Like most of the different techniques used in Traditional Chinese Medicine (TCM), Gua Sha has been used in the East for literally thousands of years. Gua Sha, which could be translated to mean "the scraping of the skin until a reddish rash appears", embraces the belief that by scraping the surface of the skin, the toxins that have accumulated under the skin causing pain, will come to the surface and be eliminated.
The technique is used whenever there is pain, either acute or chronic. Some practitioners of TCM prefer Gua Sha over any other technique when there is aching, tenderness and/or a knotty feeling in the muscles. Gua Sha moves stagnant Qi and Blood, releases the Exterior mimicking sweating, and moves Fluids. From a Western medicine view, fluids containing metabolic waste that congest tissues and muscles are brought up to the surface and expelled. Gua Sha promotes circulation and normalizes metabolic processes.
Gua Sha is mainly done on the Yang surface of the body; the back, neck, shoulders, buttocks, and limbs. On occasion, Gua Sha is applied on the chest and abdomen. The area to be Gua Sha-ed is first lubricated with massage oil. The skin is then rubbed or scraped (Gua) with a round-edged instrument until a reddish and elevated millet-like skin rash (Sha) appears. If there is no Blood stasis the skin will only turn pink. A very common instrument in Asian countries is a porcelain soupspoon. The strokes are always from top to bottom, and on the back always away from the spine. On the chest the sternum is done very lightly and then following the contour of the ribs. On women, the breast tissue is avoided. When treating the shoulders and upper arms it is important to do the back and scapula area first.
The color that the skin turns when being scraped (Sha) is both diagnostic and prognostic. A very light color Sha indicates deficiency of Blood. A dark or purple Sha indicates Blood stasis, and a dark red Sha can indicate Heat. The Sha in a well-balanced person should fade in 2 to 4 days. If the fading is slower it indicates poor circulation which could be due to a deficiency of Blood, Qi, or Yang.
After a Gua Sha treatment it is important to stay away from the sun and avoid cold drinks, coffee, and sour foods. Also, the patient should abstain from alcohol, drugs, fasting, hard labor and sex. Warm drinks are recommended, and in case of excessive tenderness a warm bath with mustard powder has been proven to be beneficial.
In most cases the patient feels an immediate shift in their condition particularly in their pain or sense of constrain. In addition to resolving musculo-skeletal pain, Gua Sha is used to treat, as well as prevent, common cold, flu, bronchitis, asthma as well as any chronic disorder involving pain (Qi and Blood stagnation). Another indication as to when to use Gua Sha is when normal finger pressure on a patient's skin causes blanching that is slow to fade.