The field of medicine has remained an extensive ground for major advancements over recent decades with the primary purpose of decreasing the suffering of humanity and improving the course of life. However, despite these modern advancements, the popularity of complementary and alternative medicine (CAM) has increased. CAM refers to therapeutic approaches that are complementary to the end goals of decreasing illness and enhancing wellness, but are alternatives to conventional medical treatment [1]. Notably, nearly half of the population in many developed countries practices CAM. The use of CAM in many developing countries is also considerable, practiced both within and outside dominant health systems [2].

One such example of CAM is Hijama, which literally means sucking (cupping) and is one of the oldest medical techniques in the world. It has not attracted much attention in the West, but it is very common in East Asia and the Middle East [3]. The various types of cupping include wet cupping, retained cupping, flash cupping, moving cupping, medicinal cupping, and needle cupping. This practice may include one of several kinds of cups, such as bamboo, glass, or earthen cups. Practitioners place these cups on precise acupoints on the patient's skin, which allows the particular area to undergo hyperemia or hemostasis, thereby resulting in a therapeutic effect [4]. In traditional Arabic culture, Hijama refers to wet cupping, which is specifically emboldened by the Islamic prophet Muhammad [3].

Despite the increasing popularity, scholars have conducted very little research on Hijama, and assessment of the results shows that this research is either controversial or carries a high risk of bias, thereby hinting at a certain degree of uncertainty. Strong evidence suggests that Hijama can be highly effective in the treatment of pain, particularly tension headaches and musculoskeletal pain [3], [4], [5]. Hijama is also known to be useful for a wide range of symptomatic conditions. Several studies have revealed its potential efficacy for symptoms of the common cold, cough, asthma, stroke rehabilitation, and acne. It is also known to remove toxins, reduce low-density lipoprotein cholesterol levels, improve blood pressure, stimulate the nervous system, and modulate the immune system [3], [4], [5]. However, apart from its effectiveness in relieving pain, the evidence for other indications is clearly insufficient. As a result, clinicians are skeptical about its therapeutic usage. Furthermore, evidence suggests that Hijama carries a significant risk of certain blood-borne infections including human immunodeficiency virus, hepatitis B, and hepatitis C, thereby raising questions about its efficacy [6].

Overall, the body of CAM literature on Hijama is inconclusive. Positive results are reported in many developing countries compared with the negative outcomes reported by the Western world [3]. The application of Hijama is considered to be safe in general, based on long-term clinical usage. However, the literature available lacks high-quality evidence to encourage the clinical use of Hijama [4]. Efforts should be made to promote extensive high-quality evidence-based research on Hijama with cooperation from both the Western world and developing countries to reduce the risk of bias and to reach a more definitive conclusion about its therapeutic uses. The general population should be made aware of its effectiveness or hazards. Cultural, social, or religious factors should not influence this research.

The authors declare that they have no conflicts of interest and no financial interests related to the material of this manuscript.