Does Suction Therapy Hurt? Understanding Discomfort and Medical Procedures

October 1, 2025 •

5 min read

According to extensive studies, endotracheal suctioning is consistently rated as one of the most painful procedures for patients in intensive care units. So, does suction therapy hurt? The answer depends heavily on the context, the technique used, and the patient's condition, with experiences ranging from mild discomfort to significant pain.

Quick Summary

The sensation of suction therapy varies depending on its purpose. Medical suctioning, particularly in critical care, is often a painful and uncomfortable experience for patients. Pain levels are influenced by the suction method, catheter size, and patient factors. Alternative therapies like cupping, however, are typically non-painful. Effective pain management strategies are available to minimize discomfort during medical procedures.

Key Points

Medical Suctioning is Often Painful: Endotracheal suctioning in critical care is a highly invasive and frequently painful procedure for patients, regardless of their level of consciousness.
Cupping Therapy is Generally Not Painful: Cupping, an alternative suction-based therapy, is not considered a painful procedure, although it can cause temporary tightness, soreness, and bruising.
Technique and Factors Impact Pain: The type of suctioning (open versus closed), suction pressure, catheter size, and patient's condition significantly influence the intensity of pain experienced during medical suctioning.
Pain Management is Crucial: Effective pain management strategies, including pre-procedure analgesia, non-pharmacological interventions, and minimizing frequency, are vital to improve patient comfort.
Patient Awareness Improves Experience: Explaining the procedure to conscious patients and providing reassurance helps manage anxiety and fear, which can heighten the perception of pain.
Pain in Unconscious Patients Requires Observation: Even unconscious patients can show signs of pain during suctioning through physiological and behavioral changes, which skilled healthcare providers are trained to recognize.

Distinguishing Between Different Types of Suction Therapy

When someone asks, 'Does suction therapy hurt?', the first step is to clarify which type of procedure they mean, as the term applies to different medical and alternative treatments. The experience of pain or discomfort differs significantly between these applications.

Medical Suctioning: Critical Airway Clearance

This is the most invasive type of suction therapy and is primarily performed in hospital settings, such as intensive care units (ICUs). It involves inserting a catheter into the patient's airway (trachea) to clear secretions that they cannot cough up on their own. Endotracheal suctioning is a critical, life-saving procedure for patients on mechanical ventilators.

Alternative Therapies: Cupping

Another form of suction therapy is cupping, an alternative medicine practice used for pain management and relaxation. In this procedure, specialized cups create a vacuum on the skin, drawing up the underlying tissue. While it can cause temporary redness and bruising, it is generally not described as painful.

Why Medical Suctioning Causes Pain

For many patients, especially those in critical care, medical suctioning is a highly unpleasant and painful experience. Several factors contribute to this discomfort:

Mechanical Irritation: The insertion and movement of the suction catheter can mechanically irritate and traumatize the sensitive lining of the trachea and airways. This can cause a sharp or tender sensation.
Coughing and Gagging: Suctioning often triggers a forceful cough reflex, which can be distressing and painful, particularly for surgical patients with abdominal or chest incisions. Patients may also experience a choking or gagging sensation.
Feelings of Breathlessness: The momentary removal of oxygen during the procedure can lead to a sensation of suffocation or having one's breath taken away, which contributes to anxiety and fear.
Procedural Anxiety: The psychological stress and fear associated with the procedure, especially in an ICU environment, can heighten a patient's perception of pain.
Vagal Stimulation: Suctioning can trigger the vagal nerve, leading to physiological responses like changes in heart rate and blood pressure, which contribute to the patient's overall distress.

Factors Influencing Pain and Discomfort

Several variables determine the level of pain a patient experiences during medical suctioning:

Technique (Open vs. Closed Suctioning): Studies have shown that using a closed suctioning system, where the catheter is part of an enclosed circuit, is less painful than the open system, which requires disconnecting the ventilator.
Suction Pressure and Duration: Excessive suction pressure can cause tissue damage and increased pain. Similarly, suctioning for longer than the recommended 10-15 seconds increases the risk of complications.
Catheter Size: Using a catheter that is too large for the airway can cause more irritation and damage to the tracheal walls.
Patient Condition: Acutely or critically ill patients often report higher pain levels. Younger patients have also been found to report greater pain intensity compared to older patients.
Adequate Preparation: Explaining the procedure to conscious patients and ensuring proper sedation and pain relief can significantly mitigate the pain and fear.

Comparison Table: Medical Suctioning vs. Cupping Therapy


Feature	Medical Suctioning	Cupping Therapy
Purpose	To clear airways of mucus and secretions in patients who cannot do so themselves.	To relieve pain, reduce inflammation, improve circulation, and relax muscles.
Patient Experience	Often described as painful, uncomfortable, and fear-inducing.	Generally not painful, but can cause mild soreness, tightness, and bruising.
Location	Typically performed in a hospital or critical care setting.	Administered in physical therapy clinics, spas, or by alternative medicine practitioners.
Procedure Duration	Brief, lasting only about 10-15 seconds per suctioning event.	Sessions can last from 5 to 25 minutes, depending on the technique.
Risks	Injury to the trachea, hypoxia, arrhythmias, and increased intracranial pressure.	Mild discomfort, bruises, burns (with fire cupping), and skin infection if not sterile.

Managing and Minimizing Discomfort During Suction Therapy

Given the potential for pain, particularly with medical suctioning, numerous strategies are employed to enhance patient comfort.

For Medical Suctioning

Reduce Frequency: A key strategy is to minimize how often suctioning is performed by only suctioning when necessary, rather than on a fixed schedule. This prevents unnecessary trauma to the airways.
Use Appropriate Technique: Healthcare providers should use the lowest effective suction pressure and the correct catheter size to minimize tissue damage. A closed suctioning system may also be used to reduce pain.
Pre-Procedure Pain Management: For conscious patients, explaining the procedure and ensuring they have received adequate analgesia and sedation can make a significant difference in their experience. Hand massage has been explored as a non-pharmacological option to reduce pain during endotracheal suctioning.
Non-Pharmacological Methods for Neonates: In premature infants, non-pharmacological interventions like facilitated tucking, skin-to-skin care, and oral sucrose have shown promise in reducing pain during endotracheal suctioning.

For Cupping Therapy

Controlled Suction: Practitioners can adjust the level of suction to the patient's comfort level, starting with a mild intensity and increasing it incrementally.
Communication: Good communication between the practitioner and the patient is essential. The patient should report any significant discomfort immediately.
Hydration and Movement: Proper hydration and integrating movement (dynamic cupping) can help manage soreness and promote better tissue gliding, which reduces tension and pain.

What if the Patient is Unconscious?

Even unconscious or sedated patients can experience pain during procedures like endotracheal suctioning. Critical care nurses are trained to recognize physiological and behavioral indicators of pain in these patients, such as grimacing, increased heart rate, and body movements. Regular assessment using tools like the Behavioral Pain Scale is crucial for ensuring pain is addressed appropriately.

Conclusion

Does suction therapy hurt? The definitive answer is that it can, especially when it involves medical airway clearance in critically ill patients, where it is often described as painful and traumatic. This is distinct from cupping therapy, an alternative treatment that typically causes mild discomfort rather than significant pain. Medical professionals have developed protocols and techniques to minimize discomfort during suctioning, such as using appropriate pressure, employing closed systems, and ensuring adequate pain management. Patient-specific factors like age, condition, and suctioning technique are all critical determinants of the pain experienced. Understanding these differences and how to manage them effectively is crucial for improving patient outcomes and overall well-being during and after the procedure.

Visit the American Association for Respiratory Care for clinical practice guidelines on suctioning.

Frequently Asked Questions

Medical suctioning is a clinical procedure to clear a patient's airway, often in an ICU, and is frequently painful. Cupping therapy is an alternative treatment that uses suction on the skin to relieve pain and improve circulation, and is not generally painful.

Yes, research indicates that unconscious patients can still experience pain during suctioning, as shown by physiological indicators such as increased heart rate, blood pressure, and specific behavioral responses.

Pain can be managed by reducing the frequency of suctioning, using a closed suction system, ensuring correct suction pressure and catheter size, and providing adequate pain medication and sedation before the procedure.

For conscious patients, it can feel like a choking or gagging sensation, coupled with a forceful cough. It can also cause a feeling of having one's breath taken away, which can be frightening.

Yes, studies have shown that using a closed suctioning system is less painful for patients compared to the open suctioning technique, where the ventilator is temporarily disconnected.

Cupping therapy creates a tight, pulling sensation on the skin. While some people find it relaxing, it can also cause mild soreness and temporary redness or bruising after the session, but it is not typically considered painful.

Yes, particularly for neonates. Non-pharmacological methods like oral sucrose, facilitated tucking, and skin-to-skin contact have been found to be effective in reducing pain responses during suctioning.