Bu tong ze: tong; tong ze: bu tong
No free flow: pain; free flow: no pain


Gua Sha or Friction massage is a modality applied in Chinese medicine to break up obstructions in the tissues of the body. It effectively and efficiently unblocks any stagnation, causing rapid pain relief and stimulating a healing response from the immune system.


When Is Gua Sha appropriate?

Traditionally gua sha was used to treat endemic diseases such a cholera (Nielsen 2013). But is incredibly effective to treat both local (injuries) and systemic imbalances (wind, cold, damp, heat).  Some examples include:

  • Clears stasis in the tissues of local injury (ex: acute shoulder injuries)
  • Clears pain in the intercostal spaces in cases of disease or trauma to the lungs or mastitis
  • Clears heat patterns in cases of diseases of ‘excess’ such as hepatitis (Nielsen 2013)

Your acupuncturist can guide you to decide what treatment course is most appropriate for your condition and constitution.


How is Gua Sha applied?

The area to be treated is checked for appropriateness of care and cleared of any clothing.

Balm or oil is applied to the area to ease application. Essential oils or liniments can be used at the discretion and appropriateness of the practitioner treating the disease.

Make sure your practitioner is wearing gloves and using disposable or sterile implements for this procedure. Any skin tags or moles should also be covered so as not to cause undue damage. Gua sha should not be applied to any open, burned or wounded skin or in cases of severe disease or deficiency.


What are you using?

Traditionally gua sha has been applied using coins, jade pieces, or ceramic soup spoons. In modern practice, gua sha should only be practiced with disposable implements due to the potential exposure to blood. In our office we use only clean disposable bottle caps with silicone edges for comfort and hygiene.


Why does it look so painful?

Gua Sha can feel intense for some people when applied, while others love the fast relief it brings to areas of discomfort. Always let your practitioner know how you are feeling to ensure your comfort. The marks left from gua sha are not bruising. The color of the ‘sha’ or petechiae that is exposed varies according the internal pathogen. It can range from light pink to dark purple. When applied correctly over healthy tissues there will be no apparent ‘sha’ visible. The ‘sha’ generally fades in 2-3 days and should be kept covered, dry and warm in the meantime.



For anyone interested in reading further on the clinical efficacy of Gua Sha, Arya Nielsen is a true expert in this field: Gua Sha: A Traditional Technique for Modern Practice 

She cites incredible sources on the traditions, uses, and results on this ancient practice in a culture of modern diseases.

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