Gua Sha: Traditional Scraping Therapy and What Research Shows

What gua sha is

Gua sha is a traditional East Asian healing technique in which the body surface is press-stroked with a smooth-edged instrument to intentionally raise therapeutic petechiae, the small red or purple dots under the skin. [1] It is also called scraping therapy in many studies. Related practices exist in other cultures. Kerokan, for example, is a traditional Indonesian treatment that abrades the skin with a blunt object such as a coin. [2]

This page describes what a trained practitioner does in general terms and what research found. It gives no how-to steps, and nothing here invites you to bruise or scrape your own skin. For the face and for tools sold online, see Facial Gua Sha and Gua Sha Tools.

How it is traditionally explained

Writers on gua sha describe it as used in East Asian medicine for conditions with features of "blood stasis," pain or inflammation. [3] That is a traditional framework. It is not a measured finding. The first published investigation of the physiology of gua sha was a pilot study; its author described it as the first of its kind. [3] Mechanisms are still described as largely based on preclinical (laboratory and animal) work. [4] See Traditional Frameworks vs Biomedical Explanations.

What a session generally involves

In general, a practitioner press-strokes a smooth-edged instrument over an area of the body until small marks appear. [1] We did not find a source we could read that gives timings or pressure, and we do not give any, because technique should be taught in person.

What research found

Several trials are small, the stroke review included only trials from China [4], and a person can tell whether scraping was done, so expectation can affect pain reports.

1. Chronic neck pain

   Promising but limited

   German randomized trial, 48 people, one gua sha treatment vs a heat pad; neck pain was lower at one week. Long-term value unclear. [1]

2. Chronic low back pain

   Promising but limited

   Review of 10 studies (627 people): pain lower overall, but not when only a single scrape session was given; quality limited. [5]

3. Low back pain vs hot pack

   Insufficient evidence

   32 people; both groups improved; larger studies needed. [6]

4. Knee osteoarthritis

   Insufficient evidence

   12 trials (997 people); possible benefit, low quality evidence [7]

5. High blood pressure (added to medicine)

   Insufficient evidence

   9 trials (765 people); used as an add-on to medicine, not instead of it [8]

6. Perimenopausal symptoms

   Insufficient evidence

   6 trials, most low quality; preliminary support only [9]

7. Spasticity after stroke

   Insufficient evidence

   16 trials, all in China; certainty very low [4]

A broader review of TCM for neck and low back pain said gua sha showed fair effects but no definite conclusions could be drawn. [10]

Who should take extra care

If you take blood thinners, have a bleeding disorder, fragile skin, a skin infection or an active rash, are pregnant, or are treating a child, ask your own clinician first. We did not find a source we could read with specific rules for these groups, so we do not state any. Never apply scraping over moles, wounds or inflamed skin without a clinician's advice.