Hijama can be mildly uncomfortable but rarely painful. It looks worse than it feels. Hijama can even be relaxing. Then negative pressure (suction) feels like a slight pinching sensation, While the incisions feel like minor scratches or even feel like someone is touching you with the tip of a pen. Most people are pleased to discover how tolerable Hijama is. It may feel ticklish for some. At the end of the day, the ultimate goal is to feel good after Hijama not during Hijama.

There are multiple different theories for why Hijama soothes pains and numerous different mechanisms for achieving this soothing effect, by impacting pain mediators. Hijama can be deeply relaxing and help dispel anxiety, stress, and depression. 

Using numbing cream on Hijama points is not recommended as it could disrupt many of the biomechanics of Hijama through Vasoconstriction for example. It is also unnecessary as the preceding dry cupping produces an analgesic effect that numbs up the incision points. The incisions serve two purposes, one is creating a detox pathway and the second is physical stimulation. While there is a line between stimulation and irritation, sometimes this line is crossed during Hijama.

In reality, the mild pain caused by Hijama can reduce acute pain and this is why we avoid pain medicine when we do Hijama. The mild pain of Hijama stimulates the release of endogenous Opiorphin, Serotonin, Enkephalin, and Endorphins. The pain gate control theory asserts that non-painful input closes the nerve “gates” to painful input, which prevents pain sensation from traveling to the central nervous system. This is one of the ways Hijama modulates pain signals. For example, the mild pain of Hijama helps numb the acute pain of Sciatica. Pain inhibits pain theory can help us understand how Hijama overcomes idiopathic pain as in the case of fibromyalgia.