Gua sha is a traditional Chinese healing method in which a trained professional uses a smooth-edged tool to stroke your skin while they press on it. This motion raises small, red, rash-like dots that show under your skin called petechiae or "sha". The name gua sha — pronounced gwahshah — comes from the Chinese word for scraping. It may also be called "skin scraping", "spooning", or "coining".
To prepare you for treatment, your therapist will put oil or medicated balm on your body. They’ll then use the stone-like gua sha massage tool to scrape to your skin in long, downward strokes. As the strokes gradually increase in pressure, you’ll notice areas of petechiae appear on your skin if there was trapped energy or "Qi" underneath.
According to traditional Chinese medicine, Qi is energy that flows through the body.
A person’s Qi must be balanced and flowing freely to ensure their health and wellbeing. Qi can become blocked, causing pain or tension in the muscles and joints. Gua sha aims to move this blocked energy to relieve aches or stiffness. Traditional East Asian medicine also views blood stasis or stagnation as a cause of pain and illness. Another aim of gua sha is to move pooled or stagnated blood to relieve symptoms.
Some physiotherapists use a version of the technique known as Instrument Assisted Soft Tissue Mobilization (IASTM). Using a tool instead of the hands during a massage allows a physiotherapist to apply more pressure. Physiotherapists may use IASTM on connective tissue that is not working to move joints as it should. This problem may be due to a repetitive strain injury or another condition. Gua sha is used alongside other treatments, such as stretching and strengthening exercises.
Researchers have carried out small studies on the following groups of people to see if gua sha works:
Women found that perimenopause symptoms, such as sweating, insomnia, and headaches, were reduced after gua sha.
A 2014 study found that gua sha improved the range of movement and reduced pain in people who used computers frequently compared with a control group that had no treatment.
In a 2017 study, weightlifters who had gua sha felt that lifting weights took less effort after treatment. This could suggest that the treatment speeds up muscle recovery.
Older adults with back pain were treated with either gua sha or a hot pack. Both treatments relieved symptoms equally well, but the effects of gua sha lasted longer.
After a week, those who had received gua sha treatment reported greater flexibility and less back pain than the other group.
Gua sha causes capillaries (tiny blood vessels near the surface of the skin) to burst. This creates the distinctive red or purple bruises known as sha. The bruises usually take a few days or a week to heal and can be tender while healing. People can take an over-the-counter painkiller, such as ibuprofen, to help with pain and reduce swelling. Applying an ice pack can help to reduce inflammation and ease any pain. Gua sha practitioners should not break the skin during the treatment, but there is a risk it could happen.
Gua sha is not suitable for everybody. People who should not have gua sha include those:
- who have medical conditions affecting the skin or veins
- who bleed easily
- who take medication to thin their blood
- who have deep vein thrombosis
- who have an infection, tumor, or wound that has not healed fully
- who have an implant, such as a pacemaker or internal defibrillator.
Practitioners of traditional East Asian medicine see some materials as having an energy that will support healing — these materials include bian stone, jade, and rose quartz. Medical grade stainless steel is often used for IASTM or when gua sha is done in a clinic.
Many people have started learning to perform gua sha on their faces to help relieve tension in the face, reduce puffiness and inflammation, and reduce sinus pressure. However, since the musculature of the face is much thinner, less pressure is used.
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