Traditional Cupping (Hijama)

What Is It?

Hijama traditionally refers specifically to wet cupping, which combines suction with superficial skin incisions. This differs from dry cupping, which uses suction without bloodletting.

Cupping has been investigated in modern research primarily as a complementary approach for musculoskeletal pain.

Traditional Use

Hijama has a long history within traditional healing systems, including Unani and other traditional medical traditions. Traditional explanations have described the practice in terms of restoring balance or removing what is considered harmful or excessive matter.

These traditional explanations represent historical or traditional frameworks and should not be presented as equivalent to established modern biomedical mechanisms.

How Does It Work?

Several mechanisms have been proposed in the research literature, including effects involving pain modulation, circulation, nitric oxide, microcirculation, and immune responses.

However, these mechanisms remain hypotheses rather than established explanations, and no single mechanism has been confirmed as the primary reason for any clinical effect.

Potential Benefits

The strongest evidence identified in the research briefing concerns short-term pain reduction, particularly in low back pain, neck pain, and chronic musculoskeletal pain.

A 2024 systematic review found improvements in low-back-pain outcomes at some short-term follow-up points, while a 2025 meta-analysis found moderate-quality evidence for reduced pain intensity in chronic musculoskeletal pain.

Evidence for improvements in functional disability and mental health is considerably less consistent.

What Does the Evidence Say?

The current evidence is strongest for short-term pain outcomes, but it is not conclusive.

Research is limited by differences between studies, small samples, inconsistent treatment protocols, self-reported outcomes, and risk of bias. Long-term benefits are also uncertain because many studies have relatively short follow-up periods.

Evidence for broader claims involving cardiovascular health, metabolic conditions, fertility, and other systemic conditions remains limited, mixed, or preliminary.

Who May Consider This Approach?

The available evidence has mainly examined cupping in people experiencing musculoskeletal pain, including low back pain, neck pain, and chronic pain.

Whether Hijama is appropriate for a particular individual should be determined through appropriate practitioner assessment rather than based solely on a condition or symptom listed on a website.

Who Should Avoid or Be Cautious With It?

The supplied research does not provide a single universally applicable contraindication list.

However, additional caution is warranted where an individual has significant medical comorbidities, an uncertain diagnosis, or may consider replacing established medical care with cupping.

A practitioner should determine suitability on an individual basis.

Risks and Possible Side Effects

Research reporting on adverse effects is incomplete.

The literature reports that adverse effects can occur and that serious complications have also been described. Therefore, Hijama should not be presented as completely risk-free simply because it is a traditional or complementary therapy.

Contraindications and Safety Considerations

The research briefing highlights the need for particular caution where:

• There are significant medical comorbidities.
• The underlying diagnosis is uncertain.
• A person may use Hijama instead of established medical treatment.
• Safety considerations have not been adequately assessed.

What to Expect During a Consultation

This section should be completed according to the actual Tibb House practitioner process rather than generated from the research alone. It should explain what the practitioner assesses, how suitability is considered, how informed consent is handled, and what the patient can expect from the consultation.

Practitioner Assessment

Hijama should follow an appropriate practitioner assessment rather than being presented as a universally applicable treatment.

The practitioner should consider the individual’s circumstances, relevant health concerns, safety considerations, and whether appropriate medical assessment is required.

Individualised Treatment Considerations

The research does not establish one standardized Hijama protocol covering treatment sites, number of sessions, or frequency. Studies vary substantially in their methods.

Therefore, Tibb House should not publish a universal treatment schedule or fixed protocol.

Any individual treatment decision should be determined by the appropriately qualified practitioner following assessment.

When Professional Medical Care Is Needed

Hijama should not be presented as a replacement for established medical care, particularly when someone has a serious or uncertain health condition.

The research briefing specifically identifies replacing established treatment for serious disease as unsupported by the available evidence.

Where symptoms may indicate a serious or urgent medical problem, appropriate medical assessment should take priority.

Frequently Asked Questions

Is Hijama the same as cupping?

Hijama traditionally refers specifically to wet cupping, while dry cupping uses suction without skin incisions. Research on “cupping” can combine both approaches, which makes the evidence more difficult to interpret.

Does Hijama help with pain?

The strongest available evidence suggests that cupping may provide short-term pain reduction, particularly for some musculoskeletal pain conditions. However, the certainty of evidence is limited by methodological problems and variation between studies.

Is Hijama proven to treat many diseases?

No. The research briefing does not support presenting Hijama as a broadly validated treatment across diseases. Evidence for many systemic conditions remains preliminary or conflicting.

Is Hijama completely safe because it is natural?

No. The literature reports adverse effects and safety concerns, and adverse-event reporting is incomplete.

Does Hijama remove toxins from the blood?

This should not be presented as an established biomedical fact. The supplied research does not establish such a mechanism.

Is the mechanism behind Hijama scientifically established?

No single mechanism has been established. Several mechanisms have been proposed, but they remain hypothetical.

Evidence & Editorial Information

Evidence Level: Moderate for short-term musculoskeletal pain outcomes; limited/conflicting for many broader health claims.

Author: To be assigned.

Reviewer: Qualified Tibb House practitioner/medical reviewer.

Reviewer Credentials: To be added.

Last Reviewed: To be added.

References / Sources: The key research identified includes systematic reviews and meta-analyses from 2020–2025, including research on low back pain, chronic musculoskeletal pain, broader pain outcomes, safety, and wet cupping.