What is Gua Sha?
Gua Sha is a healing technique used in Asia by practitioners of Traditional Medicine, in both the clinical setting and in homes, but little known in the West. It involves palpation and cutaneous stimulation where the skin is pressured, in strokes, by a round-edged instrument; that results in the appearance of small red petechiae called 'sha', that will fade in 2 to 3 days.
Gua sha involves repeated pressured strokes over lubricated skin with a smooth edge. Commonly a ceramic Chinese soup spoon was used, or a well worn coin, even honed animal bones, water buffalo horn, or jade. A simple metal cap with a rounded edge is commonly used. In cases of fatigue from heavy work a piece of ginger root soaked in rice wine is sometimes used to rub down the spine from head to tail.
The smooth edge is placed against the pre-oiled skin surface, pressed down firmly, and then moved down the muscles—hence the term "tribo-effleurage" (i.e., friction-stroking) -- or along the pathway of the acupuncture meridians, along the surface of the skin, with each stroke being about 4-6 inches long.
This causes extravasation of blood from the peripheral capillaries (petechiae) and may result in sub-cutaneous blemishing (ecchymosis), which usually takes 2–4 days to fade. Sha rash does not represent capillary rupture as in bruising, as is evidenced by the immediate fading of petechiae to echymosis, and the rapid resolution of sha as compared to bruising. The color of sha varies according to the severity of the patient's blood stasis—which may correlate with the nature, severity and type of their disorder—appearing from a dark blue-black to a light pink, but is most often a shade of red.
Practitioners tend to follow the tradition they were taught to obtain sha: typically using either gua sha or fire cupping. The techniques are not used together.
How is Gua Sha applied?
The area to be Gua Sha-ed 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 lubrication I use several types of lubricants because my patients are familiar with its smell and are comforted by it. Thick oil such as peanut oil was used traditionally.
What kind of instrument is used to Gua Sha?
A soupspoon, coin, or slice of water buffalo horn is used in Asia. I have found that a simple Buffalo Horn works best and is by far more comfortable to the patient.
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 stuck Qi and Blood, releases the Exterior mimicking sweating, and moves Fluids. In a modern medical construct these fluids contain metabolic waste that congested 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, but it is serious medicine. Knowing when to use it and what to expect from treatment is as important as good technique. People who live in chronic pain often erect emotional defenses to cope with it or can feel completely hopeless. Having that pain 'touched' and relieved can be unsettling, even shocking. It is good to be moderate in activity after treatment, even rest. I have always told my patients after treatment: no drugs, drinking, sex, fasting, feasting or hard labor, including working out, for the rest of the day. In other words, mellow mode.