Does Gua Sha Hurt and Is It Dangerous?

Wayne BloemhofTCM1 Comment

Gua sha is a traditional healing technique that originated in the Far East. It has a long history, and it is still very popular in Asia, where millions of ordinary people use it to relieve congestion and muscle pain, but it is still not very well-known in the West.

Because people don’t know much about it, there are a lot of misconceptions.

Gua sha is also widely known as ‘coining’, ‘spooning’ or ‘scraping’. Using a smooth scraping instrument, together with the proper lubricating oil, the skin is scraped repeatedly in one direction.  After a while a particular kind of marking starts to appear under the skin.

This is called “Sha” in Asia (or ‘petechiae’ in scientific journals) – and it looks a little like bruising to the untrained eye. Because the markings can look quite dramatic, it can be misinterpreted.

Many families use it safely as a folk remedy. Often a family member will know how to perform gua sha, and will be called on for help from time to time.

It is commonly used as a cure for:

  • Back pain
  • Neck and shoulder pain
  • Common colds, relieving congestion
  • Fever
  • Coughs
  • Muscular pain

It Looks Painful – Does It Hurt?

Markings from Gua Sha

Markings from Gua Sha

After a gua sha treatment the skin exhibits red, yellowish-brown or purple markings that look like bruising. If you don’t know gua sha you might mistakenly assume that the person has been beaten. But that’s far from the truth.

These markings are a good and healthy thing – it’s a sign that the body is getting rid of toxins.

Gua sha isn’t supposed to be painful at all. If you use the wrong kind of scraping instrument or lubrication you might end up breaking the skin – and that can be painful. With the proper care it is normally less painful than a deep tissue massage.

And the benefits are more profound, and last longer.

The person who is doing the scraping needs to take care over parts of the body where the skin is very close to the bone. Scraping over shoulder blades or on the delicate tissues of the neck needs to be done gently. Areas where there is more muscle and padding can be scraped more intensely without harm.

In other words, if it hurts, you may be doing it wrong!

When done correctly gua sha is invigorating. It relieves congestion and removes the tension that’s collected in your muscles over time.

After treatment it’s a good idea to drink water, and to rest. Heavy work, intensive training and excessive revelry or drinking should be avoided on the day of treatment. Take it easy and let your body heal naturally.

Is It Dangerous?

A treatment by a qualified practitioner is perfectly safe. It’s also safe for self-treatment, so long as a few common-sense precautions are taken. (See the section below).

Scientific studies have begun to investigate what happens in the body during and after a gua sha, and the benefits have been verified.

The markings that will appear are part of the body’s therapeutic response to the treatment. Blood is forced out of the fine vessels in the sub-cutis, and then gradually re-absorbed back into the body. That’s why the markings fade in two or three days. As this takes place, hemoglobin is broken down.

This increases the body’s production of an enzyme called heme oxygenase-1 (HO-1 ) – which is an anti-oxidant that protects cells. The body also releases anti-inflammatory agents at the same time – also a very good thing. (Arya Nielsen, 2015)

Dr. Nielsen adds this caution:

“There is a small but real risk of exposure to blood-borne pathogens, so gua sha instruments should not be reused on other patients. Simple metal caps that can be disposed of after one use are recommended, rather than the outdated spoon, coin, jade, stone or bone tool,”

How long do the markings and bruises last for?

First off, we don’t recommend scraping to the point where you get purple, bruising skin. Up to the point where there’s petechiae (bright red spots) is enough.

With that in mind, the markings from Gua Sha typically subside in as quickly as 72 hours. In 48 hours, there will already be a significant decrease in markings (as long as you’ve stayed hydrated, rested etc.). See the following image.

Gua Sha - Before and After

Within 24 hours, the markings have significantly subsided, and within 72 hours, they have practically all disappeared.

Some Common-Sense Tips for Gua Sha Safety

It’s important to apply a suitably thick balm, ointment or oil to the skin. The best results will come from natural oils and balms that nourish and restore the tissues being treated and help the skin to release toxins.

Avoid scraping instruments that have sharp edges – this might break the skin. Some home therapists use a ceramic kitchen spoon, for example. The best tool is one that is specifically designed for gua sha.

  • Try not to scrape over any mole, injury, pimple or mark on the skin. Place your finger over it if possible to guard against accidental contact.
  • During pregnancy gua sha isn’t normally recommended.
  • Do not use it on people who are very frail, or too weak to tolerate the treatment.
  • Don’t use gua sha on people with bleeding disorders, or for people who are taking anti-coagulant medication, like warfarin.
  • Since gua sha is very “hands-on” you should avoid giving it to a person suffering from a serious communicable disease.
  • Try to do the technique at least one hour before or after eating.
  • Don’t bath or shower for an hour or two after treatment, and keep the body covered up and warm.
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Wayne Bloemhof lives in a cabin in the woods in Knysna, South Africa, where he enjoys practicing Tai Chi and studying the human condition. He has written numerous eBooks and articles on personal growth, meditation, yoga, mindfulness, the martial arts, TCM as well as the mind-body connection. His personal aim is to improve people’s lives through sharing knowledge and insight – while doing what he loves – putting pen to paper.

One Comment on “Does Gua Sha Hurt and Is It Dangerous?”

  1. Where can I obtain a certification or can this technique be practiced my any licenced massage therapist?

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