What is Gua Sha

Gua sha is a Traditional Asian Medicine healing technique that involves instrument-assisted unidirectional press-stroking (i.e. Scraping) of a lubricated area of skin to intentionally create transitory therapeutic petechiae called ‘sha’.

Sha represents  extravasation, i.e. the movement of white blood cells from the capillaries to the tissues surrounding them.

Producing sha removes blood stagnation (poor circulation), which is considered pathogenic in Traditional Asian Medicine.

Research shows that the transitory therapeutic petechiae produced by this technique create an anti-inflammatory and immune protective effect that persists for days following a treatment.

Many patients get immediate relief  from pain, stiffness, fever, chills, cough, wheezing, and nausea and vomiting.

Gua sha is also effective in acute and chronic internal disorders including hepatitis.

The technique is not painful and patients often find it calming/sedating.


Nielsen, A. (2014). Gua Sha: a traditional technique for modern practice. Elsevier Health Sciences.


East Meets West- What doe the research show?


Chronic Neck pain and Back Pain

Gua sha has beneficial short-term effects on pain and functional status in patients with chronic neck and back pain.

Braun, M., Schwickert, M., Nielsen, A., Brunnhuber, S., Dobos, G., Musial, F., … & Michalsen, A. (2011). Effectiveness of traditional Chinese “gua sha” therapy in patients with chronic neck pain: a randomized controlled trial. Pain Medicine, 12(3), 362-369.

Lauche, R., Wübbeling, K., Lüdtke, R., Cramer, H., Choi, K. E., Rampp, T., … & Dobos, G. J. (2012). Randomized controlled pilot study: pain intensity and pressure pain thresholds in patients with neck and low back pain before and after traditional East Asian” gua sha” therapy. The American journal of Chinese medicine, 40(05), 905-917.


Myalgia (Muscle pain)

Gua Sha increases microcirculation local to a treated area, and that increase in circulation may play a role in local and distal decrease in myalgia. Decrease in myalgia at sites distal to a treated area is not due to distal increase in microcirculation. There is an unidentified pain-relieving biomechanism associated with Gua Sha.

Nielsen, A., Knoblauch, N. T., Dobos, G. J., Michalsen, A., & Kaptchuk, T. J. (2007). The effect of Gua Sha treatment on the microcirculation of surface tissue: a pilot study in healthy subjects. EXPLORE: The Journal of Science and Healing, 3(5), 456-466.


This is a  case of a 72-year-old woman who suffered from chronic headaches and received excellent therapeutic results  from Gua Sha during her 14-day inpatient multimodal treatment. This case provides first evidence that Gua Sha is effective in the treatment of headaches.

Schwickert, M. E., Saha, F. J., Braun, M., & Dobos, G. J. (2007). [Gua Sha for migraine in inpatient withdrawal therapy of headache due to medication overuse]. Forschende Komplementarmedizin (2006), 14(5), 297-300.



Heme oxygenase-1 (HO-1) has demonstrated hepatoprotective effect in animal hepatitis models. HO-1 was also reported to be upregulated with Guasha, an ancient therapeutic technique which applies instrument assisted press-stroking to treat many disorders.

Chan, S. T., Yuen, J. W., Gohel, M. D. I., Chung, C. P., Wong, H. C., & Kwong, K. K. (2011). Guasha-induced hepatoprotection in chronic active hepatitis B: A case study. Clinica Chimica Acta, 412(17), 1686-1688.


Instrument Assisted Soft Tissue Mobilization (IASTM)- Gua Sha by another name

IASTM has the ability to both detect and treat dysfunctional and painful soft tissues

IASTM creates load deformation to soft tissue resulting in the elimination of pain and normalization of the positive functional tests that revealed the conditions of supraspinatus tendinosis, Achilles tendinosis, and plantar fasciosis.

Hammer, W. I. (2008). The effect of mechanical load on degenerated soft tissue. Journal of Bodywork and Movement Therapies, 12(3), 246-256.


While Gua Sha has been around for hundreds of years, the research is relatively new in this field.

Most of the focus has been on the medicalization of this technique and the development of new tools, typically made out of surgical steel.

Empirically, Gua Sha (Instrument Assisted Soft Tissue mobilization) can be effective as a stand alone therapy or in combination with other manual therapies for:


  • Scar Tissue/Adhesions
  • Muscle Strains
  • Ankle Sprains
  • Plantar Fascitis
  • Tendonopathies:
    • Achilles Tendon
    • Patellar Tendon
    • Illiotibial Tract
    • Rotator Cuff
    • Biceps Tendon
    • Hamstring Tendons
    • Runner’s Knee
    • Jumper’s Knee
    • Tennis Elbow
    • Golfer’s Elbow
    • Baseball Shoulder
    • Swimmer’s Shoulder
    • Adhesive Capsulitis
    • Carpal Tunnel Syndrome
    • Myofascial Syndrome
    • Back & Neck Pain

If you have any of the above conditions, it may be time to “get your Sha on”

About the Author

Dr. Geoff LecovinNaturopathic Physician/Chiropractor/Acupuncturist/Certified Strength and Conditioning Specialist/Corrective Exercise Specialist/Performance Enhancement Specialist/Certified Sports Nutritionist/View all posts by Dr. Geoff Lecovin