Gua sha may elicit a more long-lasting anti-inflammatory effect relative to hot pack treatment, leading to better pain relief and mobility in elderly patients with chronic low back pain (cLBP). In a pilot study, clinicians in Hong Kong randomised 12 elderly patients with non-specific cLBP to a single 15-minute session of either gua sha or hot pack treatment in a crossover design. Both interventions were shown to be effective, and no significant difference was observed between the two for any outcome measures until the one-week follow up period. At this time point, pain reduction (21-25 per cent versus 16-18 per cent) and disability improvement (45-52 per cent versus 39-42 per cent) were significantly greater in the gua sha group compared with the hot pack group. Decreasing trends were observed in salivary levels of the pro-inflammatory cytokine tumour necrosis factor-alpha (TNF-α) and the cytoprotective enzyme heme-oxygenase-1 (HO-1) following gua sha. In the gua sha group, improvement of physical disability was found to be strongly correlated with a decrease in salivary levels of TNF-α.

The effects of Gua sha on symptoms and inflammatory biomarkers associated with chronic low back pain: A randomized active-controlled crossover pilot study in elderly. Complement Ther Med. 2017 Jun;32:25-32.