What is Gua Sha Therapy and how does it work?

Tracey RoizmanGua Sha, Muscle Scraping3 Comments

What is Gua Sha and it’s History

The first written records of gua sha date back 700 years, to the era of the Ming Dynasty, though,  the practice is thought to be much older than that, perhaps having been discovered in prehistoric times as the simple reflex of rubbing a painful area to make the pain go away.

The term gua sha is comprised of two Chinese words: gua, meaning to rub or scrape, and sha, a type of stagnant energy that causes excess heat to build within the body. Taken together, the term gua sha means the act of rubbing the skin to remove an energy blockage.  According to traditional Chinese medicine theory, by bringing heat to the skin surface, gua sha, releases the blocked energy and heat.

One of the original forms of physical therapy, gua sha is widely used to treat joint and muscle pain. Traditionally applied in accordance with the meridians, or energy channels of the body, many patients in China and other parts of Asia also use gua sha as a form of preventive medicine and a first line of defense against illness. Gua sha has been used to treat a wide range of both acute and chronic health conditions including headache, fever, digestive disorders, asthma, and respiratory infections as well as women’s health issues, insomnia, and general fatigue.


Gua sha has traditionally been performed with any handy object possessing a smooth edge that can be rubbed across the skin surface, such as a porcelain spoon or a coin. Among gua sha afficionados, however, a popular material for gua sha toolmaking is water buffalo horn, which is prized for its ability to form and hold a smooth, polished edge. Gua Sha tools are made from a variety of materials nowadays and the right one for  you depends on your budget and needs. The Sidekick Curve is a great introductory tool at an affordable price.

Gua sha is usually applied to the back, buttocks and posterior surfaces of the neck, shoulders, arms and legs. Occasionally, it is applied to the chest or abdomen. First, oil is applied to the treatment area, then, holding the edge of the gua sha tool at a 45-degree angle to the skin, the practitioner administer strokes along the skin surface.

The general health of the person receiving treatment dictates the speed and force of the strokes depends. Weaker individuals should receive lighter, slower strokes, known as tonifying therapy, while stronger individuals are more able to withstand faster, deeper pressure, often referred to as purging therapy.

Gua sha strokes are always performed in the same direction, usually downward, from the head towards the feet. Western science calls this type of stroke “tribo-effleurage”, which means friction-stroking. Between a dozen and 3 dozen strokes about 6-7 inches long are administered in the same spot before moving to the next section. It is advisable to rest after gua sha treatment. Also, make sure to hydrate with plenty of warm or room temperature water.

Though it is one of the safest forms of therapy available, gua sha is not appropriate for everyone. If you take blood thinning medication or have a bleeding disorder you should not receive gua sha. If you have moles, varicose veins or open wounds you can receive gua sha, but take care to avoid those areas.

What to Expect

Gua sha should not be painful. However, the resulting appearance of the skin after a treatment can be dramatic and alarming. The stroking motions of gua sha cause capillaries near the skin surface to bleed, causing red to purple streaks to appear along the stroke patterns.

When performed properly, gua sha does not cause the capillaries to rupture so no bruising should occur and the redness normally disappears within 2-4 days. If the marks take longer to fade this may indicate poor circulation.

Marked increase in local circulation occurs for about half an hour after a gua sha session. As the gua sha strokes are applied, fluid and toxins (metabolic waste) are drawn to the area. When the treatment ceases the fluid recedes, leaving an indentation.

During and immediately after a gua sha treatment you may begin to sweat and/or feel an energetic shift.

How it works

According to traditional Chinese medicine theory, gua sha works by dispersing blocked energy. While this is not a western medical concept, both systems acknowledge the results: decreased inflammation and pain.

So, how can gua sha’s effects be understood from a western point of view? One way is to consider the way the nervous system is constructed. The urge to rub or shake a painful body part to stop it from hurting is universal. When you do this you are creating non-painful sensations that compete with the painful ones. As both painful and non-painful stimuli enter the spinal cord on their way to the brain a reflex loop within the spinal cord inhibits some of the pain signals from reaching the brain, lessening the intensity of pain that your brain perceives.

Decreased pain perception also calms your nervous system, reduces the stress and anxiety that arises from pain and allows the body’s inherent healing mechanisms to be expressed. This leads to  increased speed of healing and improved resilience to injury and disease.

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Tracey Roizman, DC is a wholistic chiropractor and health writer. Find her online at chiroasheville.com or facebook.com/chiroashevile

3 Comments on “What is Gua Sha Therapy and how does it work?”

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