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 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 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.

How does Hijama impact pain?

Hijama has not match in addressing Idiopathic pain. Modern devices like MRI’s and Blood Tests do not always detect the what is wrong with us. People have to wait for their condition to exacerbate before a diagnosis can be made. In the beginning of a disease, the diagnosis is difficult but the treatment is easy. However after the condition gets worse, diagnosis becomes easy while treatment becomes difficult. The solution is not always pain killers, cortisone shots, nerve blocks etc.

Hijama relieves congestive buildup on sensitive nerve endings. It removes Noxious and toxic substances out of the body. When the body is injured, the immune system triggers inflammation, the release of white blood cells (to fight infection) and Fibrin protein (a fibrous sticky protein that helps form blood clot). While Fibrin is important for the healing process, excessive amount of Fibrin has devastating effects on the body.

Due to our modern lifestyle and diet, the human body gets stuck in this inflammatory mode chronically. This excessive amount of Fibrin forms a tight mesh. This mesh slows blood cells that carry oxygen and nutrients from feeding sore joints. Though the body can dissolve excessive fibrin, scar tissues and cellular waste by releasing proteolytic enzymes, our body gets overwhelmed due to the excessive amount of fibrin specially when we age.

The negative pressure of Hijama, along with the incisions, improve blood circulation and break down adhesions. Healthy blood loaded with Oxygen and nutrients relieves the pain triggered by Hypoxia (lack of oxygen). Therefore, Hijama reduces pain sensations and even override pain signals. It stimulates the sensory nerves on the skin. The pain inhibitory effect of Hijama is not limited to the targeted area, it expands to include the areas controlled by the relevant nerve. The stimulation of the sympathetic and parasympathetic nerves positively effects the organs that are under their control; This helps shed some light on how Hijama impacts Endogenous Chronic Diseases.

Hijama’s goal is not to just mask the pain. It addresses the root cause of pain as Hijama facilitates the drainage of Causative Pathological Substances CPS. CPS include both disease-causing substances and disease-related substances resulting during disease pathogenesis. Hijama activates the mechano-receptors in the periphery which triggers Hijama mediated analgesia in the form of endogenous opioids. 

Oxygen starved tissues cause pain, as in muscle ischemia induced pain. Also tissue damage causes pain and inflammation which reduces our physical ability. The damaged cells release chemicals including histamine, bradykinin, and prostaglandins. These chemicals cause blood vessels to leak fluid into the tissues. When the vicious circle starts, Hypoxia triggers pain, Pain triggers a reaction from the sympathetic nervous system which leads to further vasoconstriction of the blood vessels and reduced oxygen and nutrients. This fluid buildup slows down the exchange of oxygen and nutrients at the cell level. Hijama is literally able to suction out the pain by removing the excess fluid in the tissue space. Studies found that increased vasodilation is associated with decreased pain.

Hijama suctions out, through the incisions, local pain substances such as, Substance P, Prostaglandin, Inflammatory cells, Bacteria, Antigens, Hemolyzed blood cells, Harmful biological and chemical substances etc. That fluid mixture contains collected interstitial fluids with CPS, filtered fluids (from blood capillaries) with CPS. Hijama excretes excess localized interstitial fluid that exerts pressure on nerve endings. Therefore, Hijama treats pain source through the dilution, removal of CPS and bathing nerve endings beside promoting the release of endogenous opioids.