Gua Sha & Cupping: How These Traditional Therapies Work — And Why They’re Still So Effective Today

Gua sha and cupping are two of the oldest hands-on therapies used in Traditional Chinese Medicine. While they’re often grouped together — and both can leave visible marks on the skin — they work in quite different ways and offer distinct physiological benefits. In this blog i'm going to discuss the physiological effects and also the Traditional understanding of these modalities.

What they share is a common goal:to improve circulation, reduce stagnation, support the immune system, and help the body heal itself more effectively.

Modern research is now helping us understand why these techniques have been used for thousands of years.

What Is Gua Sha?

Gua sha involves scraping the surface of the skin using a smooth-edged tool — traditionally jade, horn, or even a spoon. Many people are familiar with the gentler, facial gua sha using jade or quart rollers.- The clinical technique we use for injury and pain, creates small red or purple marks known as petechiae, caused by tiny amounts of blood moving into the surface tissues.

In Traditional Chinese Medicine, this is known as “Sha”, and it’s seen as a sign that stagnation — of blood, fluid, or energy — is being released.

Although it looks dramatic, gua sha is a controlled and therapeutic process that stimulates healing rather than causing harm.

What Is Cupping?

Cupping works in the opposite way to gua sha.

Instead of scraping across the skin, cups are applied to create suction, gently lifting the skin and underlying tissues upward. This creates a decompressive effect, drawing blood, fluids, and metabolic waste into the area.

Cupping is particularly useful for:

• Deep muscular tension

• Chronic pain

• Restricted fascia

• Respiratory or immune congestion

Where gua sha moves and clears, cupping lifts and releases.

How Both Therapies Improve Circulation & Reduce Inflammation

Both gua sha and cupping significantly increase local blood flow — but they do so in different ways.

With Gua Sha:

• Microcirculation increases rapidly

• Stagnant blood is broken down

• Oxygen and nutrients are delivered more efficiently

• Waste products are cleared more effectively

As the body processes the tiny amount of blood released under the skin, it produces substances such as carbon monoxide (CO) in very small, beneficial amounts. This process stimulates immune cells to release IL-10, an anti-inflammatory messenger that helps reduce pain and calm inflammation.

With Cupping:

• Blood is drawn into the tissues through suction

• Oxygenation improves

• Lymphatic drainage increases

• Tissue compression is reduced

Cupping also stimulates heme oxygenase-1 (HO-1) — a protective enzyme involved in:

• Reducing oxidative stress

• Regulating inflammation

• Supporting immune function

This is one reason cupping is often used during illness, fatigue, or recovery.

Pain Relief & Muscle Recovery

Both techniques are highly effective for pain, but through slightly different mechanisms.

Gua Sha:

• Increases circulation rapidly

• Reduces inflammatory signalling

• Relaxes tight muscle fibres

• Often provides immediate relief

  
  

Particularly useful for:

• Neck and shoulder tension

• Headaches

• Postural pain

• Chronic tightness

Cupping:

• Decompresses deep tissue

• Reduces nerve pressure

• Improves fascial mobility

• Releases long-standing tension

• 
  

Especially helpful for:

• Back pain

• Sports injuries

• Restricted movement

• Chronic muscular pain

Used together, they can be incredibly effective — gua sha mobilises tissue, while cupping allows it to release and reset.

What About the Marks?

Both treatments can leave visible marks, but they mean different things. It looks far worse than it feels!

Gua Sha Marks:

• Red or purple streaks

• Caused by increased circulation

• Fade within a few days

• Indicate stagnation being released

Cupping Marks:

• Circular marks

• Reflect depth of tissue congestion

• Usually fade within 3–7 day

• Not bruises or tissue damage

As circulation improves with treatment, these marks usually become lighter and fade more quickly.

The Bigger Picture: Why These Therapies Work So Well

Both gua sha and cupping stimulate the body’s own repair systems rather than forcing change.

They:

✔ Improve blood and lymph flow

✔ Reduce inflammation

✔ Support immune regulation

✔ Ease pain and tension

✔ Encourage tissue healing

✔ Restore movement and balance

This is why they’ve stood the test of time — and why they remain so effective alongside modern healthcare.

Final Thoughts

Gua sha and cupping are different tools with the same purpose:to restore flow, reduce stagnation, and help the body return to balance.

Gua sha works by moving and clearing.Cupping works by lifting and decompressing.

Together, they form a powerful combination for pain relief, immune support, and overall wellbeing.

If you're tempted - why not book in and try it out!