What is Gua Sha?


The first time I heard of gua sha was at an Asian bodywork therapy convention in 1999. A woman named Arya Nielson showed us how it was done and we practiced on each other. I was fascinated by the technique and loved the results but figured it would be hard to convince clients to try it. Describing it makes it sound like it would hurt. And then when you see it, it certainly looks like it would. I rarely practiced it with clients but made a habit of trading sessions with a couple of my peers. Did I say that I really liked the results?

This last year I’ve started to get calls from people looking for spooning,  as gua sha is sometimes called. It seems to be catching on, even among practitioners of western styles of bodywork, who consider it a form of myofascial release.

Gua sha is a healing technique from Asia practiced mostly as a folk tradition. It is also used by practitioners of Asian bodywork therapy and by acupuncturists. This technique is prevalent in China. When Arya Nielson who is probably the authority on gua sha in the west, asked her teacher in China, ‘who taught you?’, Dr. So answered, ‘Where I learn? Everyone know!’ Misunderstood in the west as practiced by Asian immigrants it was considered a barbaric and even abusive practice, often reported to child protective services because of the bruise like quality of the surface of the skin after treatment. It has since been researched and is understood to be a useful therapy, mostly quite pleasant to experience. In folk traditions it is used to prevent and treat colds and flus and other respiratory and digestive upsets. Practitioners of East Asian medicine also consider it for any condition where there is pain or discomfort. It is used for  back or neck pain or any skeletal muscular pain.  The results tend to be fast and amazing.

Gua sha is also called spooning

gua sha is also called spooning.

Gua means to rub or create friction and sha is a term used to describe the congestion of blood at the surface of the body. When friction is applied in even repeated strokes, it raises a pattern of small red dots called petechia. This pattern, which can be quite pronounced at first, quickly begins to fade into a more bruise like quality called ecchymosis which will usually fade in 2 to 3 days.

petechia, gua sha

petechia, gua sha

We can suspect sha (or congestion of blood below the surface of the skin) when there is pain anywhere. Gua sha may fully or partially resolve a presenting problem; it will almost always help. As the practitioner make repeated even strokes on the skin  small red petechia is raised. The patient may report feeling exhilarated and invigorated. Acute pain is immediately reduced. Nausea, wheezing and shortness of breath lessen. Some words used by patients to describe how they feel after a session are; bright, awake, warm, highly aware, relaxed, enhanced, free, lightened and even enlightened.

How it works is not entirely understood, however research shows gua sha to have both anti inflammatory and immune strengthening effects. Evidence exists that a correspondence may exist between the network of meridians of Chinese medicine and the body wide network formed by connective tissue. Especially connective tissue proper called fascia.  This tissue has the ability to support, connect, contain, and transmit. The space between the superficial and deep fascia; below the skin but not the skin itself, is an area that Chinese medicine calls the cou li. The cou li is where electrical, cellular and tissue remodeling signals are thought to be  responsive to mechanical forces. Gua sha affects this area. We dredge the channels which are consistent with the planes and cleavages of connective tissue. We vent heat and we restore blood stagnation allowing nutrients to be carried to the tissues as metabolic wastes are carried away. These areas of stagnation are often areas of unresolved old injuries and congestion in the internal organs. So we could say that we bring the stagnation to the surface where it can be readily resolved.

Gua sha can also be referred to as a counteractive method, the purpose of which is to induce an artificial crisis, hastening the resolution of disease by countering internal inflammation. 


To learn more about gua sha I would recommend that you visit Arya Nielson’s website at guasha.com. and if are a practitioner I highly recommend her book titled Gua sha. Everything that I know about gua sha short of what I’ve learned from simply practicing it, I learned from Arya Nielson’s work.  From the workshop that I attended in 1999 and from the study of her book. I have to credit her with all knowledge about gua sha in this post. Any shortcomings and errors are of course mine.


 Karen Kessler LMP ABT

1104 Main Street, Suite 306
Vancouver WA 98660
360 735 9432 or contact

Karen has been practicing Asian Bodywork Therapy for over 20 years. Using shiatsu, tuina and thai massage she can help you in your quest for good health. She works both energetically and structurally to reduce pain and stress, and to promote healing and injury recovery.