Gua Sha Symptoms — Color of Sha
Deep Red —Heat Syndrome
Bright Red —Yang Deficiency with Excess Heat
Black —Cold Syndrome
Purple —Wet Eczema
Pale Blue, Purple Spots —Qi Deficiency with Blood Stasis
Blue-Purple —Severe Internal Cold
Purple-Black and Dark —Blood Stasis with Cold
Purple-Red —Wet Heat
Large Area of Warm Purple —Heart Cold
Degree of Sha Penetration
Small Dots —Toxins Accumulated in the Epidermis
Medium Dots —Toxins Penetrated Deeper into the Bone
Large Dots —Toxins Penetrated Deep into the Bone Marrow
Observation Areas
1: Occipital Region
This area reflects issues in the head and neck. If there are abnormal or tender points, it may indicate headaches, cervical spondylosis, hypertension, or pharyngitis.
2: Spinal Area — Represents Sleep and Sleep Quality
3: Bilateral Shoulder and Back Area — Reflects Shoulder Issues
⑴ If there is tenderness in this area, it may indicate headaches, shoulder pain, stiff neck, limb soreness, and eye pain;
⑵ If purple Sha appears, check for rheumatism;
⑶ If the muscles along the Large Intestine Meridian are tight with red spots, it may indicate shoulder periarthritis, with more severe Sha on the right shoulder indicating occupational strain, while the left shoulder indicates overthinking.
4: Heart and Lung Area (Thoracic Vertebrae 1-5, 6) — Reflects Respiratory Issues
⑴ If there is tenderness, stiffness, and red spots, it may indicate colds, chest tightness, or insufficient heart and lung function;
⑵ When there is heart and lung dryness and heat: easy thirst at night, dry cough; forehead prone to acne, skin dry; irritability; severe cases may lead to nosebleeds; tongue is pointed, red, with flushed cheeks, hot palms, and red lips, prone to spontaneous sweating (sweating even while sitting);
⑶ If heart and lung function is deficient, the forehead may have fine lines, skin may be dry, lips pale, insufficient Zheng Qi, speaking may be soft despite effort, prone to shortness of breath, nasal inflammation, pale complexion, and night sweats.
5: Spleen and Stomach Area (8, 9-11, 12) — Reflects Digestive Issues
⑴ If there are abnormalities, purple-black color or tenderness and swelling, it may indicate diseases caused by poor liver function.
⑵ If the spleen is weak, the eye circles may be purple-red, skin dull, pale, loose, dry lips, tasteless mouth, weight loss, and weakness, prone to dizziness.
⑶ If the spleen is damp, water retention may cause a yellowish complexion, bags under the eyes, dark acne, and a swollen upper body, with teeth marks on the tongue and pale tongue coating.
⑷ If the stomach is weak, dark circles may be prominent, poor digestion, thinness, dry and red tongue, prone to thirst, and no tongue coating when the stomach is very poor.
6: Liver and Gallbladder Area (5, 6-8, 9)
If there are tender points, abnormal spots, stiffness, pain, swelling, and purple-black color, it may indicate indigestion, gastrointestinal bloating, acute or chronic gastroenteritis, and back pain.
7: Lumbar and Kidney Area (12-L5) — Reflects Endocrine Issues
⑴ If there are tender points, stiffness, swelling, and purple-black color, it may indicate cystitis, kidney deficiency, kidney dysfunction, diabetes, edema, back pain, frequent urination, and lumbar strain.
⑵ Excess male hormone secretion: acne around the mouth, coarse hair, oily skin, irritability, and heat in the internal organs.
⑶ Excess female hormone secretion: yellowish skin around the mouth, dry skin, dull complexion, prone to spots, irritability, and menopausal syndrome.
8: Sacral Area
If there is darkening of the skin, soreness, and swelling, it may indicate sciatica, menstrual irregularities, or uterine inflammation.
9: Shoulder Blade and Limbs Area
If there are abnormal shapes, tenderness, and swelling, it may indicate limb diseases, knee pain, and vascular sclerosis.
Observation of Shape
1: Flaky —Superficial, issues only at the surface
2: Small Dots —Wet heat or cold dampness, indicating long-term accumulation; if not resolved, may lead to internal wind dampness or arthritis
3: Medium Dots —Pathological precursors
4: Large Dots —Reaction of the pathological focus
5: Blisters —Wind dampness or internal wind dampness has formed
Identifying Gua Sha Symptoms
Back Heart and Lung Area —Cold, chest tightness, weak heart and lung function; eat more (almonds, honey, pears)
Liver Wood Area —Long-term fatigue, insufficient sleep, severe cases may lead to liver cirrhosis; eat more (red and green foods)
Spleen and Stomach Area —Indigestion, gastrointestinal bloating, excessive stomach acid, back pain; eat more (yellow foods like millet, soybeans, corn, pumpkin)
Kidney Water Area —Cystitis, strong taste, back pain, prone to edema
Sacral Area —Menstrual irregularities, weak uterine function, dysmenorrhea, gynecological diseases, sciatica
Bilateral Shoulder Area —Long-term shoulder pain, headaches, stiff neck, limb soreness, severe cases may lead to vision impairment
Shoulder Blade and Limbs Area —Numbness in hands and feet, knee pain, poor ovarian function, limb swelling
Bright red dots indicate a mild condition at the surface.
Blue-purple, dark red spots indicate a long-term, severe condition with toxins in the skin and bone marrow.
Lie Down and Observe the Dazhui (Great Vertebra) —If it is particularly prominent, it indicates severe deformity.
Feel Body Temperature —If cool, indicates heavy internal cold; if warm, it is acceptable.
Press on the Cervical Vertebrae and Shoulders —If there is pain or soreness, it indicates shoulder periarthritis; if there is blockage, it indicates meridian obstruction.
Press Jianjing, Tianzong, and the Shoulder Blade Gap —If there is soreness, numbness, swelling, pain, or weakness, and if hands and feet are usually cold, it indicates shoulder issues.
Push the Bladder Meridian — Divided into Three Sections. Lung, Stomach, Gynecology. If the lung area turns deep red, it indicates internal heat. If the stomach area is dark or red, it indicates stomach cold or heat. If there are Sha particles in the gynecological area, it indicates gynecological issues like uterine cold, pain, and back pain.
Press Lumbar Acupoints — If there is soreness, swelling, or pain. It indicates lumbar muscle strain; if it remains cool after rubbing, it indicates heavy internal cold, suggesting uterine cold.
Overall Back Push —If the back is very cool and the shoulder blade area is sore, it indicates excessive internal cold and toxin accumulation. It is recommended to use Gua Sha or cupping to treat pain; if untreated, internal cold will worsen, and toxins will not be expelled smoothly.
This may lead to cervical spondylosis (dizziness, brain hypoxia, limb numbness, overall weakness, and eventually decreased immunity, leading to inability to work normally. Combined treatment can accelerate blood circulation through massage, expelling toxins via lymphatic drainage, improving cervical spondylosis and shoulder periarthritis, effectively alleviating pain and enhancing immunity).
Gua Sha “Gua Shoulder and Neck” — If the Sha particles are coarse, numerous, and black-red, with blisters, it indicates heavy toxins, slow blood circulation, and reduced lymphatic detoxification. If the shoulder blade area is black-red or blistered, it indicates shoulder periarthritis, requiring immediate treatment; otherwise, severe cases may lead to numbness and loss of movement, affecting work.
Gua Bladder Meridian, if the lung area is black-red or blistered, it indicates throat inflammation and significant internal inflammation; it is recommended to drink warm water, or it may lead to tonsillitis or gynecological issues. If the stomach area is black-red or blistered, it indicates stomach cold or excessive stomach heat.
After scraping the spine, it can be immediately observed if there is spinal deformity. If there is spinal deformity, immediate treatment is necessary.
Gua Sha Techniques
Direct Scraping Method
First, use a hot towel to clean the area to be scraped, then apply the corresponding Gua Sha medium to that area, and use the Gua Sha tool to directly touch the patient’s skin, scraping repeatedly until Sha marks appear on the surface of the skin.
Indirect Scraping Method
Place a thin cloth over the area to be scraped, then scrape directly on the cloth with the Gua Sha tool. This method is very effective in protecting the skin, mainly used for children and the elderly.
Pinching Method
According to the technique, it can be divided into pinching, pulling, squeezing, tapping, and pressing methods;
Pinching Method
Also known as the “Pinch Sha Method,” commonly referred to as “Pinching Bumps” in folk practice, involves applying Gua Sha medium to the area to be scraped. The practitioner bends their fingers, using the middle and index fingers to hook the skin, applying the Gua Sha medium, pinching the skin and muscle, then sliding outward with force and releasing.
Pinch and release repeatedly, making a “popping” sound, and can be performed continuously 6-7 times on the same area. The pinched area will show Sha marks, causing local bruising as a method to remove Sha.
This method requires no tools, only fingers.
The pinching method is flexible and can be applied to various conditions; for headaches, fever, and fatigue, one can perform it on themselves, making it a very practical self-therapy.
Pulling Method
On a specific area or acupoint of the patient, use the thumb and index finger to pull the skin forcefully, causing purple-red or dark red Sha spots to appear, achieving therapeutic effects, known as the pulling method.
The pulling method has been passed down in folk practice for a long time. Whenever experiencing heat and dampness causing Sha symptoms or discomfort, it is common to repeatedly pinch and pull the patient’s skin until local bruising occurs.
During pulling, the patient can be seated or lying down, with the skin fully exposed. The practitioner uses the pads of the thumb and index finger, dipped in cold water, to pull up a portion of the skin and subcutaneous tissue, pulling and twisting to one side, then quickly releasing.
It can also be done by pinching the skin with the pads of the thumb, index, and middle fingers, pulling in the described manner repeatedly until the desired effect is achieved. If the condition is severe, the pulling force can be increased until redness appears on the skin.
The pulling method exerts strong traction on the skin, often causing local and systemic reactions, with the patient experiencing pain in the area pulled, followed by a sense of relaxation and comfort throughout the body.
Point-Rubbing Method
Using the flat edge of the scraping board, perform large-area parallel scraping on the patient’s body.
Using fingers to apply pressure on specific areas or acupoints while making circular or spiral movements is a combined technique of pressing and rubbing.
This method is not classified as a Gua Sha technique but as a massage technique, often used in conjunction with Gua Sha in treatment and health care, enhancing efficacy and compensating for the shortcomings of Gua Sha.
In Gua Sha treatment, it is mainly used for the head, face, abdomen, limbs, joints, and hands and feet.
Picking Method
Using a needle to prick specific areas on the patient’s body to treat diseases. However, this method should not be attempted at home; it must be performed by a professional to avoid injury.
Before picking, prepare 75% alcohol, disinfecting cotton swabs, and a sterilized three-edged needle or a sewing needle, or a 916 injection needle.
The practitioner first disinfects the local skin with a cotton swab, then pinches the skin at the pricking site with the left hand, and with the right hand, quickly pierces and pulls outward, pricking each site three times, while using both hands to expel purple-dark bruises, repeating 5-6 times, and finally cleaning with a disinfecting cotton ball.
Releasing Method
This method is suitable for superficial veins in areas like the elbow pit, popliteal fossa, and temples (this method is difficult and should be performed by professionals).
Also known as bloodletting therapy, it involves pricking veins or acupoints to draw blood for treatment of diseases caused by Sha, known as the releasing method.
During treatment, the patient should be in a comfortable position, with the treatment area fully exposed. When releasing blood from a vein, the patient’s left arm should be tied near the heart with a cloth or tourniquet, and the patient should be asked to clench their fist. Then, the local skin should be disinfected with iodine cotton balls, followed by 75% alcohol to remove iodine.
Then, needle pricking for bloodletting. When bleeding from acupoints, it can be done by disinfecting the skin and directly pricking with a three-edged needle or sewing needle as needed based on the condition.
Releasing can be divided into bloodletting and pricking methods. It is similar to the picking method but with stronger stimulation, often used in severe emergencies.
This method is mainly applied to the head, neck, back, and temples. It is simple, easy to master, and effective.