Gua sha, an ancient healing technique, is getting buzz in the modern world.
Also known as “skin scraping” or “scraping therapy,” it’s used to treat chronic pain, relieve stress and even help with headaches.
Supporters include Arya Nielsen, a U.S. 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 East Asian medicine” on her website dedicated to the practice.
“I’ve seen the benefits over and over again, definitely,” Dr. Vincent Minichiello, a family physician and faculty member of the University of Wisconsin-Madison Integrative Health Program, told TODAY.
“From my experience, there really appears to be a true biochemical, mechanical reason why gua sha is effective.”
He offers it for patients in the U.S. after living in China and studying traditional Chinese medicine.
Janet Shaffer, an acupuncturist at Duke Health Integrative Medicine Center in Durham, North Carolina, called gua sha one of her favorite techniques for freeing up the fascia — the connective tissue that wraps every structure in the body.
“For some people, it’s like the knife comes out of the back,” Shaffer said of the reactions she has seen from patients after gua sha treatment. “It’s like loosening a stuck jar.”
What is gua sha?
Nielsen defines it as “instrument-assisted unidirectional press-stroking of a lubricated area of the body surface to intentionally create transitory therapeutic petechiae.”
In plain terms, a gua sha practitioner will scrape across a person’s lubricated skin in one direction — never back and forth — with a smooth edged tool, as if creating stripes, until tiny pinpoint red spots appear. These spots, known as petechiae, indicate there’s some bleeding just beneath the surface of the skin, Minichiello said. They’re different from bruising, which is deeper in the skin, he noted.
“When we see the petechiae, we’ve reached release, we’ve reached flow, we’ve unstuck,” Shaffer added. “It does look like a rash, but it’s not. And it does look like the skin is broken, but it’s not.”
She likened achieving the correct amount of redness to baking — you watch carefully to get the right browning and then you know you’re done.
What is the gua sha tool?
It’s any smooth edged object. At UW Integrative Health, Minichiello uses a porcelain soup spoon. They’re ordered in bulk and given to each patient to keep for future sessions.
Shaffer uses a jar lid, or tools shaped from jade or an animal’s horn.
What are the health benefits of gua sha?
From a traditional Chinese medicine standpoint, it improves stagnation within the body or expels influences that can cause the body to feel still, sore, achy or painful, Minichiello said.
From a Western biomedicine standpoint, studies suggest a few different mechanisms, including decreasing the body’s sensation of pain and having some anti-inflammatory properties, he noted.
It’s thought that “the skin, the nervous system and immune system interact with one another to generate a cascade of physiological responses to the scraping,” which may result in therapeutic benefits, a 2021 review of gua sha published in Journal of Family Medicine and Primary Care noted.
The practice can help with 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 offer headache relief, too, 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 can help alleviate the 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 “lymphatic drainage” touted by some gua sha enthusiasts, though it’s theoretically possible, Minichiello said. Anytime you manipulate the tissues in the body — or exercise, for that matter — there’s going to be some movement of lymph, he noted.
Where on the body is gua sha performed?
The neck, back and shoulders are common areas since research specifically points to benefits for musculoskeletal pain, Minichiello said. Shaffer has also used it across the front of the chest and the legs for sciatica, hip pain and knee pain.
One area both experts were cautious about was the face because of the bruising potential and lack of scientific evidence for any health or cosmetic benefits.
“I do not do it for other people on their face,” Shaffer said. “If folks are really forcing it, they could bruise themselves. It could be dramatic because the face is so delicate.”
Is gua sha painful?
The redness it brings about looks like it might be uncomfortable, but most people enjoy gua sha and liken it to the sensation of a deep tissue massage, Minichiello said.
“It might feel a little sore, but it’s like a good type of sore,” he described the feeling. “If it’s the appropriate treatment, usually people will feel relief pretty much right away.”
“The scraping, if done well and with the correct number of repetitions, it is not painful for most people,” Shaffer added.
Trying gua sha: What to keep in mind
Try it on a small portion of the body at a time and rest after treatment — no heavy exercise, Minichiello advised. He recommended going to a practitioner trained in traditional Chinese medicine, or a massage or physical therapist who has had gua sha training.
The redness usually goes away within about 72 hours, both experts said, so don’t schedule a session if you want to wear a backless dress the next day.
Gua sha it is not recommended on any areas of the body where the skin is already injured or compromised by sunburn, an abrasion, a rash or a previous bruise.
It can be safely used in people who are on blood thinners, but they will actually bruise, not just develop the petechiae, Minichiello said.
Can you perform gua sha on yourself?
Definitely, he noted.
“I lived in China for about a year and it was actually quite common practice. It’s not meant to be a fancy thing. It’s supposed to be a very simple technique that can be done by anybody in your family,” Minichiello recalled. “They might just do a little bit of gua sha for themselves.”
A good place to learn how to do gua sha at first is the upper back, which is “very meaty” on most people and allows you to see the red spots easily, Shaffer added.
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