1. Apply a thin layer of moisturizer (or gel) to the skin on the treatment area before use. 
2. Attach the T.E.N.S. lead wire’s pin (male) connector to the vacuum cup for  stimulation. Use two cups at the same time for + “positive” and – “negative” attachments (fig. 6 & 7). 
3. Place the vacuum cups on the skin of the treatment area (fig. 8). 
4. Use your thumb to press the top of the vacuum cup, then release; the cup will adhere to the skin of the treatment area. Adjust the suction strength as required by the pressure of your thumb on the cup (fig. 9 & 10). Press harder to create a strong suction, and more lightly for less suction.  
5. Connect the lead wires to the T.E.N.S. unit for electrical stimulation. Adjust output intensity and pulse rate/width of the T.E.N.S. unit accordingly.  
6. Now the Stimu-Cupping is using cupping massage therapy and T.E.N.S. therapy  simultaneously (fig. 11). Limit application time to approximately 10 to 15 minutes, initially or to whatever suits your needs. Then when completed, turn off the T.E.N.S. unit. Squeeze the cup on both sides and the cup can be lifted easily from the skin of the treatment area (fig. 12 & 13).  
7. After usage, clean the cups with damp cloth and dry them, then store them in their cotton draw string bag for future use.