Although acupuncture is much less painful and scary than most people expect, I also understand that there are instances in which non-needle treatments are preferred. Non-needle therapies are a good option for people who are extremely fearful of needles, for people who are unable to sit still long enough for acupuncture treatment, for children, and for individuals with severely compromised immune systems.

The combination of acupuncture and non-needle therapies such as gua sha and/or cupping can amazing and can shave weeks of treatment time off a case when compared to using acupuncture alone.

I injured my neck last summer and was used to dealing with chronic pain from my injury. I would push through the pain during the day and take a few Advil before bed, when the pain bothered me the most. I started seeing a chiropractor for it as well, seeing him bi-weekly with little to no relief. Then I saw Kristen post something online about using gua sha massage for a crick in her neck! What could it hurt to try?? The technique itself was not painful at all. I could describe some parts of it as intense, but not painful. I told myself beforehand that if the gua sha even reduced my pain by 25% I would consider it a success. I am almost 2 months out from treatment and most days my neck does not even bother me at all!! It is so nice to be able to fall into bed at night and get comfortable on my pillow again. I highly recommend gua sha massage!

– Meg Watwood, Hewitt TX

What are the benefits of gua sha?

The benefits of gua sha are numerous. Dr. Arya Nielsen, who is considered to be the Western authority on gua sha, says it is good for “any chronic disorder involving pain or inflammation.” Gua sha resolves spasms and pain, increases range of motion, and promotes normal circulation to the muscles, connective tissues, and organs. A session of gua sha will often head off an oncoming common cold and can be a huge help in quieting a lingering cough. Research has shown that gua sha causes a four-fold increase in microcirculation of surface tissue, reduces inflammation, and stimulates the immune system. Gua sha also increases the activity of heme-oxygenase-1 (an enzyme that acts to reduce internal organ inflammation). The upregulation of HO-1 partially explains the benefit of gua sha for internal organ problems such as cough, asthma, hepatitis, and liver disease.

Are the marks from gua sha abrasions or bruises?

Although the area treated with gua sha looks like road rash, the skin surface is completely intact and there is no bleeding associated with the technique. The discoloration caused by gua sha is not a bruise. Bruising occurs when a blow or shear force damages capillaries and causes bleeding into the tissue. In contrast, during gua sha, blood cells are extravasated (or pressed) through the capillary walls without damage to the capillaries or the surrounding tissues. The area that is treated often feels a bit tender following gua sha (similar to a mild sunburn) but the overall result is immediate relief of pain and improvement in range of motion.

Image of skin after Gau Sha

What happens during and after gua sha?

When performing gua sha, the therapist uses a smooth-edged tool to repeatedly stroke the skin. Gua means “to rub” or “press stroke”. Sha is a term that describes the blood congestion in surface tissue in areas where the patient may experience stiffness and pain; sha is also the term for the little red dots that are raised from applying gua sha. The medical term for the red dots that gua sha causes is “petechiae”. These petechiae represent blood cells that have been pressed outside of capillaries (tiny blood vessels) as the practitioner repeatedly strokes the skin. The body begins the process of reabsorbing these blood cells immediately and it is this process of reabsorption, along with a dramatic increase in local circulation, that results in the anti-inflammatory, immune-stimulating, and pain-relieving benefits associated with gua sha.

What is the significance of the color of sha and how fast it fades?

The petechiae caused by gua sha range in color from fresh red to dark red, blue, or nearly black. When gua sha is applied at the site of a new or relatively acute problem, the petechiae are usually bright red. This is because the blood stuck in the connective tissue under the skin has not been there for long. In contrast, the petechiae that result when gua sha is applied to an area of chronic pain or injury are often bluish or even black. This is because the blood has been stagnant for an extended period. How quickly the petechiae fade following gua sha is also significant. In young people with healthy, vital circulatory systems, petechiae fade very quickly. If I perform gua sha on my children in the morning, the petechiae are often nearly gone by the end of the day. In contrast, in older individuals, individuals with sluggish circulation, or in cases of long-standing pain, the petechiae may take nearly a week to fade completely.

What does it look like?

Collection of images after Gua Sha at 24 and 48 hour marks

Self-care after gua sha

  • Until the appearance of your skin returns to normal, avoid exposing the treated area to drafts, direct sunlight, or extremes of temperature.
  • In cool or windy weather, wear a scarf to cover the treated area. Wear a shirt to cover the treated area at night.
  • Drink plenty of water in the three days following treatment.
  • Although the treated area often feels dramatically less painful and more flexible, be aware that the area is vulnerable to re-injury if it is overtaxed by vigorous activity in the days following treatment.

For the past ten years I have made frequent use of ear pellets, seeds, and tacks (also called auriculotherapy) to reinforce the effect of the acupuncture treatments I perform in my office. I have found this treatment to be of key importance in the long-term management of chronic pain in many of my patients.

Auriculotherapy has been in the news a lot lately, from Penelope Cruz being photographed at a recent event with tiny gold balls on acupuncture points in her ears, to the United States Air Force developing an auriculotherapy protocol called Battlefield Acupuncture that is being used to treat pain in troops in combat zones, to ear seeds receiving favorable coverage in the New York Times (below).

I have completed training with Richard C Niemtzow, M.D., PhD, MPH (inventor of Battlefield Acupuncture) and offer the complete Battlefield Acupuncture protocol using the same semi-permanent tacks that are used by the Air Force physicians. I also offer the ear pellet therapy described by my friend Jill Blakeway, L.Ac. on the Dr. Oz show below.

What is cupping?


How does cupping help?


What causes cupping marks?


Self-care after cupping


Cupping therapy in the news

On Your Marks for an Ancient Therapy Traditional Chinese Medicine Technique Uses Heated Glass Cups to Heal Ills What Caused Gwyneth’s Spots?

This treatment is extremely safe and uses 450 nm (calming blue) and 635 nm (stimulating red) cold lasers to stimulate acupoints. The really cool thing about this treatment is that recent research suggests that acupuncture meridians function like optical fibers or “light pipes” and transmit light energy throughout the body (this research is described in more detail below). Stimulating acupuncture points with lasers helps stimulate healing, reduce inflammation, stimulate the release of natural pain-relieving substances, and reinforce physiological balance.

Surprisingly effective

The treatment only takes a few moments and results that I have had to this point suggest that in many cases laser treatment is as effective as needle treatment. For instance my husband has severe chronic elbow pain as a result of nerve damage. His work is physically demanding and his pain is often quite intense in the evening and most nights he has a hard time falling asleep because of his pain. Last night I used my new lasers to treat him and he was snoring within minutes. He slept well last night and reports today that he feels unusually good!

Modern research shows similarities between acupuncture meridians and fiber optics

Some of the most interesting research about acupuncture is currently happening in Korea. A North Korean anatomist named Bonghan Kim discovered anatomical structures that correspond to acupuncture meridians in humans and other mammals in the early 1960’s. But, because he did not reveal the microscopic dye staining technique which he used to make these vessels visible, very few scientists were able to confirm his discovery. Then, in 2002, researchers in South Korea directed by Kwang-sup Soh began using modern micro-anatomical methods to reinvestigate these structures. At first this network of threadlike vessels was called the Bonghan System after Kim Bonghan. It has recently been renamed and is now known as the Primo Vascular System (PVS). The PVS consists of fine, threadlike structures that are found under the skin, inside of blood and lymphatic vessels, and also forming web-like networks on the surfaces of the internal organs. The Bonghan channels are filled with a circulating fluid that includes microcells containing DNA molecules which, like stem cells, are capable of regenerating damaged organs and tissues. Furthermore, the DNA in these microcells may be capable of emitting laser like coherent light called biophotons which would allow for the communication of incredible amounts of information at the speed of light. This biological fiber optic network would have the capacity to manage the organizational complexity of embryonic development and the ongoing repair and maintenance of our body that keeps us healthy in spite of demanding physical and emotional stresses. To learn more about this research, please click here.