analyses, appropriate control groups, risk of bias, consistency, and clinical significance rather than isolated positive studies.

𝐓𝐡𝐞 𝐝𝐞𝐭𝐨𝐱𝐢𝐟𝐢𝐜𝐚𝐭𝐢𝐨𝐧 𝐜𝐥𝐚𝐢𝐦

There’s a claim that just refuses to die: cupping “removes toxins.”

Let’s be clear: it doesn’t.

If toxins could be pulled out through the skin by a plastic cup, your body would be in serious trouble. Human physiology does not work like that. Detoxification is handled primarily by your liver and kidneys. They metabolize, filter, process, and excrete many waste products and compounds every minute of every day. No suction device is bypassing that system.

What cupping actually does is apply negative pressure to the skin and superficial tissues. This can lead to local blood pooling and capillary rupture, which is why you see circular marks. Those marks are not toxins leaving the body. They are bruises, blood, and fluid shifts. That’s it.

There is no anatomical pathway, no established physiological mechanism, and no credible clinical evidence showing that unspecified “toxins” are drawn out through intact skin by suction.

Can some people feel temporary symptom relief after cupping? Yes. That is a different discussion and may relate to sensory input, expectation, relaxation, and short-term changes in how the nervous system interprets signals from the area. None of that requires inventing a detox story.

So no, a plastic cup is not outperforming your liver and kidneys.

More broadly, “detox” is not a sufficiently specific scientific claim on its own. To establish that a treatment removes a toxin, researchers would need to identify the substance being removed, establish where it is located, measure it before and after treatment, compare the change with an appropriate control, demonstrate that the treatment caused the change, and show that the change has meaningful clinical consequences.

The available evidence does not establish that cupping removes unspecified toxins from the blood, muscles, organs, or lymphatic system.

A dark circular mark is therefore evidence of a local tissue response to suction—not evidence of detoxification.

𝐖𝐡𝐚𝐭 𝐝𝐨𝐞𝐬 𝐭𝐡𝐞 𝐞𝐯𝐢𝐝𝐞𝐧𝐜𝐞 𝐚𝐜𝐭𝐮𝐚𝐥𝐥𝐲 𝐬𝐡𝐨𝐰 𝐚𝐛𝐨𝐮𝐭 𝐩𝐚𝐢𝐧?

The pain evidence is more nuanced.

Some randomized trials and systematic reviews report short-term improvement in musculoskeletal pain, including some forms of neck and back pain. For example, a systematic review of cupping for chronic pain found larger effects when cupping was compared with no treatment, but no statistically significant advantage over sham cupping for pain or disability. The authors also emphasized substantial heterogeneity and methodological limitations, including risk of bias (Cramer et al., 2020).

Similarly, a systematic review of cupping for neck pain found reductions in pain compared with some control conditions, but the authors concluded that the low quality of the evidence prevented definitive conclusions about efficacy (Kim et al., 2018).

That distinction matters because the control group can substantially affect the apparent size of a treatment effect. If people receiving cupping improve more than people receiving no treatment, that demonstrates that the two groups experienced different outcomes—but it does not necessarily demonstrate that the suction itself produced the difference. Expectation, attention, relaxation, natural fluctuations in symptoms, regression to the mean, and other nonspecific effects can all contribute to improvement.

This is one reason sham-controlled trials are particularly informative when evaluating an intervention such as cupping, where the treatment itself is difficult to blind but some aspects of the experience can be simulated.

One randomized trial found that dry cupping was not superior to sham cupping for pain, physical function, mobility, quality of life, psychological symptoms, or medication use in people with chronic nonspecific low-back pain (Silva et al., 2021).

More recent evidence has not eliminated this uncertainty. A 2025 systematic review and meta-analysis of dry cupping for nonspecific chronic low-back pain found no overall evidence that dry cupping was superior to placebo or other therapies.

More specifically, only three randomized controlled trials met that review’s inclusion criteria. Two compared dry cupping with sham cupping, while one used a no-intervention control. One individual study found dry cupping superior to sham cupping, but the pooled meta-analysis did not show overall superiority of dry cupping over the control groups. The authors concluded that more adequately designed randomized controlled trials are needed (Pinheiro et al., 2025).

A separate 2023 evidence-mapping study identified 14 meta-analyses covering five pain-related conditions. Using AMSTAR 2, the authors rated 36% of the underlying reviews as critically low quality, 50% as low quality, 7% as moderate quality, and 7% as high quality. Using GRADE, they found no high-quality evidence demonstrating efficacy for pain-related outcomes.

At the same time, the authors concluded that very-low- to moderate-quality evidence suggested that cupping may be effective for several conditions, including chronic pain, knee osteoarthritis, low-back pain, neck pain, chronic back pain, and herpes zoster (Wang et al., 2023).

In other words, the review did identify a positive signal in parts of the literature. But the methodological limitations and low certainty of much of that evidence make strong conclusions difficult.

The overall evidence suggests a possible short-term benefit for some pain conditions, but confidence in the specific therapeutic effect of cupping remains limited.

That wording is important. Limited evidence is not the same thing as evidence that something can never work. It means that the available research does not currently provide enough high-quality, consistent evidence to make strong claims about the size, reliability, or specific cause of the benefit.

𝐈𝐦𝐩𝐫𝐨𝐯𝐞𝐦𝐞𝐧𝐭 𝐝𝐨𝐞𝐬 𝐧𝐨𝐭 𝐧𝐞𝐜𝐞𝐬𝐬𝐚𝐫𝐢𝐥𝐲 𝐩𝐫𝐨𝐯𝐞 𝐭𝐡𝐞 𝐩𝐫𝐨𝐩𝐨𝐬𝐞𝐝 𝐦𝐞𝐜𝐡𝐚𝐧𝐢𝐬𝐦

People may genuinely feel better after cupping. Pain naturally fluctuates, some conditions improve over time, attention and relaxation can affect symptoms, expectations can influence pain perception, and sensory stimulation can temporarily change how the nervous system processes signals.

These are plausible explanations, not proof of one established mechanism.

A proposed physiological mechanism can make a treatment hypothesis worth investigating, but it cannot establish that the treatment produces a clinically meaningful benefit.

This distinction is important because a person can experience genuine symptom relief without the explanation commonly given for that relief being correct.

Genuine symptom relief does not prove that toxins were removed or damaged tissue was repaired, but it also does not mean that a person’s improvement was imaginary.

𝐓𝐡𝐞 𝐛𝐫𝐮𝐢𝐬𝐢𝐧𝐠 𝐢𝐬 𝐫𝐞𝐚𝐥—𝐛𝐮𝐭 𝐰𝐡𝐚𝐭 𝐝𝐨𝐞𝐬 𝐢𝐭 𝐦𝐞𝐚𝐧?

The circular marks produced by dry cupping are generally the result of local tissue changes caused by negative pressure, including capillary rupture and blood pooling. Their appearance can vary depending on the amount and duration of suction, the individual’s tissues, and other factors.

The presence, darkness, or number of marks therefore cannot be used as a measurement of how much “toxicity,” inflammation, or stagnant blood supposedly existed in an area.

In other words, a darker mark does not mean more toxins were removed, and more cups do not automatically mean a more effective treatment.

The mark demonstrates that the intervention produced a physical response. It does not establish that the response was therapeutically beneficial.

𝐖𝐞𝐭 𝐜𝐮𝐩𝐩𝐢𝐧𝐠 𝐢𝐬 𝐚 𝐝𝐢𝐟𝐟𝐞𝐫𝐞𝐧𝐭 𝐫𝐢𝐬𝐤 𝐜𝐚𝐭𝐞𝐠𝐨𝐫𝐲

Wet cupping deserves additional caution because it intentionally breaks the skin and removes blood. That creates risks that are not present to the same extent with dry cupping, including bleeding, scarring, burns or other skin injury, and infection.

If equipment or technique is contaminated or inadequately sterilized, bloodborne pathogens can be transmitted. Bloodborne infections, including hepatitis B, hepatitis C, and HIV, have been reported as potential complications associated with cupping practices (Rehman et al., 2014).

A case report or letter describing a complication cannot establish how frequently that complication occurs. It can, however, demonstrate that a particular complication is biologically possible. Wet cupping therefore should not be described as harmless simply because it is traditional or considered “natural.”

𝐖𝐡𝐚𝐭 𝐜𝐚𝐧 𝐰𝐞 𝐫𝐞𝐚𝐬𝐨𝐧𝐚𝐛𝐥𝐲 𝐬𝐚𝐲?

The fairest evidence-based conclusion is that cupping may be an optional adjunct for short-term relief of some musculoskeletal symptoms, but the evidence supporting a specific therapeutic effect remains limited and uncertain.

It should not be marketed as detoxification, blood cleansing, hormone balancing, lymphatic resetting, a cure, or a substitute for appropriate medical assessment and evidence-based care.

A responsible practitioner might say:

“Cupping uses suction to stimulate the skin and superficial tissues. It often leaves temporary marks. Some people find it relaxing or helpful for short-term discomfort, but we cannot claim that it removes toxins or treats disease.”

That statement separates what we know from what we are merely hypothesizing.

A cup can pull on the skin, leave a mark, and possibly help someone feel better. None of those facts demonstrates detoxification. Δ