Comparative Clinical Study of Hijama bil shart (Wet Cupping) and Hijama bil nar (Fire Cupping) in Irq al- nasa’ (Sciatica)

Background: ‘Irq al nasa’ an Arabic term to which we call ‘Sciatica’ is clinically defined as the pain along with Sciatic nerve and its component nerve roots. Pain may vary from mild ache to severe burning or shooting, or tingling in nature. According to Unani literature, sciatica (Irq al-nasa') may be caused by accumulation of morbid matter or phlegm (Khilt balgham galeez) in the affected area. “Hijama” means “to suck” is a Unani regimental method of treatment, which helps to evacuate the morbid materials from the body and reassure the blood flow to the site of Hijama. Objective: This study aims to compare the efficacy and safety of hijama bil-shart (wet cupping) and hijama bil-nar (fire cupping) in the management of sciatica. Methods: In an open, randomized, controlled study out of 70 sciatica patients, 60 were randomly allocated in test and control group, 30 in each. The test group received wet cupping and control group were applied with fire cupping at 0th, 15th, 30th and 45th day. Results: While observation of visual analogue scale for pain, limb movement, straight leg raising test, deep tendon reflexes at ankle and knee joint, and stiffness along with Bragard’s sign, the intergroup comparison of pre and  post treatment results showed wet cupping is more effective than fire cupping (p<0.001). Conclusion: Hijama bil-shart (wet cupping) is more effective than hijama bil-nar (fire cupping) in managing sciatica. Both the therapies were generally well tolerated. Keywords: Cupping, Hijama, Sciatica, Unani