Does Gua Sha work? Health Benefits of the Skin Scraping Technique

Gua sha, an ancient healing technique, is making a splash in the modern world.

Also known as “skin scraping” or “scratching therapy,” it is used to treat chronic pain, relieve stress, and even help relieve headaches.

Proponents include Arya Nielsen, an American acupuncturist and assistant clinical professor at the Icahn School of Medicine at Mount Sinai in New York, who calls gua sha “one of the best-kept secrets of traditional Asian medicine from the East” on its website dedicated to the practice.

“I’ve seen the benefits time and time again, without a doubt,” Dr. Vincent Minichiello, family physician and faculty member of the University of Wisconsin-Madison Integrative Health Program, said today.

“In my experience, there really seems to be a real biochemical and mechanical reason why gua sha is effective.”

He offers it to patients in the United States after living in China and studying traditional Chinese medicine.

Janet Shaffer, an acupuncturist at Duke Health Integrative Medicine Center in Durham, NC, called gua sha one of her favorite techniques for releasing fascia — the connective tissue that wraps around all structures in the body.

“For some people, it’s like the knife is sticking out of their back,” Shaffer said of the reactions she’s seen in patients after gua sha treatment. “It’s like loosening a stuck jar.”

What is guasha?

Nielsen defines it as “instrument-assisted unidirectional pressure on a lubricated area of ​​the body’s surface to intentionally create transient therapeutic petechiae”.

Put simply, a gua sha practitioner will scrape a person’s lubricated skin in one direction – never back and forth – with a smooth-edged tool, as if creating scratches, until tiny dots appear. red appear. These spots, known as petechiae, indicate bleeding just below the surface of the skin, Minichiello said. They are different from bruises, which are deeper in the skin, he noted.

“When we see the petechiae, we’ve reached release, we’ve reached flow, we’ve lifted off,” Shaffer added. “It looks like a rash, but it’s not. And it looks like the skin is broken, but it’s not.

She compared getting the right amount of redness to baking — you watch carefully to get the right browning and you know you’re done.

Traditional Chinese Medicine Gua Sha
The treatment creates petechiae, or tiny bleeding spots under the skin.Getty Images

What is the gua sha tool?

It is any object with smooth edges. At UW Integrative Health, Minichiello uses a porcelain tablespoon. They are ordered in bulk and given to each patient to keep for future sessions.

Shaffer uses a jar lid or tools shaped like jade or animal horn.

What are the health benefits of gua sha?

From the perspective of traditional Chinese medicine, it improves stagnation in the body or expels influences that can make the body feel immobile, achy, sore, or sore, Minichiello said.

From a Western biomedicine perspective, studies suggest a few different mechanisms, including decreasing the body’s sense of pain and some anti-inflammatory properties, he noted.

“The skin, nervous system, and immune system are thought to interact with each other to generate a cascade of physiological responses to scratching,” which may result in therapeutic benefits, a 2021 review of gua sha published in the Journal of Family Medicine and Primary Care noted.

The practice may help relieve chronic neck pain, researchers reported in the journal Pain Medicine.

Since the source of chronic tension headaches is often musculoskeletal tension in the upper neck, gua sha can also relieve headaches, Minichiello said.

It also appears to be an effective treatment for patients with chronic low back pain, according to a 2019 study published in Complementary Therapies in Clinical Practice.

Gua sha may help relieve symptoms of perimenopause, such as hot flashes, fatigue and insomnia, according to a separate review published in the same journal.

There’s less evidence for the “lymphatic drainage” touted by some gua sha enthusiasts, though it’s theoretically possible, Minichiello said. Every time you manipulate body tissues — or exercise, for that matter — there will be lymph movement, he noted.

Where on the body is gua sha practiced?

The neck, back and shoulders are common areas since research specifically points to benefits for musculoskeletal pain, Minichiello said. Shaffer has also used it on the front of the chest and legs for sciatica, hip pain, and knee pain.

One area both experts were cautious about was the face due to the potential for bruising and the lack of scientific evidence of health or cosmetic benefits.

“I don’t do it for other people on their face,” Shaffer said. “If people really force it, they might get bruises. It could be dramatic because the face is so delicate.

Is gua sha painful?

The redness it causes seems uncomfortable, but most people enjoy gua sha and liken it to the feeling of a deep tissue massage, Minichiello said.

“It might feel a little sore, but it’s like a good kind of wound,” he described the feeling. “If it’s the right treatment, people will usually feel relief almost immediately.”

“Scratching, if done well and with the right number of repetitions, is not painful for most people,” Shaffer added.

Dr. Gladys Leung, Chuan Spa Traditional Chinese Medicine Consultant administering the "Guasha" at Chuan Spa, Langham Place in Mong Kok.13SEP12
A traditional Chinese medicine consultant administers gua sha in Hong Kong.South China Morning Post / Getty Images

Trying Gua Sha: What to Keep in Mind

Try it on a small part of the body at a time and rest after treatment — not strenuous exercise, Minichiello advised. He recommended going to see a practitioner trained in traditional Chinese medicine, or a masseur or physical therapist who has been trained in gua sha.

The redness usually subsides within about 72 hours, the two experts said, so don’t schedule a session if you want to wear a backless dress the next day.

Gua sha is not recommended on areas of the body where the skin is already injured or compromised by a previous sunburn, abrasion, rash or bruise.

It can be used safely in people who are taking blood thinners, but they will actually bruise, not just develop petechiae, Minichiello said.

Can you perform gua sha on yourself?

Certainly, he noted.

“I lived in China for about a year and it was actually quite a common practice. It’s not meant to be a fancy thing. It’s meant to be a very simple technique that can be done by anyone. who in your family,” Minichiello recalled. “They might just make a little gua sha for themselves.”

A good place to learn to do gua sha at first is your upper back, which is “very meaty” for most people and allows you to easily see the red spots, Shaffer added.