Clinical Improvement in a Morbidly Obese Patient of Sciatica/lumbosacral Radiculopathy with Ilaj bit Tadbeer

Abstract ‘Irq al-Nasā (Sciatica) is one of the most common manifestations of Waja‘ al-Ẓahr (backache), a type of Waja‘ al-Mafāṣil (arthritis/ arthralgia). In Unani medicine, Waja‘ al-Mafāṣil is one of the most common disorders caused prevalent in general population and increases with advancing age. As per Unani classical text, arthralgia is mostly caused due to Balgham (phlegm), followed by Dam (blood) and Ṣafrā’ (bile), whereas Sawdā’ (black bile) is rarely involved. The management is based on the elimination of the māddī asbāb (causative matters) and rectification of sū’-i-mizāj (impaired temperament), which can be attained by tanqiya māwad (evacuation of morbid matter) and Ta‘dīl (restoration). We present the case of a 55-year-old female patient suffering from lumbar radiculopathy manifesting as sciatica, besides morbid obesity (Grade II). She was treated with multiple sessions of Ḥijāma bi’l Sharṭ (cupping with scarification), ḥijāma mutaḥarrika (gliding cupping), inkibāb (steam therapy), and riyāḍat (exercises). Over a period of nearly 8 months, the patient gradually started having improved mobility, feeling of lightness in the body, reduced pain, and flexibility in joints. Ḥijāma and inkibāb can be safely and effectively utilized in the management of sciatica and lumbar radiculopathy, without the use of pharmacological or surgical treatment.