Gua Sha: Explained
When I choose to incorporate a new technique or tool into my massage practice, it is essential to me that there be evidence-based reasons, and that I understand the benefits for my clients. Communicating these benefits to clients and the public generally, and helping people to make an informed decision about their bodywork session, is a highly important part of my job as a therapist.
In a past blog post, for example, we explored cupping therapy. Today, we’re going to talk about Gua Sha!
What is Gua Sha?
Gua Sha (“Gua” meaning scrape or scratch; “Sha” meaning red ) is a widely used healing technique originating in East Asia that is now used by medical practitioners, acupuncturists, bodyworkers, and individuals across the world. Sometimes called ‘coining,’ ‘spooning,’ or ‘scraping,’ Gua Sha is an instrument-assisted technique in which a practitioner press-strokes a lightly lubricated area of the body/skin with a smooth tool to intentionally create friction and transitory therapeutic “petechiae” (pe-TEE-kee-uh), aka the “Sha” of Gua Sha.
Let’s break that down: There are many types of tools used for Gua Sha, the most common being made of polished stone (such as jade or quartz), wood, stainless steel, or other metals. The petechiae/Sha is created by the eruption of blood in the subcutaneous layer of tissue (below the surface of the skin), and presents as a red, sometimes spotted look to the skin. It’s worth noting that this is not a bruise, per se. It is described as ‘transitory’ and ‘therapeutic’ because the redness of the petechia fades after a few hours or days, and it can bring relief from pain, increased range of motion, and other benefits of increased blood flow. We’ll discuss more of the benefits of Gua Sha below.
There is a rich history within East Asian medical traditions and communities of the use of Gua Sha for many mild to severe conditions of the body. In this blog post, I will be focusing my discussion on the treatment of musculoskeletal conditions, because these are the conditions for which I use Gua Sha in my massage practice.
How does Gua Sha feel?
First, a note: many people may be familiar, through experience or reputation, with the “Graston Technique.” This is a specific approach to tool-assisted treatment and follows specific protocols and a prescribed course of treatment. It can be much more vigorous, intense, and sometimes painful than other techniques of Gua Sha. I do not practice the Graston technique (though I don’t dispute its efficacy), and you should not expect pain or discomfort when I apply Gua Sha.
In a treatment session with me that includes Gua Sha, I would incorporate using the stone tool (I use Bian stone, jade, and rose quartz) into my other massage techniques, focusing on areas that need increased circulation. These areas of the body may be sources of pain or discomfort, or may be areas that are suffering from stiffness and decreased range of motion.
Gua Sha can also be used to stimulate acupressure points to help with such conditions as anxiety, poor sleep, and headache. Gentle application of Gua Sha to the face, head, neck, and feet can itself provide system-wide relief and relaxation - a treatment which can be added on to a massage as well as a fully-clothed Craniosacral session. Gua Sha is also safe for pregnancy massages as well!
What are the benefits of Gua Sha?
Gua Sha can help to mitigate headaches, reduce muscle tension/soreness, improve range of motion in areas where there is limitation, and increase circulation to areas of stagnation. The reduction of pain from Gua Sha treatment is particularly interesting because of the many possible mechanisms by which Gua Sha has this pain-reducing effect. Chronic neck pain, back pain, and plantar fasciitis are just a few of the conditions that have been studied in clinical trials. Those trials have suggested that Gua Sha can reduce pain for a number of reasons:
Anti-nociceptive effects (i.e. blocking the detection of pain signals in the brain)
Increase in microcirculation, which decreases myalgia (sensitization resulting from overuse of a muscle)
Increase in circulation of nitric oxide, which has effects on platelet function, inflammation, and pain perception
Interestingly, there is also said to be “an unidentified pain-relieving biomechanism associated with Gua Sha.” Some studies have shown pain relief in areas that are further away from the site of treatment, which cannot be accounted for by an increase in circulation or other mechanisms elsewhere studied. Somehow the Gua Sha treatment on one area of the body is helping to reduce pain in an untreated area - certainly an added benefit, mysterious as it may still be.
I love discovering different ways to enhance the already tremendous effects of receiving bodywork such as Massage and Craniosacral therapies. Gua Sha, having been used for many centuries, is becoming better understood and supported by research. I’m pleased to be able to offer this technique in my practice, and to explore the benefits for your health and well-being!
Works Cited
Baburao Jadhav, Aditi, and Peeyoosha Gurudut. “Comparative Effectiveness of Gua Sha, Cryostretch, and Positional Release Technique on Tenderness and Function in Subjects with Plantar Fasciitis: A Randomized Clinical Trial.” International Journal of Therapeutic Massage & Bodywork: Research, Education, & Practice, vol. 16, no. 1, 2 Mar. 2023, pp. 13–23, https://doi.org/10.3822/ijtmb.v16i1.749. Accessed 30 Mar. 2023.
Braun, Maximilian, et al. “Effectiveness of Traditional Chinese “Gua Sha” Therapy in Patients with Chronic Neck Pain: A Randomized Controlled Trial.” Pain Medicine, vol. 12, no. 3, Mar. 2011, pp. 362–369, https://doi.org/10.1111/j.1526-4637.2011.01053.x. Accessed 6 Nov. 2019.
Caravia, Linda. “Sarga Bodywork Online.” Onlinecourses.sargabodywork.com, 2024, onlinecourses.sargabodywork.com/courses/. Accessed 20 Feb. 2024.
DC, Thomas Hyde. “The Graston Technique: An Instrument Assisted Soft Tissue Manual Therapy for Back Pain.” Spine-Health, 13 May 2013, www.spine-health.com/treatment/chiropractic/graston-technique-instrument-assisted-soft-tissue-manual-therapy-back-pain.
Lauche, Romy, et al. “Randomized Controlled Pilot Study: Pain Intensity and Pressure Pain Thresholds in Patients with Neck and Low Back Pain before and after Traditional East Asian “Gua Sha” Therapy.” The American Journal of Chinese Medicine, vol. 40, no. 05, Jan. 2012, pp. 905–917, https://doi.org/10.1142/s0192415x1250067x.
Lee, Myeong Soo, et al. “Using Guasha to Treat Musculoskeletal Pain: A Systematic Review of Controlled Clinical Trials.” Chinese Medicine, vol. 5, no. 1, 2010, p. 5, https://doi.org/10.1186/1749-8546-5-5.
“Medical Definition of ANTINOCICEPTION.” Www.merriam-Webster.com, www.merriam-webster.com/medical/antinociception.
“Myalgia - an Overview | ScienceDirect Topics.” Www.sciencedirect.com, www.sciencedirect.com/topics/medicine-and-dentistry/myalgia.
Nielsen, Arya, et al. “The Effect of Gua Sha Treatment on the Microcirculation of Surface Tissue: A Pilot Study in Healthy Subjects.” Explore (New York, N.Y.), vol. 3, no. 5, 1 Sept. 2007, pp. 456–466, pubmed.ncbi.nlm.nih.gov/17905355/, https://doi.org/10.1016/j.explore.2007.06.001.
Perren-Jones, Mark. “Gua-Sha Tool Assisted Technique Certificate Course.” Udemy, Udemy Inc, Aug. 2023, www.udemy.com/course/gua-sha-an-ancient-tool-assisted-massage-technique-for-pain/. Accessed Oct. 2023.