Clinical study of Irq al-Nasa (Sciatica) with therapeutic evaluation of Hijama bil shart (wet cupping) in its management: An open-label, block randomized, standard controlled clinical trial.

Physicians since classical times were familiar with the malady sciatica. In the Unani system of medicine, Sciatica is known as Irq al-Nasa  also known as Langdi ka dard, Rengan baw.  Zakariya rhazi in his book Kitab ul mansoori mentioned that Irq al-Nasa is the pain which starts from hip and radiates to  thigh, sometimes even to calf muscles and legs.  The causative agents are Khilti-Dam(sanguine) or Khilt balgam ghaleez which gets accumulated in hip joint or a mixture of Khilti-balgam wa safra (phlrgm and bilious humor). It has been mentioned in book kitabul umda fil jarahat that for relieving severe pain Hijama bil shart (wet cupping) should be done. Sciatica is known as Sciatic nerve root entrapment or Sciatic nerve root pain or lumbosacral radicular syndrome or Lumbar radiculopathy. It signifies low back pain with radiation to ipsilateral leg, thereby implying pain radiating along sciatic nerve, which automatically contain fibres originating in L4-S2 roots. The prevalence of sciatica estimate vary widely 1.2-43%.  Sciatica is of two types Acute and Chronic. Most common etiology of sciatica is intrusion of L4,L5 or S1 nerve that is from the herniated disk and apparent as neuropathic pain affecting one side that is extending from the gluteal region down the leg to the foot.Conventional therapies given in sciatica for treatment include Analgesics, NSAIDs, Acupuncture Traction therapy, microdisectomy etc. Thses drugs and various surgical procedures are associated with certain side effects and many complications therefore, search for safe and effective is need of  on hour. Ancient physicians advocated Hijama bil shart in treatment of irq al-Nasa.