Gua Sha (Guasha)


What is Gua Sha (Guasha)?

therapy imageGua Sha is a healing technique used in Asia by practitioners of Traditional Chinese Medicine, but is little known in the West. It involves palpation and cutaneous stimulation, where the skin is pressured, in strokes, by a round-edged instrument.

Gua means to scrape or rub. Sha is a 'reddish, elevated, millet-like skin rash' (aka petechiae). Sha is the term used to describe blood stasis in the subcutaneous tissue before and after it is raised as petechiae.

Gua Sha is one technique that intentionally raises a Sha rash or petechiae. The results after treatment are the appearance of small red petechiae, that will usually fade in 2 to 3 days.

Raising Sha removes blood stagnation which is considered to be pathogenic, promoting normal circulation and metabolic processes. The patient can experience immediate relief from pain, stiffness, fever, chill, cough and nausea.

Gua Sha is valuable in the prevention and treatment of acute infectious illness, upper respiratory and digestive problems, and many other acute or chronic disorders.


When is Gua Sha used?

Gua Sha is used whenever a patient has pain, whether it is associated with an acute or chronic disorder. There may be aching, tenderness and/or a knotty feeling in the muscles. Palpation reveals Sha when normal finger pressure on a patient's skin causes blanching that is slow to fade.

In addition to relieving acute or chronic musculoskeletal pain, Gua Sha is used to treat, as well as prevent, mild to severe conditions such as colds, flu, fever and heatstroke, as well as respiratory problems such as asthma, bronchitis, and emphysema, plus functional internal organ problems as well as musculoskeletal problems from fibromyalgia to severe strain, spasm or injury (Nielsen, 1995).


Where is Gua Sha applied?

therapy imageSha is raised primarily on the back, neck, shoulders, buttocks, and limbs. On occasion, Gua Sha is applied at the chest and abdomen.


How is Gua Sha applied?

The area to be treated is lubricated with oil. The skin is then rubbed with a round-edged instrument in downward strokes. One area is stroked until the petechiae that surface are completely raised. If there is no blood stasis the petechiae will not form and the skin will only turn pink for a few minutes.


What kind of instrument is used for Gua Sha?

A Chinese soupspoon, a slice of water buffalo horn, or a shaped piece of jade or green agate is used.
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What does the type of Sha indicate?

The color of the Sha is both diagnostic and prognostic. Very light coloured Sha can indicate deficiency of blood. If the Sha is fresh red, it is of recent penetration. If the Sha is purple or black, the blood stasis is long-standing. If brown, the Blood may be dry. Dark red Sha can indicate heat.


How fast will the petechiae fade?

The Sha petechiae should fade in 2-4 days. If it is slower to fade, this can be an indication of poor blood circulation.


What are the benefits of Gua Sha?

In most cases the patient feels an immediate shift in their condition, particularly in their pain or sense of constraint.

Gua Sha moves energetic blockages and stagnant blood, releases the exterior of the skin mimicking sweating, and moves fluids. In modern medical opinion, these fluids contain metabolic waste that congest the surface tissues and muscles.

Gua Sha promotes circulation and normalizes metabolic processes. It is a valuable treatment for both external and internal pain, and facilitates the resolution of both acute and chronic disorders.


Is Gua Sha safe?

Gua Sha is a completely safe technique. Knowing when to use it and what to expect from treatment is as important as having a good technique.

People who live in chronic pain often put up emotional defences to cope with it, or can feel completely hopeless. Sometimes, experiencing that pain being 'touched' and relieved can be unsettling, even shocking. This can release pent up emotions as well as relieving pain, and consideration must be given to allowing a recovery time. It is a good idea to moderate activity after treatment, and preferably rest.

Best practice includes advising patients to avoid drugs, alcohol, sex, fasting, feasting or hard labour, including working out, for the rest of the day. In other words, take it easy after treatment.



  • Nielsen A. Gua Sha: A Traditional Technique for Modern Practice. Edinburgh: Churchill Livingstone; 1995.
  • German research trial
  • News Digest


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