Cupping Therapy (Al-Hijamah): An Exploratory Study of Healthcare Professionals Controversial Beliefs and Conceptions, Kingdom of Saudi Arabia

Background: Cupping therapy (Al-Hijamah) is a traditional therapy, supported and practised by people around the world since ancient times. Cupping therapy related to complementary and alternative medicine is associated with controversial, false beliefs and misconceptions. Objective: This study aimed at exploring controversial beliefs and conceptions about cupping therapy among healthcare professionals, Riyadh, Kingdom of Saudi Arabia (KSA). Methods: A cross-sectional study involving 241 healthcare professionals was carried out from January to June 2016. All participants requesting license for practicing cupping therapy underwent one week Al-Hijamah training course at National Center for Complementary and Alternative (NCCAM). Prior to training course, all subjects completed a 23-item predesigned questionnaire related to controversial beliefs and misconceptions concerning cupping therapy. All participants gave written informed consent. Results: Healthcare professionals who participated in the study (n=241) were 93 physicians, 56 physiotherapists, 61 nurses and 31 other specialists. Saudi participants represented 46.1%. 60.6% were adult males with mean clinical experience of 13.0±9.37 years. "Al-Hijamah gets rid of bad blood" was the commonest controversial belief reported by 68.1% of participants. A proportion of participants (31.5%) reported "Al-Hijamah is absolutely safe" and "Al-Hijamah is effective in the treatment of all diseases". The least controversial beliefs reported by 12%, 8.7% and 2.9% of participants were "Cupping can be used for all patients and all diseases”, "Cupping like a blood donation is not different" and "The scarification of cupping (in wet cupping) must be deep", respectively. Conclusion: The explored controversial beliefs and misconceptions related to cupping therapy may impact knowledge, attitude and practice of cupping practitioners. Therefore, all healthcare professionals need to be regularly exposed to a training course targeting these beliefs and misconceptions concerning cupping therapy prior to giving them license for practicing this traditional modality. Continuing research in cupping mechanisms of action is another prioritized area which can provide scientific explanations underlying its efficacy and outcome together with alleviating its false beliefs and misconceptions