Gua sha: traditional healing for our modern times

July 4, 2014 0 comments Health

Gua sha is a healing technique of traditional Chinese Medicine, often used with acupuncture. It involves press-stroking of a lubricated area of the body surface to intentionally create transitory therapeutic petechiae called ‘sha’ representing release of blood from blood vessels into tissue just beneath the skin.  During treatment the petechiae or sha appear as red dots and then gradually merge together to create a reddish tinge to the skin (called ecchymosis).  This fades over a few days.

The photo shows gua aha applied to the neck and shoulder to alleviate pain from a chronic whiplash injury to the neck and radiating aches and pain in the shoulder.  The gua sha will be applied to the opposite shoulder and further down the back to complete the treatment.

Raising sha removes “blood stagnation” considered pathogenic in traditional Chinese Medicine. Modern research shows the transitory therapeutic petechiae produce an anti inflammatory and immune protective effect that persists for days following a single Gua sha treatment.  Gua sha is used to treat pain as well as in mild to severe conditions such as colds, flu, fever, heatstroke, and respiratory problems such as asthma, bronchitis, and emphysema; functional internal organ problems as well as musculoskeletal problems from fibromyalgia to severe strain, spasm or injury.

It is a safe treatment.  Dr Arya Nielsen who is leading authority on Gua Sha explains, “the most significant complication related to Gua sha reported in Western medical literature is its misinterpretation as abuse.” This is due to the dramatic look of the skin colouration which people interpret incorrectly as bruising.

Recent research compiled by Dr Nielsen into the biomechanism of Gua sha has illuminated at least a partial knowledge of the physiology of its therapeutic effect.

Gua sha results in a 400% increase in surface skin perfusion. Research shows that pain relief at the treatment site was maintained to a great extent at follow up scans 2 or 3 days later even though perfusion rates returned to baseline.  Interestingly the increase in microcirculation rates were limited to the area treated but pain relief extended beyond the area treated and beyond the time of microcirculation change. (Nielsen, Knoblauch, and Dobos et al. 2007). Other studies have demonstrated that this perfusion is many times greater than massage and even acupuncture (75%), which was greater than massage.   The biochemical mechanism of this is theorised:

  1. The Nitric Oxide pain relief theory: as this is released during gua sha and circulated in the blood stream it causes smooth muscle relaxation and vasodilation (Findley 2009; Hockling et al 2008).  It also regulates platelet function, reduces inflammation (less irritation of nerves) and thus reduces pain (Mackenzie et al. 2008).
  1. Up regulation of heme oxygenase-1 (HO-1) – As the blood is released to the surface, the immune system is stimulated to reabsorb the blood. The breakdown of haemoglobin in the blood cells upregulates the enzyme HO-1 (via gene expression) and its catalysates (carbon monoxide, biliverdin and bilirubin), which are anti-inflammatory and cytoprotective (Xia et al 2008).

Dr Nielsen cites many studies showing Gua sha successfully used to treat a range of internal organ and inflammatory problems such as allergies, asthma, inflammatory bowel disease, chronic hepatitis and so on.

More research is of course needed, but on the basis of the many studies already available, the implications are profound and predict an expanding role for Gua sha in treating many inflammatory conditions.

Reference: Arya Nielsen (2013), A Traditional Technique for Modern Practice 2nd Edition.  Churchill Livingstone, Elsevier.  Includes full research references cited here.


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