The wellness practice involves scraping your skin with a coin, spoon, or stone until tiny red spots (called petechiae) appear. Petechiae indicate broken capillaries under the skin, and they are thought to have therapeutic effects, including promoting blood flow and circulation and potentially improving your body’s natural healing process. “Gua sha means ‘to scrape sand,’ and it was traditionally used in China to aid in the movement of ‘qi,’ or energy flow,” says Elizabeth Bahar Houshmand, MD, a board-certified dermatologist based in Dallas and a fellow of the American Academy of Dermatology. Traditional Chinese medicine practitioners believe that by stimulating petechiae and promoting energy flow, gua sha can alleviate symptoms of some diseases and other health complaints, per Johns Hopkins Medicine. But what does the research say? Read on to learn what benefits gua sha may offer.

1. May Help Relieve Chronic Pain

According to Houman Danesh, MD, director of integrative pain management at the Icahn School of Medicine at Mount Sinai in New York City, gua sha helps promote blood flow to the area being scraped, which can help reduce pain and stiffness. “It’s commonly used to get relief from tension headaches, neck and back pain, or swelling,” he says. In fact, many physical therapists use the Graston Technique, a method similar to gua sha, to reduce pain and improve mobility in people with musculoskeletal conditions. “So, if someone has adhesive capsulitis, also known as frozen shoulder, you could do gua sha on the shoulder to break down microscopic scar tissue or adhesions,” says Jeff Gould, a licensed acupuncture practitioner with the Johns Hopkins Integrative Medicine and Digestive Center in Lutherville, Maryland. Scraping mobilizes the tissue, boosts circulation, and flattens out muscle knots, improving range of motion and pain, he explains. For example, in a past study, adults with chronic neck pain who received a single gua sha treatment saw significant improvements in pain severity after one week, compared with those who used a heating pad. Whether gua sha is effective for long-term neck pain management needs to be studied further, however. Similarly, a randomized clinical trial published in 2019 in Complementary Therapies in Clinical Practice found that patients with chronic lower back pain reported less pain intensity and better overall health after two gua sha treatments, compared with the control group. However, more research is needed to confirm these results.

2. May Help Ease Perimenopause Symptoms

Perimenopause refers to the transition to menopause, or the time when women reach the end of their reproductive years, according to the Mayo Clinic. It often has physical symptoms, causing many women to experience hot flashes, sleep problems, and mood changes. While there are many different treatments available for menopausal symptoms, some women turn to complementary therapies like gua sha, under the guidance of a healthcare provider, to build an integrative approach to dealing with the perimenopause transition. In a study in China, published in 2017 in Menopause, women with perimenopause symptoms who received 15-minute gua sha treatments once a week, in addition to their conventional treatment, saw more significant improvements in symptoms and quality of life than women who didn’t. Specifically, the women in the gua sha group said that they experienced greater reductions in hot flashes, insomnia, fatigue, nervousness, and headache after eight weeks. More research is needed, but preliminary evidence suggests gua sha may serve as a promising, effective, nondrug treatment for perimenopausal syndrome in some women.

3. May Help Improve Diabetic Neuropathy

Diabetic neuropathy is a serious diabetes complication that may affect up to 50 percent of people with diabetes, according to the Mayo Clinic. It’s a type of nerve damage that occurs when high levels of blood sugar (glucose) injure nerves throughout the body. Diabetic neuropathy is commonly seen in the legs and feet, causing numbness and pain, and it can even cause problems in the digestive system, urinary tract, blood vessels, and heart, the Mayo Clinic notes. Gua sha may help by boosting circulation and enhancing nerve communication. In a randomized controlled trial in China, published in 2019 in Complementary Therapies in Clinical Practice, patients with diabetic neuropathy saw significant symptom improvements after 12 weekly gua sha sessions, compared with those who didn’t receive gua sha. Specifically, the patients said that they experienced improvements in sensory function, balance, nighttime burning sensations in the legs and feet, and plasma glucose levels (a common method of diagnosing and monitoring diabetes). Given that research is very limited, it’s likely best that you stick with your conventional diabetes and neurology care at this time, and consult your physician before trying gua sha as a complementary therapy.

4. May Boost Exercise Performance and Recovery

There is some evidence out of China that suggests that gua sha may improve exercise performance and speed up recovery afterward. In a study published in 2019 in the Journal of Traditional Chinese Medicine, researchers had 44 men receive gua sha, sham gua sha (no petechiae), or no gua sha, alongside their normal twice weekly weightlifting training. After eight weeks of therapy, the men who received gua sha reported less perceived effort in completing the snatch and clean and jerk exercise, compared with the other men, even though everyone used only 85 percent of their one-rep max (the maximum amount of weight they’re able to lift in a single repetition). Researchers postulated that gua sha may have helped promote faster muscle recovery, as the men weren’t limited by fatigue from past training sessions. These results echo findings from a study published in 2017 in the Journal of Traditional Chinese Medicine. However, larger studies are needed to confirm these results.

5. May Soothe Autoimmune Diseases

While the research is limited, gua sha may benefit people with autoimmune diseases. “You can use gua sha to reduce systemic inflammation, so I use it a lot on patients with autoimmune diseases, like lupus,” Gould says, describing his own anecdotal reports of caring for his patients. It may help lower inflammation and provide symptom relief when done on an ongoing basis, he says. Scraping the tissues promotes better circulation of blood and nutrients in the body, which can help lower inflammation. Stimulating petechiae is also thought to activate anti-inflammatory immune proteins known as cytokines, per a review published in 2021 in the Journal of Family Medicine and Primary Care. Keep in mind that gua sha is not a cure for autoimmune diseases, and that you should always consult with your primary healthcare provider first before trying any new complementary therapies. More research is still needed to understand how gua sha may help people with autoimmune diseases.