Role of Hijama’ (Cupping Therapy) in the Management of Niqras (Gouty Arthritis)

Abstract

Gout is a potentially progressive and debilitating form of chronic inflammatory arthritis caused by the deposition of monosodium urate crystals in synovial fluid and other tissues, characterized by sudden & severe episode of pain, warmth and swelling in a joint. People suffering from recurrent attacks frequently experience pain and disability, reduced health-related quality of life and productivity and increased morbidity. NSAIDs, colchicines, glucocorticoids, uric acid lowering agent like uricostatic drugs (allopurinol, a xanthine oxidase inhibitor), Uricosuric drugs (Probenecid) are very effective but risky in patients having pre-existing renal, cardiovascular, gastrointestinal and metabolic disorders. Cupping (Al-Hijama) is a widely used therapeutic regimen of Unani system of medicine with high acceptance in Egypt and Arab countries. It is used for the treatment of various inflammatory and painful conditions like sciatica, gout, rheumatoid arthritis, pain of knee, removal of deep swelling, disease of liver and skin etc. It is a minor surgical excretory procedure related scientifically to the principles of renal glomerular filtration and abscess evacuation where a pressure-dependent excretion of causative pathological substances occurs. Cupping is thought to act mainly by increasing local blood circulation and relieving the painful muscle tension. It acts by improving microcirculation, promoting capillary endothelial cell repair, accelerating granulation, and angiogenesis in the regional tissues. It is the best deep tissue massage which normalizes the patient's functional state and progressive muscle relaxation. In Unani system of Medicine, this is a simple and economic treatment, effectively treating diseases with different etiologies and pathogenesis.

Literature Review Wet Cupping Technique on Uric Acid Levels in Patients With Hyperuricemia

“…This condition is also above with the body's metabolism at the age of 50 years has decreased so that uric acid is increasing. 90% of gout is caused by the kidneys not being able to completely excrete uric acid through urine (Akhtar et al, 2017).…”

Analysis of clinical efficacy of Si Miao decoction combine with acupuncture and cupping treatment for gout: a systematic review and meta-analysis

“…Lee, et al have performed a systematic review on acupuncture for gouty arthritis and found it to be an effective complementary medicine 12 . Cupping therapy, commonly known as Al-hijamah in Islamic medicine, is also well-known amongst traditional practitioners in treating arthritis [12][13][14] .…”

The relation between gouty arthritis and menopause: A Unani conceptual review

“…For serum urate values greater than 9 mg/dl, the cumulative incidence of gout reaches 22% after 5 years. Hippocrates had particularly mentioned that-gout is very common in men but maybe seen in women after menopause [2] . [5,13,17] .…”