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  • Ben Heathcote

Gua Sha in Chinese Medicine

What is it?

Developed and used for centuries throughout Asia, Gua Sha (pronounced 'gwarshar') is a manual therapeutic technique mainly utilised by practitioners of traditional Chinese medicine for a variety of applications.

Gua Sha goes by many different names including spooning, scraping and even coining. It's an old technique that's even been picked up by non traditional modalities in recent times and relabelled as the 'Graston technique' with Chiropractors, Osteopaths and Physiotherapists discovering it's benefits. No matter what we call it, the technique and results are virtually the same.

In clinic, gua sha is only performed after a comprehensive consultation. It is usually part of a complete treatment that also includes acupuncture, herbal, dietary and exercise advice. Gua sha is not usually a stand alone technique.

How it's done

The technique itself sees the practitioner using a flat, smooth edged, hard, hand held instrument which is then scraped directionally on the chosen place of the body. The area being worked on is lubricated with an oil or liniment. This makes gua sha more comfortable while an area is being worked.

My personal favourite gua sha tool is a simple ceramic soup spoon. It may not be fancy but it does a wonderful job because it is perfectly shaped to hold and has a perfectly smooth rounded edge for applying to the patient. Other gua sha tools specifically designed for the job include those made out of wood, stone, metal and jade. It is common in Vietnam for the gua sha tool to simply be a coin.


Most commonly used to clear muscular tension and stiffness, gua sha is a physical therapy. By working through areas of tension, stiffness and pain using the gua sha tool, your practitioner can actually feel where adhesions and muscle fibre bunching are occurring. Then by increasing the pressure these adhesions and entangled muscle fibre can be physically broken down. Once these are cleared blood circulation to the area is naturally restored resulting in less pain, decreased stiffness and improved function. Gua sha in this form feels similar to a strong massage. However, if patients find the technique too sore, the pressure can be reduced and still be effective..

There is actually a wide variety of reasons that gua sha may be used:

  • Pain

  • Stiffness

  • Decreased range of movement

  • Fever associated with cold, flu, upper respiratory tract infections

  • Cosmetic reasons

  • Athletic performance

Post Treatment

Side effects of this type of gua sha include redness and petechiae on the skin. Petechiae is red spotting on the skin caused by broken capillaries just under the surface. However, this redness or bruising is not dangerous and the skin is not broken. Any colour brought to the surface should be gone in 2-3 days after the treatment. Some people may experience some level of skin sensitivity after a treatment. This is also temporary and quite normal.

Although some images of gua sha may seem extreme because of the amount of colour/bruising that occurs, it's important to remember that this colour will only occur when there is excessive tension and stiffness in muscles. As treatment continues, each time gua sha is used the colour will become lighter and lighter until no more colour comes to the surface.

Interestingly, when working through a problem area, where there is an entanglement of the muscle fibres, the spot that becomes red and coloured first is often the spot where tension and muscle fibre bunching is at its worst. Thus, gua sha is not only therapeutic but may also be used as a diagnostic tool to find the origins of muscle tension in larger areas.

Cosmetic Uses

Gua sha has always been popular for cosmetic reasons in countries such as China, Japan and Korea. And now we see there is more demand for this kind of gua sha in Australia, the USA and Europe too. Performed on the face, the aim is to improve the complexion, muscle tone and aid lymphatic drainage. It's popularity has been bolstered by recent articles in magazines such as Elle and Vogue.

Be aware that when gua sha is used on the face it is done so with a lighter application. It is not painful and there should be no bruising. This is very different to gua sha that is performed on other areas of the body. Gua sha performed properly on the face should feel relaxing and gentle, quite similar to some types of facial massage. Gua sha on the face for cosmetic reason is nearly always followed by acupuncture, jade roller treatment and sometimes light cupping to reinforce the effects of the treatment.

Chinese Medicine Theory

Using the unique diagnostic criteria of Chinese medicine is another way that gua sha is chosen as the treatment of choice. Chinese medicine discerns health issues under different categories such as Wind, Damp, Cold and Heat. When Heat and Wind is diagnosed then gua sha may be chosen as part of the treatment approach.

Heat may present as fever due to infection or even heat associated with menopause. Wind, on the other hand, may present as a stiff neck or uncontrollable twitches and muscle cramps. These are all indicators for gua sha to be used.


Encouraging news for gua sha enthusiasts: a study in 2014 found increased movement in neck and shoulder pain sufferers following gua sha treatment. These were people that tended to use computers too much. And further research in 2017 actually found that athletic performance increased after gua sha treatment on weight lifters that participated in the study. So here we have two studies that show the benefits of gua sha in terms of not only health benefits but also in terms of exercise and sports performance.


A complete Chinese medicine consultation is used to determine exactly which techniques should be used for each individual. And gua sha is often just part of a treatment that may also include acupuncture, herbal advice, moxibustion, diet advice and lifestyle advice.

If you would like to find out more about gua sha and its benefits or book in for your first gua sha treatment please Contact Us today. Our practitioners are happy to answer any questions you have regarding this technique or any other Chinese medicine related questions.

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