Gua Sha/Graston Technique

Gua Sha is a traditional Chinese practice that would traditionally be performed by stimulating the skin with hard-sided items such as jade or bone. It is a practice that could be a cousin to acupuncture and massage but emphasizes the direct localized force of the item on the skin of the patient. It works to increase the blood flow under the skin and the circulation in the soft tissue under the skin. This, in turn, has numerous positive effects on the body including anti-inflammatory and immune system benefits.

  1. The production of HO-1

Early studies show that gua sha may help cells create heme oxygenase-1. HO-1 can help reduce inflammation and is one of many possible benefits of gua sha.

  1. Relief of chronic pain

Gua sha has been used to help alleviate chronic pain. The increase in blood flow and direct application to trouble areas can help relieve discomfort.

  1. Hepatitis B

There are some initial studies that show gua sha may help decrease live inflammation. This could be particularly helpful to individuals that have hepatitis B, a liver infection. Chronic Hepatatis B can cause serious illnesses such as cirrhosis or liver cancer. While gua sha is not a cure for hepatitis B, it is one type of treatment that may help relieve some of the symptoms.

  1. Migraine relief

Increase in blood flow and circulation an also lead to relief for chronic migraine sufferers. Gua sha can be used to help when painful migraines strike.

  1. Perimenopause

Women who experience perimenopause can experience a wide array of symptoms including hot flashes, fatigue, insomnia, anxiety, and mood swings.  Gua sha can be a complementary treatment in conjunction with other items such as medication or hormone therapy to help alleviate these symptoms.

  1. Tourette syndrome

There are initial studies that show gua sha may have a positive effect on those suffering from Tourette’s syndrome when used along with other treatments. Changes in lifestyle, acupuncture, herbs, and gua sha were all used to help improve this situation.

  1. Neck and back pain

The stimulating effects of gua sha may help ease neck and back pain. Your treatment provider can focus on specific areas of the body that help increase blood flow in your neck and spine and relieve trouble spots that are causing you discomfort.

What to Expect

While traditional gua sha practitioners used jade or bone, your therapist will likely use a gua massage tool.  Your visit with a gua sha practitioner may seem short compared to a massage or physical therapy session. You may only receive treatment for approximately ten minutes. Your practitioner will use oil or another lubricant to minimize abrasions and will work to identify problem areas.  After a gua sha session, you may have red marks on your skin. The scraping of the skin can cause capillaries near the skin to burst, but these will disappear within a couple days. It is important to note that gua sha may not be appropriate for people who have blood conditions or disorders.

Side Effects

Gua sha typically has minimal side effects including temporary bruising or discoloration of the skin. There may also be some soreness or tenderness in the areas treated. These should all dissipate within a short period of time. Gua sha is not an appropriate treatment for everyone. You need to disclose your medical history and existing symptoms or issues to your practitioner prior to treatment.

Graston Technique

The Graston Technique is a form of manual therapy known as soft-tissue instrument-assisted mobilization. It is one of a number of manual therapy approaches that uses instruments with a specialized form of massage/scraping the skin gently.


The therapy is designed to help the practitioner identify areas of restriction and attempt to break up scar tissue.

The Graston Technique is often practiced by chiropractors, osteopathic physicians, physical therapists, occupational therapists, and some licensed massage therapists and athletic trainers.

Graston Technique Goals

The general goals of the therapy are to reduce the patient’s pain and increase function through a combination of:

    • Breaking down the scar tissue and fascia restrictions that are usually associated with some form of trauma to the soft tissue (e.g., a starianed muscle or a pulled ligament, tendon, or fascia).
    • Reducing restrictions by stretching connective tissue in an attempt to rearrange the structure of the soft tissue being treated (e.g., muscle, fascia, tendons, ligaments).

  • Promoting a better healing environment for the injured soft tissue.

There also appears to be a neurologic benefit to treating patients with the Graston Technique Instruments. This response is similar to that involved with other manual therapies. The literature suggests that when a patient is given manual or instrument assisted soft tissue mobilization (IASTM) therapy, certain nerve fibers are activated. Additionally, the body’s position sense organs, such as mechanoreceptors and proprioceptors, seem to respond to these forms of treatment.

Potential Benefits of Graston Therapy

Most of the back is comprised of muscles, fascia, ligaments, and tendons. Injuries to these soft tissues play a significant role in the pain and dysfunction associated with back problems. While it may not sound like a serious injury, a simple back muscle strain or torn ligament in the back can cause excruciating pain and difficulty with movement.

The Graston Technique offers several potential advantages to the patient with such an injury:

  • Decreasing overall treatment time
  • Fostering faster rehabilitation/recovery
  • Reducing the need for anti-inflammatory medication
  • Resolving chronic conditions thought to be permanent

The treatment may be used alone or in conjunction with other treatments.