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Whether it's the so-called 50 Shades effect or simply an increased appetite for all things 'taboo', BDSM is reportedly becoming more commonplace.
Certain, more extreme forms of bondage, however, have recently come under fire from medical professionals.
Specifically, the practise of 'kinbaku.'
Originating as part of the Japan's fetish subculture, kinbaku translates as "tight binding" and is a fetish which sees its fans tying each other up with rope VERY tightly in and elaborate patterns.
The fetish scene in Japan has been growing in recent years, The Daily Beast reports.
With this growth, however, also comes an increase in injuries and owing to feelings of shame, many of these incidents are going unreported.
A doctor, Golden San who is both an S&M practitioner and chiropractor told the site: "Women in Japan are embarrassed to admit that their boyfriend ties them up or that they like it.
"Men are ashamed to admit their dominatrix injured them. Some are not sure Japan’s national health insurance will cover their injuries.
"Things like damaged nipples are not easy to explain."
It's not just anxiety over giving an explanation - many kinbaku fetishists fear the potential repercussions.
"There are many reasons those who are in the fetish world as a business hesitate to go see a real doctor - shame and fear for their professional reputation.
"They also worry that the police will treat the case as an assault rather than an accident between two consenting adults. Of course, the issue of losing face is huge too."
As for the injuries themselves, these occur when the ropes aren't correctly tied and can result in limb necrosis and serious injury.
There's also a risk of whiplash, neck injuries, burns from hot candle wax, jaw problems from biting the rope and other items, dislocated joints, and nerve issues.
The doctor added, "There are some injuries too much for me to handle. There are a lot of cases where the men who injure the women aren't willing to pay the medical fees."
