Based on traditional Chinese medicine or TCM, Gua Sha is the ancient art of muscle scraping to release energy or inflammation in the body. This treatment can be performed by acupuncturists and involves "scraping" the skin with smooth tools similar to spoons or stones.

How it Works

Today's gua sha practice involves scraping a smooth tool across the skin to reduce inflammation, increase collagen production, and improve skin's appearance. The full-body treatment is typically performed by a sports massage therapist or acupuncturist.

massage therapist using gua sha tool on client's back


Does it Work?

Similar to sports cupping, gua sha has been described as a method of massage using a tool. Research shows that gua sha can be effective in the treatment of musculoskeletal problems, tension headaches, migraines, chronic neck pain, swelling, anxiety, and fatigue.

practitioner using gua sha tool on patient's shoulder


Gua Sha for Perimenopause

Perimenopause, which can begin as much as a decade before menopause, can cause many of the same symptoms. Gua sha is a common treatment for perimenopause in Traditional Chinese Medicine, thanks to its ability to encourage circulation and its anti-inflammatory effects. One study combined gua sha with other TCM treatments — with a control group receiving only the other treatment — and the results showed the self-evaluated quality of life had improved considerably more for the first group.

practitioner using gua sha tool on patient's back


Treating Hepatitis B

In an interesting study, the use of gua sha on a patient with hepatitis B resulted in changes to liver function — specifically, liver enzyme levels were reduced following the treatment due, the researchers believe, to some relief of previous inflammation. While this is a small study, it does support the anti-inflammatory benefits of the topical treatment.

practitioner using gua sha tool on patient's back


A Treatment for Tourette Syndrome?

A 2016 study cites just a single case of using gua sha for Tourette syndrome treatment. The practitioner combined the physical treatment with TCM herbs and prescribed lifestyle changes, and after 35 weekly treatments, the patient's symptoms — which included facial tics and constant throat clearing — had improved by 70%. Though much more research is needed, this small study shows the other possible benefits of this ancient practice.

diagnosis concept with medical book for tourette syndrome


Who Shouldn't Try Gua Sha

While gua sha is considered safe for most people, there are things to consider. If the practitioner presses too hard with the tool, there is a risk of inflammation or nerve damage. Additionally, people with diabetes or poor circulation should let their practitioner know, so the pressure can be adjusted. It may also be risky for individuals with significantly thin skin and those who take blood thinners. Gua sha should not be done over top of rashes, bruises, sunburns, cuts, pimples, or other growths.

massage therapist using gua sha tool on patient's upper back


The Tools: S-Shaped and Wing Tip

The S-shaped tool may be the length of the palm or the whole hand; it is available in plastic and resin styles. Practitioners use this multi-purpose option on the hands, feet, back, neck, lats, and shoulders. It has limited use on the face or smaller parts of the body due to its size.

Smaller than the S-shaped style, the wing tip is also multipurpose. With three sides for scraping and a broad shape for easy grip, this is one of the more popular gua sha tools. It is most commonly used on the chest, shoulders, legs, and smaller sections on the back. It can also be used on the hands and arms.

acupuncturist using gua sha tool on client's neck


Dolphin, Fish, and Spoon Tools

The dolphin tool offers a broader shape that is easier to grip. This makes it a good choice for deep tissue work or bulkier parts of the body such as the glutes and thighs. Traditionally made with jade or amethyst, these days it is also available in stainless steel.

The spoon type offers pressure control and convenience, making it one of the more popular varieties. It is useful on the neck, shoulders, soles of the feet, and palms of the hands. It is available in stone, resin, plastic, or more recently, stainless steel.

The fish-shaped tool is typically used for smaller areas of the body. It excels in deep tissue treatments due to the ability to grip it firmly and apply pressure. It is particularly good for cramps the in calves and thighs and pulled muscles in the back or shoulders.

close up of massage therapist using spoon-shaped gua sha tool


Can You Do Gua Sha Yourself?

If you buy the proper tool and follow the procedure safely, you may be able to give yourself at-home gua sha treatments, though the ability to fully relax while someone else is administering the treatment likely has a beneficial effect.

To treat tightness in the neck, first be sure to use massage or coconut oil to help the gua sha tool slide smoothly across your skin. Apply moderate pressure with the end of the tool and draw it repeatedly in one direction — such as down the neck from below the ear to the shoulder — until redness or "sha" appears on the skin. Avoid scraping over bone.

cropped image of woman using gua sha tool on her neck


History of Gua Sha

Gua sha has a lengthy history dating back to the Paleolithic Era in China, with written records from as long as 700 years ago. It was used to balance and distribute blocked qi (pronounced chi), the energy or life force that flows through the body and can be stopped up at points of tension. Earlier modifications involved using hands, stones, and other natural tools to massage people who were ill or injured.

traditional chinese medicine concept with Chinese symbols and herbs


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