Hijama is an ancient healing practice that involves placing cups on the skin to create suction, drawing blood toward the surface to promote circulation and reduce inflammation. The term comes from the Arabic word meaning “sucking” or “drawing out,” and the practice has roots in Egyptian, Chinese, and Islamic medical traditions spanning thousands of years. It comes in two forms: wet cupping, which involves small skin incisions to draw out a small amount of blood, and dry cupping, which uses suction alone without any cuts.
Wet Cupping vs. Dry Cupping
The two types of hijama work differently. In dry cupping, a practitioner places cups (glass, silicone, or bamboo) on the skin and creates a vacuum, either by heating the air inside the cup or using a mechanical pump. This pulls the skin and underlying tissue upward, increasing blood flow to the area. Traditional descriptions note that dry cupping warms the tissue and draws blood toward the surface.
Wet cupping adds an extra step. After the initial suction, the practitioner removes the cup and makes small, shallow incisions in the skin with a sterile blade. The cup is then reapplied, and the suction draws out a small quantity of blood. Proponents believe this removes metabolic waste and stagnant blood from the body. Wet cupping is the form most closely associated with the term “hijama” in Islamic tradition, where it holds particular cultural and spiritual significance.
What Happens in the Body
Research on hijama’s biological effects centers on two main pathways: improved blood circulation and reduced inflammation. The suction appears to stimulate blood vessels in the treated area to release nitric oxide, a molecule that widens blood vessels and increases blood flow to surrounding tissues. This enhanced circulation delivers more oxygen and helps clear metabolic byproducts from the area.
Studies on athletes who underwent wet cupping found measurable decreases in inflammatory markers after treatment. Specifically, levels of two key ratios used to gauge systemic inflammation dropped significantly in blood samples taken after cupping compared to before. Research has also found cupping is associated with decreased secretion of pro-inflammatory signaling molecules, including interleukin-6 and tumor necrosis factor-alpha, both of which play central roles in chronic pain and swelling. For athletes, the proposed benefits include improved blood flow to muscles, increased oxygen delivery, and pain relief.
What the Evidence Says About Pain
Pain management is the most studied application of hijama, and the results are cautiously encouraging. A large evidence-mapping study published in Frontiers in Neurology examined cupping’s effects across multiple pain conditions. For chronic pain broadly, moderate-quality evidence showed a large and statistically significant reduction in pain intensity compared to control groups.
The findings break down by condition. For knee osteoarthritis, three sets of moderate-quality evidence found that cupping reduced pain scores on standard scales, particularly when combined with conventional treatment. Chronic neck pain saw meaningful improvements as well, with one moderate-quality analysis showing a notable drop in pain ratings. Low back pain showed similar trends, with moderate-quality evidence supporting a reduction in pain scores. These are promising signals, though the researchers noted that the quality of available studies varies widely, and stronger trials are still needed.
Effects on Weight and Cholesterol
A systematic review of five studies involving 489 patients examined cupping’s effects on metabolic health markers. The results showed statistically significant reductions in waist circumference (about 6 cm on average), body weight (roughly 2.5 kg), and BMI (about 1.3 points) compared to control groups. Cupping also significantly lowered LDL cholesterol, the type most associated with cardiovascular risk.
However, the therapy did not produce significant changes in total cholesterol, triglycerides, HDL cholesterol, fasting blood sugar, blood pressure, or total body fat percentage. Three of the included trials reported no adverse events. These results suggest cupping may offer modest metabolic benefits for certain markers, but it is not a standalone treatment for conditions like diabetes or high blood pressure.
What a Session Feels Like
During a hijama session, you’ll typically lie face down while the practitioner applies cups to specific points on your back, neck, or shoulders, though other areas can be treated depending on the condition. The suction creates a tight, pulling sensation that most people describe as firm pressure rather than pain. In wet cupping, the small incisions feel like light scratches. Sessions generally last 20 to 40 minutes.
Afterward, you’ll have circular marks where the cups were placed. These are not true bruises but discolorations caused by blood being drawn to the surface. They typically begin fading within 2 to 4 days and disappear completely within 7 to 10 days. To help the marks heal faster, stay well hydrated, avoid harsh scrubs or exfoliants on the treated areas, and apply a gentle moisturizer like aloe vera. It’s best to wait until the marks fully disappear before getting another session or deep tissue massage on the same area.
Safety and Risks
Hijama is generally considered safe when performed by a trained practitioner using sterile, single-use equipment, but it does carry real risks. The most common side effects are persistent skin discoloration, scarring, and mild burns (from fire cupping techniques). Infections can occur if proper sterilization protocols are not followed.
The most serious concern involves bloodborne disease transmission. The U.S. National Center for Complementary and Integrative Health warns that cupping equipment can become contaminated with blood, whether intentionally during wet cupping or accidentally during dry cupping. Reusing equipment between patients without proper sterilization can spread hepatitis B, hepatitis C, and other bloodborne infections. Always verify that your practitioner uses disposable cups and blades, or properly sterilizes reusable equipment between clients.
Hijama may also worsen certain skin conditions, including eczema and psoriasis. People who take blood thinners, have bleeding disorders, or are pregnant should discuss cupping with a healthcare provider before trying it. And while the circular marks are harmless, they are visible, so you may want to plan sessions around events where you’d prefer not to have marks showing.