What Is Cupping (Hijama)

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What is Cupping (Hijama)? For thousands of years, healers across the Middle East, Central Asia, and the Mediterranean have practiced a therapy that looks simple from the outside but carries a deep medical philosophy within: cupping — known in the Arab and Unani world as Hijama. In my clinic in Abu Dhabi, UAE, Hijama is one of the most requested therapies. Patients come with curiosity, and sometimes with doubt. Both are welcome. Let me explain what Hijama truly is — first through the eyes of traditional Unani medicine, then through what modern science observes.

THE UNANI UNDERSTANDING

Unani medicine, the Greco-Arab system I practice, sees the human body as governed by four humours, or Akhlat: blood (Dam), phlegm (Balgham), yellow bile (Safra), and black bile (Sauda). Health is their balance; illness begins when one of them becomes excessive or morbid. Hijama belongs to a branch of Unani treatment called Ilaj-bil-Tadbeer — regimental therapy. Its purpose is Tanqiya: the gentle evacuation of morbid or stagnant matter from the body, so that balance can return. The classical scholars — Ibn Sina (Avicenna), Al-Razi, and others — described cupping in detail nearly a thousand years ago, including the best points on the body, the best days, and who should avoid it. This is important: in Unani medicine, Hijama is not a casual wellness trend. It is a precise procedure with rules refined over centuries

HIJAMA IN THE PROPHETIC TRADITION

For Muslim patients, Hijama carries an additional, deeply cherished meaning: it is a Sunnah. The Prophet Muhammad (peace be upon him) not only recommended cupping but was himself cupped. He said, in a hadith recorded in Sahih al-Bukhari and Sahih Muslim: "The best of your remedies is cupping." And in another narration: "Healing is in three things: a gulp of honey, cupping, and cauterization — but I forbid my Ummah from cauterization." It is also narrated that on the night of the Isra (the Ascension), the angels said to him: "O Muhammad, instruct your Ummah in cupping." This is why, for many believers, Hijama is not only a therapy but an act of following the Prophet's guidance — healing the body while honoring the Sunnah

DRY CUPPING VS WET CUPPING (HIJAMA)

There are two main forms: Dry cupping uses only suction. Cups are placed on the skin — usually the back, shoulders, or legs — creating a vacuum that lifts the skin and underlying tissue. No blood is drawn. Traditionally it is used to move stagnation, relax tight muscles, and draw the body's attention to an area. Wet cupping is what most people mean by "Hijama." After a few minutes of dry suction, the practitioner makes very small, superficial scratches on the skin and reapplies the cups. A small amount of blood and tissue fluid is drawn out. In Unani terms, this is the evacuation step — removing what the body no longer needs. Both methods use the same principle: controlled suction. The difference is whether evacuation follows

WHAT MODERN SCIENCE OBSERVES

Modern researchers have studied cupping with growing interest. What they observe is measurable: the suction increases local blood circulation in the skin and superficial muscle, creates temporary marks as tiny capillaries respond to the pressure change, and appears to stimulate the nervous system — many patients report deep relaxation afterward, which researchers link to the body's own calming responses. Studies have explored cupping for muscular tension, back discomfort, and general well-being, with mixed but often encouraging results. Science is still catching up with what traditional practitioners have observed for centuries. My own view, after 15 years of practice: the two perspectives do not contradict each other. The Unani physician spoke of "evacuating morbid humours"; the modern researcher speaks of "improved microcirculation and tissue response." They may be describing the same event in two languages

WHAT HAPPENS IN A HIJAMA SESSION

In my practice, no Hijama session begins with cups. It begins with assessment — Nabz (pulse reading) and Mizaj (temperament analysis) — because in Unani medicine, the treatment must match the person, not just the complaint. A typical session follows these steps:

1. Consultation and assessment — we discuss your condition, and I read the pulse and assess temperament.

2. Preparation — the skin is cleaned, and sterile, single-use cups and blades are prepared. Hygiene is absolute; nothing is ever reused.

3. Cup placement — cups are applied to carefully chosen points.

4. The procedure — for wet cupping, light superficial scratches are made and the cups reapplied for a few minutes.

5. Aftercare guidance — you receive clear instructions for the next 24 to 48 hours.

Most patients describe the sensation as a tight pulling feeling, not pain. Sessions are calm and unhurried.

AFTERCARE IN THE TRADITIONAL WAY

Classical Unani guidance after Hijama is simple and wise: rest, keep the area clean and covered, avoid heavy meals and strenuous exertion for a day, and drink water. The body has done work; give it quiet time to settle

WHO SHOULD BE CAUTIOUS

Hijama is a real procedure and not suitable for everyone. Extra caution is needed for pregnant women, people with bleeding disorders or very low blood pressure, those on blood-thinning medication, and anyone with severe anemia or chronic illness. This is why the assessment before the session matters more than the session itself. A responsible practitioner will sometimes advise against Hijama — and that honesty is part of the medicine

A LIVING TRADITION

Hijama has survived for millennia not because of marketing, but because generation after generation of patients found value in it. Today it sits at an interesting meeting point: ancient enough to carry the wisdom of Ibn Sina, modern enough to be studied in research laboratories. If you are considering Hijama, choose a licensed practitioner who assesses you first, uses sterile single-use equipment, and explains everything before beginning. The cups are the smallest part of the therapy. The knowledge behind them is the real treatment.

By Hakeem Qaiser Khan