Gua sha is a common method used in traditional Chinese medicine for health preservation. However, sometimes gua sha can be painful even if no sha (red marks or petechiae) appears. What could be the reason for this?
Why is Gua Sha Painful but No Sha Appears?
1. Insufficient Qi and Blood
If gua sha is painful but no sha appears, it may be due to insufficient Qi and blood in the body.
In traditional Chinese medicine, sha is seen as a manifestation of abundant Qi and blood. Sha is the result of toxins and waste materials filtered out from the blood and body fluids by the intensified Qi. Most people will have sha after treatment, but there are also some people who do not. According to Chinese medicine theory, this is due to insufficient Qi and blood in the body. The Qi and blood cannot fully fill the skin and subcutaneous tissues, so even if gua sha is performed forcefully and painfully, it is difficult to achieve the desired sha appearance.
2. Thick Fat Layer
Sometimes, if a person is too overweight or has a strong physique, gua sha may be painful but no sha appears.
This is because in some obese or muscular individuals, the excessive subcutaneous fat acts as a cushion, preventing the stimulation of yang Qi (excessive oil outside the capillaries). Therefore, even if gua sha is painful, no sha will appear.
3. Gua Sha performed too frequently
Some people may feel lighter after gua sha, so even if their body is healthy, they will continue to perform gua sha after the sha marks fade. In this case, because the previous few gua sha sessions have already eliminated the body's stasis toxins, the body does not produce many toxins in a short period of time. Therefore, even if gua sha is performed painfully, no sha will appear.
What to Do if Gua Sha is Painful but No Sha Appears
If gua sha is painful but no sha appears, be careful not to increase the force in order to produce sha. This may cause rupture of superficial blood vessels. Just follow the normal gua sha time and intensity, and scrape all areas gently. Because with correct gua sha technique, even without sha, it will not have any negative effects.
What Does Sha Appear Immediately After Light Scraping Indicate?
If sha appears immediately after light scraping, it indicates the presence of stasis toxins in the body.
"Sha" is the "stagnant impurities" in the meridians, commonly known as toxic sha. It hinders the circulation of Qi and blood, the exchange of nutrients and metabolic products, and causes tissue and organ damage. "Sha" is a harmful toxin that causes many diseases and accelerates aging in the body. It can also be said that stasis blood and pathological products separated from the microcirculation are called sha. If a healthy person undergoes gua sha and there is no sha, it usually manifests as reddened skin, local warmth, and a sense of lightness in the body. If sha appears immediately after light scraping, it indicates the presence of sha toxins in the body.
What Does Sha Appearing after Neck Gua Sha Indicate?
If sha appears after gua sha on the neck, it indicates possible lesions in adjacent tissues and organs, such as chronic pharyngitis, tonsils, bronchitis, etc.
Gua sha is guided by the theory of meridians and acupoints in traditional Chinese medicine. By using special gua sha tools and corresponding techniques, a certain medium is applied to the surface of the body, repeatedly scraping and rubbing, causing red papules or dark red bleeding points and other changes in the skin, known as "sha" appearance. The appearance of sha during gua sha indicates that local lesions have occurred.
What are the Precautions for Gua Sha?
1. Avoid Wind and Keep Warm during Gua Sha Treatment
During gua sha treatment, avoid wind and keep warm. When the room temperature is low, try to minimize exposure of the treated area. Do not perform gua sha near electric fans or in drafty areas during hot summer temperatures. When gua sha opens the skin pores and releases sweat, if exposed to wind and cold, the pathogenic factors can directly enter the body through the open pores, which not only affects the effectiveness of gua sha but can also cause new diseases due to wind and cold exposure.
2. Treat Only One Condition at a Time
During each treatment, the scraping time should not be too long, and the principle of treating only one condition at a time should be strictly followed. Large-scale gua sha treatment should not be performed continuously to protect the body's healthy Qi.
For each condition, select 1-2 specific scraping sites when applying the combination of meridian acupoints and holographic acupoints.
3. Drink a Cup of Hot Water after Gua Sha Treatment
During gua sha treatment, sweat pores open and pathogenic factors are eliminated, which consumes part of the body's fluid. After gua sha treatment, drink a cup of hot water to replenish the lost fluids and promote metabolism, accelerating the elimination of metabolic waste.
4. Pay Attention to the Timing of Bathing after Gua Sha
After gua sha treatment, to avoid exposure to wind and cold pathogens, the skin pores should be closed and return to normal before bathing, which generally takes about 3 hours. However, during bathing, if the body is not completely dry, gua sha can still be performed. During bathing, when the pores are slightly open, gua sha can be performed for a short time, which has a significant effect, but attention should be paid to keeping warm.
5. Pay Attention to the Direction of Gua Sha
Do not scrape back and forth. In principle, gua sha should be performed from top to bottom and from the inside to the outside. For the face, scrape from the inside to the outside; for the head, scrape from the top to the surroundings; for the neck, scrape from top to bottom; for the back and waist, scrape from top to bottom and from the inside to the outside; for the chest, scrape from the inside to the outside; for the abdomen, scrape from top to bottom; for the limbs, scrape from top to bottom. After scraping one area, move on to another area, do not scrape randomly.
6. Pay Attention to the Duration of Gua Sha
The scraping time for each area is 3-5 minutes; the scraping time for each area using supplementary scraping technique is 5-10 minutes. Typically, for each patient, 3-5 areas should be selected for scraping. For patients who do not produce sha or produce less sha, the appearance of sha spots or purpura on the skin is sufficient, and there is no need to forcefully produce sha.
7. Pay Attention to the Interval Time
Before the sha marks from the previous gua sha treatment have disappeared, gua sha should not be performed again in the same area. There should be an interval of 3-6 days between gua sha treatments, based on the disappearance of the sha marks on the skin. Typically, 3-5 treatments constitute one course.
Who Should Avoid Gua Sha?
1. Gua sha therapy in traditional Chinese medicine is not recommended for individuals with abscesses, ulcers, rashes, or unknown lumps on the skin surface, as it may cause infection and spread of the wounds. Gua sha therapy should be avoided in painful areas or fractured areas of acute sprains or injuries, as gua sha therapy can aggravate bleeding at the wound site.
2. Individuals with severe cardiovascular and cerebrovascular diseases, liver and kidney dysfunction, and overall edema should not undergo gua sha therapy. Gua sha therapy increases subcutaneous congestion and promotes blood circulation, which increases the burden on the heart, lungs, liver, and kidneys, exacerbating the condition.
3. Individuals with skin ulcers and other skin diseases should avoid gua sha therapy because gua sha involves scraping the superficial layer of the skin, which can easily cause rupture and infection, worsening the condition.
4. Individuals with hemophilia or leukemia: Due to the congestion caused by gua sha, individuals with low platelet count should exercise caution. Gua sha may be needed for areas with external injuries, such as arm abrasions, broken skin on the back, or leg fractures.
5. Gua sha is not recommended for pregnant women, especially on the abdomen, lumbar sacral area, etc., as it may cause miscarriage.
6. Individuals with lower limb varicose veins: It is best for this group of people to avoid gua sha. If gua sha is necessary, it should be done with caution. The scraping direction should be from bottom to top, and the technique should be as gentle as possible. Gua sha may cause local pain, and failure to avoid wind and cold after gua sha can lead to colds, etc.
