Gua Sha Therapy


In Chinese, gua means scraping or scratching. This term may suggest skin abrasion, but gua sha tools have smooth edges and cause no injuries to the skin. Gua sha tools can have various shapes, from spoons to specialized combs made out of animal horns, but the tools’ smooth edges are the key. Gua sha practitioners, who are often acupuncturists, use “repeated unidirectional pressured stroking with a smooth-edged instrument over a lubricated area until sha blemishes appear. Stroking is then applied to an adjacent stroke line until sha appears. This continues until the area intended for treatment is covered” (Nielsen, 2008). Curiously, if the practitioner chose a wrong area to do gua sha on, then nothing would happen, no blemishes and no sha (called transient petechiae and ecchymosis in western medicine), only slight redness.

What Is Gua Sha Therapy Good for?

Most commonly, gua sha is used for neck and/or shoulder problems, lower back pain, sciatica, ankylosing spondylitis, osteoarthritis, arthralgia, trigeminal neuralgia, headaches, migraines, sinusitis, dysmenorrhea, and renal colic (Nielsen, 2008). At least theoretically, gua sha can be used for treatment of many conditions, and if it may not be the ideal treatment option when used by itself, it may enhance the treatment success when it is used in combination with acupuncture, cupping, tui na, or herbal medicine. Research studies investigate the effectiveness of gua sha for specific conditions. One study, for example, explored the effects of gua sha in treatment of the symptoms related to premenopausal syndrome: “The results of this study suggest that Gua sha therapy was effective and safe in relieving perimenopausal symptoms and improving the quality of life in participants with perimenopausal syndrome” (Meng et al., 2017). The authors of another study of gua sha’s success in treatment of low back pain concluded that “Gua Sha appears to be an acceptable, safe, and effective treatment for patients with chronic low back pain” (Saha et al., 2019).

How Does Gua Sha Work?

Researchers have been focusing on gua sha’s most obvious effect: surface tissue profusion, which means changes in the microcirculation in the skin and the underlying tissues. The results have demonstrated that the blood flow in the area in which gua sha was done increased 400% and lasted for about 25 minutes before returning back to its original state; “Gua Sha appears to sustain an increase in microcirculation greater and longer than massage or acupuncture” (Nielsen, 2008). The increase in blood flow invigorates the healing process, or, more specifically, “Gua Sha treatment can up-regulate the innate and adaptive immune functions of the skin and boost the response against intradermal antigens” (Chen et al., 2016).


  1. Chen, T., Liu, N., Liu, J., Zhang, X., Huang, Z., Zang, Y., … & Ding, Z. (2016). Gua Sha, a press-stroke treatment of the skin, boosts the immune response to intradermal vaccination. PeerJ4, e2451.
  2. Meng, F., Duan, P. B., Zhu, J., Lou, Q. Q., Fang, Z. H., An, H. L., … & Hu, Q. (2017). Effect of Gua sha therapy on perimenopausal syndrome: a randomized controlled trial. Menopause24(3), 299-307.
  3. Nielsen, A. (2008). Gua Sha: a clinical overview. Jornal of Chinese Medicine Times3(4).
  4. Saha, F. J., Brummer, G., Lauche, R., Ostermann, T., Choi, K. E., Rampp, T., … & Cramer, H. (2019). Gua Sha therapy for chronic low back pain: a randomized controlled trial. Complementary therapies in clinical practice34, 64-69.