刮痧 Gua Sha and Medical Massage

By Dan Morris DN, Diplomat, LMT

刮 :Gua meaning: to scrape

痧:Sha meaning: cholera. Taken from the pinyin 砂 meaning sand. The Chinese character or pinyin has been described by Wikipedia to be petechiae which means bruises. Hence the definition according to Wikipedia for gua sha is scraping bruises. However, the word petechiae originates from Italian as in bruising and seems to be inconsistent with the pinyin 砂 sand from which 痧 sha is taken. It would seem more consistent to translate Gua Sha as scraping sand or dirt.

The Chinese would more likely have believed that medical conditions and disease would have the underlying cause of some type of impurity or evil (dirt) that could be removed by “scraping.”

We can see how this would be likely from the teachings of the physician Zhang Feng Kui from the Ming Dynasty who believed that pathogenesis and disease symptoms of “sha” entered the body through the mouth, nose or the pores of the skin and damage the health. As it penetrated deeper into the body it became fierce as it accumulated. Scraping would serve to bring “sha” to the surface of the body where through sweating the toxins or dirt can be excreted thereby restoring good health. (http://www.chinaculture.org/chineseway/2010-10/11/content_399028.htm)

Gua Sha is one of the oldest healing techniques used by man. There is fossilized evidence that “medical” instruments made of stone or bone were used by early man to scrape the skin. Within the discipline of Traditional Chinese Medicine Gua Sha can be used to:

• Promote Chi
• Promote Blood Circulation
• Remove Toxic Heat
• Remove Stagnant Blood

Gua Sha can be used to treat patients who present with symptoms of:

• Chronic Pain
• Systemic Toxicity
• Poor Blood/Lymph Circulation
• Slow or Impeded Healing
• Inflammatory Conditions

Experienced practitioners of Traditional Chinese Medicine use Gua Sha as a primary technique in both treating and preventing disease. Gua Sha can be effective in treating:  

• Degenerative Joint Diseases
• Headaches
• Chronic Neck, Shoulder, and Back Pain
• Muscloskeletal Disorders
• Hypertension
• Vertigo
• Sinusitis
• Arthritis
• Bursitis
• Neuralgia
• Asthma
• Tendonitis
• Carpal Tunnel
• Myositis and Myalgia

Gua Sha affects body biochemistry and physiology in the following ways. By:

• Stimulating mechanoreceptors in the skin
• Creating a form of counter irritation therapy
• Increasing blood flow to the treated areas
• Promoting fluid flow and fluid dynamics in the tissue
• Stimulating the immune system and white blood cell activity
• Promoting the release of endorphins
• Promoting connective tissue growth and repair.

Method of Application:

Gua Sha usually follows Medical Massage Therapy. When using Gua Sha in combination with Medical Massage it will be used as a finishing technique as follows:

1. Place the client in a neutral position with the area to be treated in a properly folded position and not stretched or tense.
2. Gather all supplies and materials to be used and have them easily accessible. This should include plenty of towels. (I like to have paper towels available, too.)

• Drape the client so as to expose the area to be treated being careful to not over expose the client. This will also serve to protect any clothing that may be worn at the time of treatment from medicated oils.
• Begin kneading and massaging the area to be treated. A medicated oil such as Po Sum On may be used at this time while kneading and massaging.
• Layer the medicated oil with repeated applications while treating the area with Gua Sha.
• Use a sterile tongue depressor to gently but firmly scrape the area being treated.  Use more medicated oil as necessary for lubrication. Be sure to be thorough scraping in as many directions as possible. (This scraping is the main treatment technique of Gua Sha.)
• DO NOT use a non – disposable tool or comb as cross – infections are possible.
• After the scraping procedure is completed, use a clean towel to pat and vigorously rub the area to remove excess medicated oil. (I use a paper towel first as the oil will stain the towel.) Do not touch the area with your bare hand.
• After completing these steps the area should be treated by spraying it with a cooling liniment such as Zheng Gu Shui (zen-goo-shwe) or a mixture of one part Witch Hazel to one part Aloe Vera to one half part alcohol. I use 100 proof vodka for the alcohol since rubbing alcohol is toxic.
• Repeat three times with the cooling liniment allowing the area to air dry in between and then after. Be careful to not allow the liniments to stain the client’s clothing.

After the Gua Sha has been completed the client should feel relaxed and rested. A light warm feeling should be experienced. Any pain that the client may have experienced before the treatment should feel much better.

Gua Sha may be followed and combined with red light therapy or infrared heat lamp. Be sure the infrared is moderate.

The area treated may also be wrapped in a towel and allowed to rest for a few minutes after treatment.

A light bruising may occur but it should not be excessive. The use of Zheng Gu Shui will help prevent bruising. Also the use of a cooling liniment serves to close the pores after treatment and to constrict the blood vessels. There is always a small amount of micro trauma to the surface of the area being treated. This will also cause a small amount of occult blood to be present which will require the need to use caution so as to avoid any cross infection.

Taken from: Zhang Feng Kui- Diseases in the Summertime. Translated by Zhang Min.,  

Also taken from Lecture: Introduction to Acupuncture – Dr. John Ruburto, AMMA 09/19-21/2003