Therapeutic Efficacy of Hijāma Dalkiyya (Gliding Cupping) and Targeted Exercises in Waja-i-Mafṣal-i-Katif (Frozen Shoulder) Management: A Case Report
Abstract
Background: Frozen shoulder (Waja-i-Mafṣal-i-Katif) is a painful condition that leads to stiffness and restricted movement of the shoulder joint. While conventional treatments often rely on medications, Unani regimenal therapy provides a non-invasive alternative for management.
Objective: This study aims to assess the effectiveness of Hijāma Dalkiyya (Gliding Cupping) combined with targeted shoulder exercises in improving pain, mobility, and functional ability in individuals with frozen shoulder.
Methods: A 67-year-old male diagnosed with right shoulder adhesive capsulitis underwent 21 gliding cupping sessions and structured exercises. Pain levels and shoulder mobility were evaluated using the Shoulder Pain and Disability Index (SPADI) and clinical diagnostic tests before and after treatment.
Results: The intervention resulted in a notable improvement in range of motion (ROM), a reduction in SPADI scores, and the negation of previously positive diagnostic tests. The combined effects of cupping therapy and exercise enhanced blood circulation, reduced inflammation, and restored flexibility, improving shoulder function.
Conclusion: Unani regimenal therapy, particularly gliding cupping with targeted exercises, shows promise as an effective, non-pharmacological approach for treating frozen shoulder. Further clinical studies are recommended to validate these findings and integrate this method into modern rehabilitation practices.
Keywords: Frozen shoulder, Unani therapy, Hijāma Dalkiyya, Gliding cupping, Shoulder rehabilitation
Keywords:
Frozen shoulder, Unani therapy, Hijāma Dalkiyya, Gliding cupping, Shoulder rehabilitationDOI
https://doi.org/10.22270/jddt.v15i7.7215References
1. Phansopkar P. A Review on Current Notion in Frozen Shoulder: A Mystery Shoulder. Cureus. 2022 Sep;14(9). https://doi.org/10.7759/cureus.29362
2. Edwards O, Counihan M, Li X. Epidemiology of frozen shoulder. In Frozen Shoulder 2024 Jan 1 (pp. 53-57). Academic Press. DOI https://doi.org/10.1016/B978-0-443-15995-4.00011-8
3. Uppal HS, Evans JP, Smith C. Frozen shoulder: a systematic review of therapeutic options. World journal of orthopedics. 2015 Mar 3;6(2):263. https://doi.org/10.5312/wjo.v6.i2.263 PMid:25793166 PMCid:PMC4363808
4. Maheshwari J, Mhaskar VA. Essential orthopedics. 4th edition. Published by Jaypee Brothers. 2014, 295.
5. Tashjiian RZ. The effectiveness of nonoperative treatment for frozen shoulder: a systematic review. Clin J Sport Med. 2012; 22(2):168-9 https://doi.org/10.1097/JSM.0b013e31824c2b01 PMid:22388345
6. Tukmachi ES. Frozen Shoulder: A compression of Western and traditional Chinese approaches and a clinical study of its acupuncture treatment. Acupuncture in Medicine. 1999; 17(1):9-21. https://doi.org/10.1136/aim.17.1.9
7. Cleland J, Durall CJ. Physical therapy for adhesive capsulitis: Systematic review. Physiotherapy. 2002; 88(8):450-7. https://doi.org/10.1016/S0031-9406(05)60847-4
8. Barua SK, Alam Z. Phonophoresis in adhesive capsulitis (Frozen shoulder). Chattagram maa-o-shishu hospital medical college journal. 2014; 13(1):60-64. https://doi.org/10.3329/cmoshmcj.v13i1.19423
9. Bridgman JF. Periarthritis of the shoulder and Diabetes Mellitus. 1972; 31:69-71. https://doi.org/10.1136/ard.31.1.69 PMid:5008469 PMCid:PMC1005864
10. Anonymous. Taber's cyclopaedic medical dictionary. Vol-2. Jaypee Brothers. YNM, 1625.
11. Smith LL, Burnet SP, McNeil JD. Musculoskeletal Manifestation of diabetes mellitus. Br J Sports Med. 2003; 37:30-35. https://doi.org/10.1136/bjsm.37.1.30 PMid:12547740 PMCid:PMC1724591
12. D'Amato KE, Rogers M. "Frozen Shoulder"-A Difficult Clinical Problem. Osteopathic Family Physician. 2012 May 1;4(3):72-80. https://doi.org/10.1016/j.osfp.2011.12.001
13. Vita F, Pederiva D, Tedeschi R, Spinnato P, Origlio F, Faldini C, Miceli M, Stella SM, Galletti S, Cavallo M, Pilla F. Adhesive capsulitis: the importance of early diagnosis and treatment. Journal of Ultrasound. 2024 Jun 6:1-9. https://doi.org/10.1007/s40477-024-00891-y PMid:38844748 PMCid:PMC11333403
14. Pandey V, Madi S. Clinical guidelines in the management of frozen shoulder: an update!. Indian journal of orthopaedics. 2021 Apr;55(2):299-309. https://doi.org/10.1007/s43465-021-00351-3 PMid:33912325 PMCid:PMC8046676
15. Eqbal K, Eqbal J, Jahan T. Frozen shoulder and evidence based unani medicine: A review.
16. Chan HB, Pua PY, How CH. Physical therapy in the management of frozen shoulder. Singapore medical journal. 2017 Dec;58(12):685. https://doi.org/10.11622/smedj.2017107 PMid:29242941 PMCid:PMC5917053
17. Anonymous, Standard Operating Procedure for Hijama. Central Council for Research in Unani Medicine, New Delhi. 2024, P 26.
18. Kalam MA, Barjes J, Shugufta H. Effect of Ḥijāma bilā Shart (Dry cupping) and Unani formulation on Waja'-i-Mafṣal-i-Katif (Frozen Shoulder) - A Case Study. Int J AYUSH Case Rep. 2024;8(3):351-356. https://doi.org/10.70805/ija-care.v8i4.654
19. Anonymous, Standard Operating Procedure for Hijama. Central Council for Research in Unani Medicine, New Delhi. 2024, P 31.
20. Palm Beach Orthopaedic Institute. Frozen Shoulder Home Exercises [Internet]. Palm Beach Gardens, FL: Palm Beach Orthopaedic Institute; Available from: www.pboi.com
21. Anonymous. National formulary of Unani Medicine. Part 1. reprint ed. New Delhi: Ministry of H&FW, Govt of India;2006; p.194
22. Von der Heyde R, Droege K. Assessment of Functional Outcomes. Palm Beach Orthopaedic Institute; 2014.https://doi.org/10.1016/B978-0-323-09104-6.00008-0
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Copyright (c) 2025 Bushra Husain , Irshad Ahmed Wani , Mohammad Najeeb , Mohd Nayab , Abdul Nasir Ansari , Mehmooda Begum

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