Cupping therapy, which is one of the modern physical therapy methods, has become popular as one of the complementary and traditional treatment applications in the world and in our country in recent years and is applied as a complementary treatment in different regions of the world in chronic diseases that do not respond to conventional treatment.

Although cupping therapy is applied in different ways, it is basically applied as wet (hijama)  and dry cupping therapy. In both applications, cups are placed on the skin by creating negative pressure and make room for new oxygenated blood in the extracellular area under the skin. .

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Application Methods

While horn, pottery, metal and bamboo were used as cups in the past, disposable glass and PVC (hard plastic) ones are more preferred today.

In cupping treatment, cups are placed first, the skin swells with the negative pressure created, and hyperemia occurs. After about 5 minutes, the cups are taken. If hijama is to be applied, scratches are made on these areas, the cups are placed by creating negative pressure again and the liquid is discharged. Hijama is actually a combination of dry cupping and wet cupping therapy.

Ateş  or pump is used to create negative pressure on the applied area. It is thought that the flame will create uncontrolled pressure and cause capillary damage. Pump Pressure system is a preferred method because the intensity of the vacuum  can be controlled.

The application technique is also very important in terms of effectiveness. The upper layer of the skin is the epidermis, and the lower layer is the dermis. There are capillaries in the dermo-epidermal area. It is recommended that the scratches on the skin be superficial (such as 0.1‐02 mm), not traumatizing the capillaries as much as possible while opening the skin barrier, and expelling the fluid, especially in the interstitial area. The amount of blood excreted during the application of Hacamat  varies according to the patient, and its therapeutic effect is not related to the amount of blood.  There are different mug implementations; In the movable cup, cream/oil is applied to the applied area , the cup is placed and moved to certain areas.

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Cup Application Types

Dry cupping therapy Wet cupping therapy (hijama) Moving cupping therapy Empty cupping therapy Needle cupping therapy Water cupping therapy Hot mug/moxa cupping Herbal cup, cupping massage (moving cup)

Generally, the cups are placed in the neurolymphatic passage areas of the skin. These are the acupuncture points in Chinese medicine. Ibn-i Sina listed the areas where hijama was done as follows.

• back of neck

• Forehead

• between the shoulders

• neck side

• shoulder heads

• above the calves

• top of my head

• Gill

• Hips

• knees

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What Should Be Considered Before And After Cupping Treatment?

A diet low in protein is recommended for one or two days before and after the application.  It is not recommended to take a bath within 24 hours after the procedure. Since the increase in the mesenteric arterial circulation after a meal may decrease the blood flow to the skin, it is recommended to apply the cupping  on an empty stomach.

For whom:

Wet cupping (hijama) is not recommended for people with bleeding disorders, anemia, pregnant women, advanced heart and kidney failure, cancer patients, people under 2 years old and over 60 years old.

When is it done:

There is no clear information about time in the hadiths that our Prophet recommended cupping. However, he often had hijama treatment done to stay healthy.

Due to the changes in blood pressure due to the gravity of the moon, it is recommended to apply cupping on the 17th, 19th, 21st and 23rd of the month according to the lunar calendar.

The amount of blood excreted during hijama  application varies according to the patient, and it is thought that its therapeutic effect is not related to the amount of blood.