Gua Sha is a familiar practice for many. When experiencing headaches or colds, people often consider Gua Sha therapy. In simple terms, it involves using a smooth hard object, fingers, or metal tools to repeatedly scrape, press, or pinch specific areas on the body, causing the skin to develop bruises and spots. Gua Sha is very effective for conditions like heat stroke, colds, and muscle soreness. But what is the underlying principle?

Why Does Gua Sha Work?

The normal human body is in a state of smooth circulation of Qi and blood. However, certain areas may experience muscle strains or remain in a tense state, leading to the accumulation of metabolic waste. From a TCM perspective, this is known as phlegm and blood stasis. These unexpelled waste products can obstruct the body’s metabolism, worsening circulation and creating a vicious cycle of accumulation.

This condition can be treated with medication, but it often takes a long time. Gua Sha can directly disrupt the small blood vessels and surrounding tissues in the affected area, allowing these metabolic wastes to be expelled quickly. In simpler terms, Gua Sha provides an outlet for the body’s ‘toxins’ to be eliminated. Clinically, Gua Sha is widely used for patients with stiff shoulders and necks, lower back pain, external heat, acute pharyngitis, and heat stroke. Most patients report feeling significantly more comfortable after treatment.

Some discomfort may occur during Gua Sha, known as ‘dizziness from scraping,’ which often happens during the first attempt, when overly fatigued, after a poor night’s sleep, when particularly anxious, or when treatment is received on an empty stomach. In such cases, Gua Sha should be stopped immediately, and the patient should lie down and drink warm water. If symptoms do not improve, they should be taken to the hospital promptly.

Methods and Tools for Gua Sha

Common tools for Gua Sha include various types of Gua Sha boards (often made from water buffalo horn or other animal keratin), Gua Sha sticks, coins, and ceramic spoons. A lubricant should be prepared beforehand to prevent skin damage, with common options including solid petroleum jelly, creams, or liquid options like water, sesame oil, specially formulated Gua Sha oil, or essential oils.

The area for Gua Sha is generally treated in points and lines to achieve a surface effect, which can be categorized into linear, radial, and point scraping:

Linear scraping involves scraping in a straight line from one point outward, commonly used on the back of the head, neck, back, and limbs. This is the most frequently used method in clinical practice.

Radial scraping radiates from a single point in a fan shape, often used on the sides of the head and the back of the neck.

Point scraping is limited to a specific point, commonly applied to clearly defined pain areas or acupuncture points.

The general technique involves holding the Gua Sha board at a 30-60 degree angle to the skin, maintaining a consistent speed and scraping in the same direction. The main principle is to scrape from top to bottom and from the inside out, applying appropriate pressure that the patient can tolerate. For those who are weak, elderly, or children, a lighter pressure should be used.

Four Things to Know Before Gua Sha

1. Is it necessary to scrape until bruising for it to be effective?

When the body develops bruises, it indicates the expulsion of metabolic waste, so achieving some bruising is generally a good sign. However, many people mistakenly believe that darker bruises are better. This is a misconception; excessive scraping can lead to extreme fatigue or even skin damage, increasing the risk of infection.

Therefore, the most important principle is to adhere to the guideline of ‘bruising is sufficient,’ meaning that a slight reddening or pale purple-red is enough to stop.

2. Can I scrape multiple areas at once?

Many patients, thinking they can get more health benefits by scraping multiple areas, may not realize that Gua Sha is a method of expelling excess. Scraping too many areas can deplete Yang energy and may have adverse effects. Generally, it is recommended to choose one or two areas per session. After scraping, take a moderate rest and drink warm water for better results!

3. How long should I wait between Gua Sha sessions?

Gua Sha should not be performed too frequently. The standard practice is to wait until the bruises have faded, which usually takes three to five days. Therefore, it is recommended to perform Gua Sha no more than once a week, allowing the local tissues time to recover. Repeated sessions within two to three days can lead to muscle inflammation and fibrosis over time.

4. Are there any contraindications or precautions for Gua Sha?

Each Gua Sha area should not exceed 10 minutes of scraping or should be limited to the point of bruising; do not force it!

Avoid excessive force or uneven pressure and rhythm during scraping.

During Gua Sha, it is important to keep warm and ensure good air circulation in the room, allowing the patient to choose a comfortable position.

After Gua Sha, avoid immediately exposing oneself to wind, engaging in labor, drinking cold beverages, or taking a shower. It is advisable to rest for a while and drink warm water.

Avoid consuming raw, cold, or greasy foods that are hard to digest.

Individuals with hemophilia or bleeding tendencies, severe illnesses, pregnant women, or those with abdominal issues during menstruation, those who are particularly fearful or allergic to Gua Sha, or those with open wounds should not undergo Gua Sha.