Al-hijamah (wet cupping therapy of prophetic medicine) as an Adjuvant Non-operative Management for Treating Simple Knee Joint Sport Injury and Associated Pain (A Case Study)

Salah Mohamed El Sayed^{1, 2,}

¹Department of Clinical Biochemistry and Molecular Medicine, Taibah Faculty of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia

²Department of Biochemistry, Sohag Faculty of Medicine, Sohag University, Egypt;Prophetic Medicine Course and Research, Taibah College of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia.;Al-hijamah specialist physician, Taibah College of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia

Cite this paper

Salah Mohamed El Sayed. Al-hijamah (wet cupping therapy of prophetic medicine) as an Adjuvant Non-operative Management for Treating Simple Knee Joint Sport Injury and Associated Pain (A Case Study). American Journal of Sports Science and Medicine. 2023; 11(1):1-6. doi: 10.12691/AJSSM-11-1-1

Abstract

A 16 year old male football player presented with right anterior knee pain of 3 days duration that was accompanied by tenderness, mild swelling and painful walking after falling down to the ground during a sport game. Right knee joint X-ray revealed no bone fractures or displacement. Orthopedic evaluation revealed no suspicion of a meniscus lesion or cruciate ligaments injuries and there was no need for additional investigations, or an MRI. Biochemically, liver and kidney function tests were normal. Response to non-steroidal analgesics was not satisfactory. The patient was experiencing severe pain upon knee squatting and was not able to do regular walking and knee bending during regular walking. Treatment was initiated using Al-hijamah (wet cupping therapy of prophetic medicine). Al-hijamah works via clearing the tissues and blood from causative pathological substances e.g. pain-causing substances as inflammatory substances, prostaglandins, substance P and others according to the evidence-based Taibah mechanism (Taibah theory). Importantly, cupping therapy was reported to increase the production of heat shock proteins and endogenous opioids (β-endorphins) that act as pain-killers. Cupping therapy is also reported to decrease the serum level of the pain-related substance P. Some previous studies have reported that skin puncturing during Al-hijamah increased the release of endogenous opioids such as endorphins, enkephalins, and dynorphins, which intensified the cupping therapy-induced analgesic effects. Al-hijamah was performed via applying a single medium-sized cup at the tender area at the frontal lower aspect of the right patella that included the whole painful area. The pain immediately resolved and the patient took rest for about 2 days and returned to normal activities including a return to playing football. The patient reported complete resolution of the symptoms in one week’s time with no symptoms recurrence on follow up for several months later. In conclusion, Al-hijamah is a wonderful promising conservative management for treating minor sports trauma and associated pain.

Keywords

Al-hijamah, anterior knee injuries, tenderness, sucking cups, X-ray

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Witvrouw E, Werner S, Mikkelsen C, Van Tiggelen D, Vanden Berghe L and Cerulli G. Clinical classification of patellofemoral pain syndrome: guidelines for non-operative treatment. Knee Surgery, Sports Traumatology, Arthroscopy 2005; 13: 122-130.
[2]	Sanchis-Alfonso V. Holistic approach to understanding anterior knee pain. Clinical implications. Knee Surgery, Sports Traumatology, Arthroscopy 2014; 22: 2275-2285.
[3]	Houghton KM. Review for the generalist: evaluation of anterior knee pain. Pediatric Rheumatology 2007; 5: 1-10.
[4]	Smith TO, McNamara I and Donell ST. The contemporary management of anterior knee pain and patellofemoral instability. The Knee 2013; 20: S3-S15.
[5]	El Sayed SM, Abou-Taleb A, Mahmoud HS, Baghdadi H, Maria RA, Ahmed NS and Nabo MMH. Percutaneous excretion of iron and ferritin (through Al-hijamah) as a novel treatment for iron overload in beta-thalassemia major, hemochromatosis and sideroblastic anemia. Medical hypotheses 2014; 83: 238-246.
[6]	Sayed E, Mahmoud H and Nabo M. Medical and scientific bases of wet cupping therapy (Al-hijamah): In light of modern medicine and prophetic medicine. Alternative & Integrative Medicine 2013; 1-16.
[7]	El Sayed SM, Mahmoud HS and Nabo MMH. Methods of wet cupping therapy (Al-Hijamah): in light of modern medicine and prophetic medicine. Alternative & Integrative Medicine 2013; 1-16.
[8]	El Sayed SM, Al-quliti A-S, Mahmoud HS, Baghdadi H, Maria RA, Nabo MMH and Hefny A. Therapeutic benefits of Al-hijamah: in light of modern medicine and prophetic medicine. American Journal of Medical and Biological Research 2014; 2: 46-71.
[9]	Kannus P and Järvinen M. Nonoperative treatment of acute knee ligament injuries: a review with special reference to indications and methods. Sports Medicine 1990; 9: 244-260.
[10]	Hassan SMA, Aboonq MS, Albadawi EA, Aljehani Y, Abdel-Latif HM, Mariah RA, Shafik NM, Soliman TM, Abdel-Gawad AR and Omran FM. The Preventive and Therapeutic Effects of Ajwa Date Fruit Extract Against Acute Diclofenac Toxicity-Induced Colopathy: An Experimental Study. Drug Design, Development and Therapy 2022; 16: 2601.
[11]	Tian H, Tian Y-J, Wang B, Yang L, Wang Y-Y and Yang J-S. Impacts of bleeding and cupping therapy on serum P substance in patients of postherpetic neuralgia. Zhongguo Zhen Jiu= Chinese Acupuncture & Moxibustion 2013; 33: 678-681.
[12]	Ekrami N, Ahmadian M, Nourshahi M, Shakouri G H. Wet-cupping induces anti-inflammatory action in response to vigorous exercise among martial arts athletes: A pilot study. Complement Ther Med. 2021 Jan; 56: 102611.
[13]	Subadi I, Nugraha B, Laswati H and Josomuljono H. Pain relief with wet cupping therapy in rats is mediated by heat shock protein 70 and ss-endorphin. Iranian Journal of Medical Sciences 2017; 42: 384.
[14]	Ersoy S and Benli AR. Continue or stop applying wet cupping therapy (al-hijamah) in migraine headache: A randomized controlled trial. Complementary therapies in clinical practice 2020; 38: 101065.
[15]	El-Shanshory M, Hablas NM, Shebl Y, Fakhreldin AR, Attia M, Almaramhy HH, Baghdadi H, Ayat M, Albeihany A and El-Dardear A. Al-hijamah (wet cupping therapy of prophetic medicine) significantly and safely reduces iron overload and oxidative stress in thalassemic children: a novel pilot study. Journal of Blood Medicine 2018; 9: 241.
[16]	El-Shanshory M, Hablas NM, Shebel Y, Alhadramy O, El-Tahlawi R, Aboonq MS, Soliman TM, Abdel-Gawad AR, El Sayed SM and Abdallah HI. Al-hijamah (the triple S treatment of prophetic medicine) exerts cardioprotective, tissue-protective and immune potentiating effects in thalassemic children: a pilot clinical trial. American Journal of Blood Research 2020; 10: 447.
[17]	El-Shanshory M, Hablas NM, El-Tahlawi R, Awny S, Aboonq MS, Al Jaouni SK, Abdel-Latif TM, Abdel-Gawad AR, Okashah AM and Fakhreldin AR. Al-hijamah (the triple S treatment of prophetic medicine) significantly increases CD4/CD8 ratio in thalassemic patients via increasing TAC/MDA ratio: a clinical trial. American Journal of Blood Research 2022; 12: 125.
[18]	Aboonq MS. Al-hijamah (wet cupping therapy of prophetic medicine) as a novel alternative to surgery for carpal tunnel syndrome. Neurosciences Journal 2019; 24: 137-141.
[19]	Hudes K. Two cases of medial knee pain involving the medial coronary ligament in adolescents treated with conservative rehabilitation therapy. The Journal of the Canadian Chiropractic Association 2011; 55: 120.
[20]	Salter RB. Textbook of disorders and injuries of the musculoskeletal system: An introduction to orthopaedics, fractures, and joint injuries, rheumatology, metabolic bone disease, and rehabilitation. Lippincott Williams & Wilkins, 1999.
[21]	Reider B. Medial collateral ligament injuries in athletes. Sports Medicine 1996; 21: 147-156.
[22]	Edson CJ. Conservative and postoperative rehabilitation of isolated and combined injuries of the medial collateral ligament. Sports medicine and arthroscopy review 2006; 14: 105-110.
[23]	Mahmoud HS, Abou-El-Naga M, Omar NAA, El-Ghazzawy HA, Fathy YM, Nabo MMH and El Sayed SM. Anatomical sites for practicing wet cupping therapy (Al-Hijamah): in light of modern medicine and prophetic medicine. Altern Integ Med 2013; 2: 1-30.
[24]	El Sayed SM, Baghdadi H, Abou-Taleb A, Mahmoud HS, Maria RA, Ahmed NS and Nabo MMH. Al-hijamah and oral honey for treating thalassemia, conditions of iron overload, and hyperferremia: toward improving the therapeutic outcomes. Journal of blood medicine 2014; 5: 219.
[25]	Baghdadi H, Abdel-Aziz N, Ahmed NS, Mahmoud HS, Barghash A, Nasrat A, Nabo MMH and El Sayed SM. Ameliorating role exerted by Al-Hijamah in autoimmune diseases: effect on serum autoantibodies and inflammatory mediators. International journal of health sciences 2015; 9: 207.