What Is Guasha Exactly?

I often describe guasha to patients as being a cousin of cupping. The functions of the two treatments overlap in a few ways, but there are also some real differences. If you’ve had cupping and know how beneficial it can be, you have to try guasha as well! It’s awesome!

Basically, it’s just a method of using a smooth, flat tool with either water or oil as a lubricant, to scrape the tissue in any area of the body that some kind of pain, stiffness or other problem might be present. The original idea behind the treatment was that heat, toxins, or other pathological influences could become stuck inside the skin, the vessels, muscles etc., and would linger there until removed. So guasha was used as a way to clean the tissue out, and help the body to “expel” pathogens that may have been contributing to pain, fevers, infections and so forth.

One of the most interesting things about guasha, is that while it’s most commonly used today in the treatment of pain, it’s regularly used throughout Asia as a means of bringing down fevers and helping in the treatment of upper respiratory tract infections, and other inflammatory conditions. This partly comes from the effect guasha has in drawing heme-oxygenase and nitric oxide out of the tissue, so that it can be re-absorbed into the circulation, where it has beneficial effects on the liver and on inflammation in general.

Traditionally, cupping is used in a similar manner, for similar reasons, however, guasha has the advantage of also effectively removing and treating adhesions from tissue that cupping would not necessarily affect. Also, guasha can be used on some areas, like the neck or the elbow, where some cups just won’t stick, and make it possible to get the same tissue cleaning and regenerative effects, even in the little nooks and crannies that smaller joints and more contoured tissues tend to have.


So why would anyone do guasha? It sounds uncomfortable, and who wants to walk around with a big red and purple patch on them?

Well, the basic reason is that despite being perhaps the most primitive tool in the kit, it’s still one of the most effective and versatile. The advantages of guasha are the following :

    • Pain relief
    • Accelerated healing of injury
    • Reducing fever and augmenting immune function
    • Reducing and removing adhesions from within myofascial tissue
    • Cleaning out old, stagnant blood and metabolic waste from tissue
    • Stimulating damaged tissue / scar tissue to remodel in a beneficial way

In my experience, guasha is the tool of choice for aches, pains, and inflammation that has not responded to other treatments, so if acupuncture, cupping, electrical stimulation, laser, or anything else has not really caused a particular problem to budge, guasha might be the difference that makes the difference. The reason is that the specific technique, and the right approach can have a unique effect on pain and other health issues that other modalities just won’t produce because they don’t introduce the right combination of friction, pressure, mobilization of blood, lymph and other important fluids, and as a result, just won’t reach the problem with the right stimulus. There are some cases where if I had to choose one only tool for treatment, it would be guasha, over acupuncture, herbs, cupping etc.


Yes, guasha works well with acupuncture, massage, physio, chiropractic treatments. A good guasha session can make a joint easier for a chiropractor to adjust, so that they don’t have to really crank on it to get an effective adjustment, and it can relax and clean the tissue in such a way that a physio or kin’s exercises will be much easier, and produce even greater benefit for rehabilitation than they otherwise would. Obviously, guasha pairs beautifully with acupuncture as the two modalities developed together and make a fantastic team, but it’s really important to understand that guasha can be incorporated into pretty much any therapeutic or pain relieving treatment program.

While I would not necessarily suggest getting massage directly after, and in exactly the same area as a patient had guasha done, generally within a day or so it would be ok to do as long as the practitioner were aware of the recent treatment and made any necessary adjustments to technique and pressure. In fact, if this is done, the massage could actually help the colour and sensitivity from guasha to clear more rapidly and completely, and hence result in a better over all healing effect.

The same applies to any other modality, as long as your practitioner knows you’ve had some guasha, and are aware of any sensitivity you notice, they can make the appropriate adjustments to their technique as well.

Guasha Case Studies