Gua Sha (Scraping)


What is Gua Sha (or Myofascial Release)?

Gua Sha is a myofascial release technique that involves the cutaneous stimulation of the skin in rapid strokes using a round-edged instrument.  We also call this “scraping.”  The purpose of gua sha is to improve local blood circulation and smooth fascia which may be causing of pain.

This results in increased circulation and often, the patient experiences immediate improvement of pain, stiffness, or respiratory issues.  Many physical therapists use a technique called “Graston” which is derived from the ancient Chinese technique of gua sha, except they use metal instruments and use it strictly for helping with the muscles.  As you can see below, there is a wide range of reasons why gua sha is used in Chinese medicine.


How does Gua Sha/Scraping work?

  • Increases surface microperfusion (circulation) 1
  • Reduces pain and produces a better sense of well-being 1
  • Reduces inflammatory symptoms in chronic illness (heme oxygenase-1) 4
    • Cough, asthma, bronchitis, emphysema
    • Mastitis 10, 8
    • Gastritis
    • Musculoskeletal painful conditions (neck 9, back)
    • Migraine 6
    • Postherpetic neuralgia 7
  • Reduces fever and stimulates immune system (heme oxygenase-1) 3
  • Reduces symptoms of acute and chronic hepatitis and viral replication 2, 6, 5


Woman receiving gua sha treatment on neck


  1. Nielsen A, Knoblauch NTM, Dobos GJ, Michalsen A, Kaptchuk TJ. The effect of Gua Sha treatment on the microcirculation of surface tissue: a pilot study in healthy subjects. Explore (NY). 2007;3(5) (October):456-466.
  2. Nielsen A 1995 Gua Sha: A Traditional Technique for Modern Practice. Edinburgh: Churchill Livingstone.
  3. Kwong KK, Kloetzer L, Wong KK et al. Bioluminescence imaging of heme oxygenase-1 upregulation in the Gua Sha procedure. J Vis Exp. 2009.
  4. Xia ZW, Zhong WW, Meyrowitz JS, Zhang ZL. The role of heme oxygenase-1 in T cell-mediated immunity: the all encompassing enzyme. Curr Pharm Des. 2008;14(5):454-464
  5. Chan S, Yuen J, Gohel M, Chung C, Wong H, Kwong K. Guasha-induced hepatoprotection in chronic active hepatitis B: A case study. Clin Chim Acta. 2011;in412; 1686-1688.
  6. Schwickert ME, Saha FJ, Braun M, Dobos GJ. [Gua Sha for migraine in inpatient withdrawal therapy of headache due to medication overuse.]. Forsch Komplementmed. 2007;14(5) (October):297-300.
  7. Nielsen A. Postherpetic neuralgia in the left buttock after a case of shingles. Explore (NY). 2005;1(1) (January):74.
  8. Chiu C-Y, Chang C-Y, Gau M-L. [An experience applying Gua-Sha to help a parturient women with breast fullness]. Hu Li Za Zhi. 2008;55(1) (February):105-110.
  9. Braun M, Schwickert M, Nielsen A et al. Effectiveness of Traditional Chinese “Gua Sha” Therapy in Patients with Chronic Neck Pain; A Randomized Controlled Trial. Pain Med. 2011;12(3) (January 28):362-9.
  10. Chiu J-Y, Gau M-L, Kuo S-Y, Chang Y-H, Kuo S-C, Tu H-C. Effects of Gua-Sha therapy on breast engorgement: a randomized controlled trial. J Nurs Res. 2010;18(1) (March):1-10.


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