About Gua Sha

Gua sha is an ancient healing technique used by many clinicians of Traditional Chinese medicine (TCM). Massage oil is applied to the skin of the area to be treated. A smooth-edged instrument is used to apply short or long strokes on the skin, typically in the area of pain or on the back parallel to the spine.  This stroking motion creates raised redness (petechiae) or bruising (ecchymosis). Petechiae will show up where scar tissue/adhesion's/stagnation is in the soft tissue. 

Pain, both acute and chronic, is the most common indication for gua sha. In the TCM tradition, pain is oftentimes caused by the the soft tissue having adhesion's which causes a decrease in blood flow and range of motion to the muscles and fascia. The guiding principle behind gua sha is that this technique has the ability to break up scar tissue and adhesion's in the fascia to promote blood flow in the area, thereby relieving pain.

While gua sha is most commonly used to treat pain, it can also be utilized by TCM clinicians to address conditions such as asthma, bronchitis, colds, flu, fever, heatstroke, fibromyalgia, strains, sprains, and muscle spasms.

There are several theories that may explain why this ancient technique works: gua sha increases blood flow (microcirculation) in the soft tissue, potentially stimulates the body’s natural pain-relieving opioid systems, and it may block the pain response pathways so you feel pain relief. 

Some view gua sha as folk medicine, but the scientific research community may beg to differ! Researchers from institutions like Harvard and Beth Israel Medical Center are demonstrating both efficacy as well as offering insight on why gua sha works. A study published in a 2011 edition of Pain Medicine demonstrated that gua sha decreased pain for chronic neck pain sufferers, noting that “neck pain severity after 1 week improved significantly better in the gua sha group compared with the control group (heat therapy).”

Researchers have used various techniques, including Doppler images, to show that microcirculation is indeed increased in the treated area, therefore decreasing both local and distal areas of pain. In the mice model, gua sha was shown to influence an enzyme (Heme Oxygenase-1) that has a protective antioxidative effect in the cells. An interesting case study showed gua sha decreases inflammatory markers of a patient with liver injury due to Hepatitis B, suggesting gua sha may even have a protective effect on the liver. As is the case for most healing modalities in Eastern Medicine, modern science has yet again validated the effectiveness of this ancient technique.



Braun, et al. “Effectiveness of Traditional Chinese ‘Gua Sha’ Therapy in Patients with Chronic Neck Pain: A Randomized Control Trial” Pain Medicine 2011; 12:362-369

Chan, et al. “Guasha-induced Hepatoprotection in Chronic Active Hepatitis B: A Case Study” Clinica Chimica Aca 412 (2011) 1686-1688

Kwong, et al. “Bioluminescence Imaging of Heme Oxygenase-1 Upregulation in the Gua Sha Procedure” Journal of Visualized Experiments 2009; 1-3.

Nielsen, et al. “The Effect of Gua Sha Treatment on the Microcirculation of Surface Tissue: A Pilot Study in Healthy Subjects” Explore September/October 2007, Vol. 3, No.5