Clinical Efficacy of Ḥijāma bi’l Sharṭ (Wet Cupping Therapy) in Steroid-induced Avascular Necrosis

Abstract Avascular necrosis (AVN) is a progressive orthopedic disorder characterized by disruption of blood supply to bone tissue, leading to ischemia, necrosis, and joint dysfunction. In this study, two patients previously diagnosed with AVN, presenting with progressive low back pain radiating to the right thigh, are enrolled. The condition was managed through Ḥijāma bi’l Sharṭ (wet cupping therapy; WCT) administered weekly for a duration of 5 weeks. Four cups were applied over the sacral region, right hip, and upper right thigh. Pain and disability were assessed using the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI). Case 1 reported 90% pain relief (VAS) and 96.15% improvement in disability (ODI), while Case 2 demonstrated 88.89% and 94.74% improvement, respectively. Marked reductions in pain and restoration of range of motion were observed in both cases. These findings highlight the efficacy of Ḥijāma bi’l Sharṭ (WCT) in managing AVN.