BRIDGING THE GAP: EXPLORING THE MECHANISM OF HIJAMA BI’L SHART (WET CUPPING) RELIEVING CERVICAL SPONDYLOTIC RADICULOPATHY (WAJA-UL-UNUQ)

Mariya Khan, Yasmeen Shamsi*, MD Wasi Akhtar, Sadia Nikhat, Sohrab Ahmad Khan

Cervical spondylosis refers to a range of age-related degenerative changes in the cervical spine, affecting the intervertebral discs, facet joints, ligamentum flavum, uncovertebral joints, and laminae. These changes develop slowly over time and are commonly seen in individuals beyond their fifth decade. Problems arise when deteriorating structures press against the spinal cord or nerve roots, producing chronic neck pain and stiffness. One well-recognised consequence is cervical radiculopathy, in which a compressed or irritated nerve root generates pain, tingling, or weakness that travels down the arm.[1] Symptoms typically begin as dull neck pain before spreading into the arm along a recognisable nerve distribution.[2] In Unani medicine, Waja broadly denotes pain arising from either a temperamental imbalance (Su-e-Mizaj) or a physical disruption. Joint-related pain falls under Waja-al-Mafasil, which is further divided by cause and location.[3] Subtypes include Niqras (gout), Waja-al-Warik (hip pain), Waja-al-Rukbah (knee pain), and Waja-al-Unuq or Waja-al-Raqabah for neck pain.[4] Classical Unani texts do not use terms like "cervical spondylosis" or "radiculopathy," since these are modern classifications. However, their descriptions of Waja-al-Unuq and Waja-al-Asab Unuqiyah bear a strong resemblance to these conditions as understood today.