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Gua sha for Covid-19: A Chinese Medicine Approach to Covid Symptoms

Few people are aware that Gua sha has been used to treat some of the symptoms of the effects of Covid-19 in China. In this episode, Clive explains how it is being used in hospitals in China and details the protocol used and also gives you a plan of treatment to use at home from one of China's experts in Gua sha.

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Episode Transcript

How is Gua sha being used in the Coronavirus pandemic?

Hello and welcome to episode 13 of the Gua sha Show and this week we’re looking at how the aftermath of Coronavirus has been treated using Gua sha in China and advice by one of China’s experts on treating yourself and your family at home. This is something that it would seem not many people know about but Gua sha has been used in hospitals right from the beginning of the pandemic and is commonly used in the treatment and prevention of what can be termed long Covid-type symptoms. These are the lingering symptoms after some people has had COVID-19.

Understanding Long COVID and its Symptoms

According the the Centers of Disease control and prevention in the US, long COVID is a term to describe a range of symptoms that can last weeks or months after first being infected with the virus that causes COVID-19. It might even appear weeks after infection even if mild and even if you had no symptoms. Some of the symptoms reported are:

  • Tiredness or fatigue

  • Difficulty thinking or concentrating

  • Headache

  • Loss of smell or taste

  • Dizziness on standing

  • Heart palpitations

  • Chest pain

  • Difficulty breathing or shortness of breath

  • Cough

  • Joint or muscle pain

  • Depression or anxiety

  • Fever

  • Symptoms that get worse after physical or mental activities

Gua sha: A Traditional Approach to Treating Long COVID

I normally stay away from talking about Coronavirus because it’s an area which is constantly changing and there are just too many ‘experts’ out there. But I thought it would be interesting for you to hear how Gua sha is being used. And as was made plainly clear by Hu Guangqin, Chairman of the World Federation of Chinese Medicine Societies' Sha Therapy and Cupping Therapy Professional Committee, who is one of the Gua sha experts drafted in to create a standardized Gua sha treatment in light of the pandemic, people at home can learn a simple form of Gua sha treatment to relieve symptoms of physical discomfort and enhance immunity. Like I always do, she advises that if you don't have special equipment, use tableware - small plates or Chinese soup spoons which you can find at home. There’s nothing fancy about Gua sha!

So while Dr.Guangqin rightly believes that in terms of Gua sha it’s best to treat yourself under the guidance of a professional who can provide a treatment plan based on diagnostic principles and signs and symptoms for people to do at home, here is some of her generalized advice:

How to Perform Gua sha at Home for Covid Relief

  1. Start by scraping the back. She advises to mainly to focus on the acupoints of the bladder channel and the Du channels, and also the liver channels of the flank on both sides of your body. Now for anyone who doesn’t know where the bladder and Du channels are, it’s not very complicated. She’s referring to 3 lines down the back. One is from an acupoint called Du-16 which is just under your occiput bone, the bony protuberance of your skull at the top of the back of your neck. So feel the back of your head, find the protuberance and let your hand drop into the natural dip. So you start there. And you scrape all the way down the midline to your lower back. This is called the Du channel and it’s basically following the spine. And then the bladder channel is around three finder widths out from this line either side of the spine in the muscle. So three lines. One on the spine and one either side. Scrape each as you would normally scrape the back. Short scrapes about a hand width in length with a downwards direction. I’m presuming you know how to do this, if you don’t, go find out. I’ve got a lot of material. So do around 30 strokes in each channel at a frequency of 3-5 times a second. Which is actually quite fast. Just try that with a tool. Try and scrape with 3 strokes every second. Do it for 5 seconds and I’ll count you down so you can feel how long the seconds are. Dr.Guangqin maintains that this regulates the internal organs, maintains sufficient energy, enhances the body's defense capabilities, and relieves symptoms such as fatigue, fever, and cough. Note that sha may come to the surface but if the person is weak then it may not and it’s not a good idea to try to use more force to elicit it. And this basic scraping technique for your back is actually part of the main set of techniques used in hospitals to treat people after COVID-19. Except that the treatment is longer with 30-60 times at a frequency of 60 strokes a minute. And also the acupoints are specified telling you exactly from where to where.

  2. So the second part of Dr.Guangqin’s home care advice is to scrape the yang channels on the outer side of the limbs and the yin channels on the inner side. So anyone who follows what I do would know this already. And again there’s nothing complicated in this. Lift your arms to your side and twist your hands so that your palms face the front. Everything on the front of the arm is yin and everything at the back is yang. Scrape down the yin and up the yang. Again about 30 times in each channel. The frequency of scraping the yang channels is 3 to 5 times/sec, and the inner yin channel is 1 to 3 times/sec. So the yin is slower. Treatment should be with no pain and no sha and it can be 1-2 times a day. The tool is not shared and is cleaned and disinfected after each use. So what this does is maintains the twelve channels, veins, collaterals, and tendons to circulate the whole body qi and blood, connect the organs and limbs, communicate smoothly between the upper and lower internal and external channels, and relieve the symptoms of fatigue in your limbs.

Gua sha in Hospitals: A Standardized Treatment for Post-Covid Symptoms

So I mentioned about hospital treatment and what has happened is that in order to standardize Gua sha treatment, the World Federation of Chinese Medicine Societies' Gu Sha therapy and cupping therapy professional committee asked experts from 10 of the leading bodies in China for their contributions in how to treat. This included the universities of Tianjin, Hubei , Changchun, Hebei, Beijing, Heilongjiang and also Hong Kong Academy of Chinese Medicine and Technology.

And what at least some of them have been using is to strategize treatments according to diagnoistic principles.

Case Study: Gua sha for Improving Symptoms in Covid Recovering Patients

Let’s start with Dr. Zhang Yangpu and the Department of Rehabilitation Medicine of Hubei Hospital of Integrated Traditional Chinese and Western Medicine, who has led a team using Gua Sha to improve the symptoms of chest tightness, palpitation, wheezing, and coughing in patients recovering from Coronavirus. 

1. Treat the lungs

1.Lung channel is scraped at, medium intensity, the speed is 60 times/min, 30-60 times, requiring Sha;

2.heavy scraping and rubbing at Chize or Lung 5 and Lung 7, 30-60 times in the up and down direction. Frequency 1 to 3 times/sec. Do not force Sha.

2. Invigorate Yang Qi. Treat fatigue.


Step 1: First scrape and rub the hairline Du 16, 30 times, follow the Du Channel from Du 16 to the end of the tailbone 30-60 times, medium intensity, frequency 60 times/min.

The second step: scrape along the first side line of the bladder channel on both sides of the back from Bl 10 to Bl 54. 30-50 times on the left and right, medium intensity, frequency 60 times/min, people with severe Qi deficiency may not produce sha or faint sha, and do not force sha.


On Renmai, take Ren 17 as the center and take about 10cm in length for 3 minutes, moderate intensity, and speed 60 times/min. Sha is required for the first scraping test, but Sha is not forced for follow-up treatment.

3. Lung-spleen-qi deficiency syndrome: shortness of breath, fatigue, anorexia, nausea, fullness, weak stool, loose stools. 

  • To invigorate qi and invigorate the spleen/pancreas, scrape around St-36 in the lower limb (an areas of 10cm in length along the stomach channel) for 3 minutes, light intensity, speed 30 times/min. 

  • Regulate the intestines, benefit the lungs and invigorate the spleen/pancreas by scraping the large intestine channel, at medium intensity, with a speed of 60 times/min, 30-60 times, not forced to find sha.

4. Deficiency of Qi and Yin: fatigue, shortness of breath, dry mouth, thirst, palpitations, excessive sweating, poor appetite, low or no fever, dry cough and less phlegm. 

Scrape at KD-3 (an area of 10cm in length with KD-3 at the center) for 3 minutes, with light intensity, 30 times/min, not forced to find sha.

Treatment once every 2 days, a total of 2-3 times.

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