Feeling sick? Maybe your back needs a scraping

Posted Sept. 26, 2012, at 8:56 a.m.

When Jason Hamacher and Jennifer Luu’s daughter was born in May 2010, things didn’t go exactly as planned. Luu had to opt for a Caesarean section rather than the natural delivery she’d hoped for; Hamacher had a wicked cold that quickly worsened.

“My head congestion turned into sinus infection and then into chaos” when combined with the challenges of newborn care, Hamacher says. Sleep proved elusive for father, mother and child. “I was horribly sick, and there’s an infant, and I’m super-exhausted.” Hamacher was so wrung out he often found himself lying on the floor of the nursery.

That’s when Buu Tran, Hamacher’s mother-in-law, made an unusual proposition: She would scrape his back with a kitchen spoon. It’s a technique that she learned as a child growing up in Asia. Tran, an ethnic Chinese, emigrated to the United States from Vietnam in 1977.

“It’s going to feel like you’re bleeding, but you won’t be bleeding,” Hamacher remembers Luu explaining. Tran scraped his back with a spoon for about 30 minutes, then gave him some chrysanthemum tea.

“Did it cure my sinus infection? No,” Hamacher says. “Did my overall well-being feel better? Yes . . . the all-encompassing sickness feeling left immediately.”

Hamacher had undergone gua sha [pronounced "gwah sah"], an East Asian home remedy for respiratory problems and other ailments. Often called “scraping,” the technique is beginning to find fans in the West.

Like most alternative therapies, gua sha has not been subjected to extensive scientific studies. One small study, published last year in the journal Pain Medicine, found short-term benefits for chronic neck pain when compared to a thermal heating pad.

Leslie Fazio, a physical therapist at the MedStar National Rehabilitation Network location in Arlington, Va., first heard of gua sha from a co-worker and incorporated the technique into her practice. She now uses it to treat back pain, muscle problems in the leg, such as Achilles tendinitis, and foot problems such as plantar fasciitis. She notes that for patients, the practice isn’t necessarily pleasant.

“It can be uncomfortable,” Fazio says.

Like massage therapists, gua sha practitioners palpate their patients to find areas that feel tight. They then rub them with a spoon or similar tool until they turn red. “Essentially, you are scraping the restriction in their skin,” Fazio says.

Where to scrape tight muscles is obvious; where to scrape for other ailments is decided by traditions that associate different organs with specific parts of the body.

Some patients turn to gua sha with a “why not?” attitude.

Brian Lowit, 37, a manager at a record label in Arlington, says he has had back pain for more than two decades. He tried gua sha last year as part of a regimen that included massage, visits to a chiropractor and structural integration, another alternative therapy that manipulates the body’s connective tissues.

Lowit estimates that Fazio treated him with gua sha about five times in one month.

“I’m skeptical of a lot of stuff,” Lowit says. “I’ll try whatever, but in the end I’m like, ‘Why would this work?’ ” But he was pleasantly surprised.

In photos taken after the first treatment, Lowit’s back looks as though he has fallen backward into a pool off a high diving board: The skin is totally red, with scrapes and welts showing, especially in areas where he had complained of tingling that he felt was caused by poor circulation and muscle stiffness.

After a few days, the redness faded. Photos taken after subsequent treatments make his back look much less painful. “As you break up restrictions, you get less of the reaction,” says Fazio, who compares gua sha to taking a crayon impression of a leaf on wax paper. Just as the toughest parts of the leaf are darkest on the wax paper, the most constricted muscles turn the deepest red during scraping. When trying to figure out where to apply pressure, Fazio says, “it shows you itself.”

“At first, I thought, ‘Should I do this every week for the rest of my life?’ ” Lowit says. “I was scared to stop.”

Researchers at the University of Duisburg-Essen teaching hospital in Germany designed a randomized clinical trial in which some patients with chronic mechanical neck pain received gua sha while a control group was treated with heating pads to the neck.

The study concluded that “neck pain severity after one week improved significantly in the gua sha group compared to the control group. Significant treatment effects were also found for pain at motion,” and their quality of life improved, the study said.

It added that “the value of gua sha in the long-term management of neck pain and related mechanisms remains to be clarified.”

On her Web site, Arya Nielsen, director of acupuncture in the Department of Integrative Medicine at the Beth Israel Medical Center in New York, makes sweeping claims about the prevention and treatment abilities of gua sha. In a telephone interview, she said she believes that gua sha is a promising treatment for neck pain and mastitis, the breast engorgement that affects some breast-feeding mothers.

Nielsen, who has written one of the few books in English on gua sha, explains that the therapy intentionally raises transitory therapeutic petechiae, or minor hemorrhages from broken blood vessels. She says the scraping, which she calls “instrument-assisted unidirectional press stroking,” stimulates an anti-inflammatory and immune response.

“Because the petechiae look alarming, gua sha has kind of suffered from misconceptions in the West,” Nielsen says. “Asian immigrants had some amount of reticence showing what they were doing in their medicine.”

“Gua sha doesn’t hurt,” says Benjamin Kligler, the research director of integrative medicine at Beth Israel. Kligler says that gua sha works by stimulating the immune system and that scraping the back can help alleviate conditions that aren’t related to back pain.

“It could not be used to replace the antibiotic,” he wrote in an e-mail. But “gua sha may stimulate the body’s own immune response, which in turn could help fight the infection, making the antibiotic more effective.”

While Kligler isn’t aware of another hospital in the country offering gua sha, he estimated that hundreds of acupuncturists in New York are doing so. Though it’s routinely taught at Eastern medicine institutions, there’s no gua sha licensure or certification. Indeed, asking someone who grew up with gua sha about the practice is surreal — a bit like asking a grandmother how she figured out that you’re supposed to drink ginger ale when you have a stomachache.

“It’s like a culture — we don’t learn it,” says Tran, Jennifer Luu’s mother. (Her daughter served as an interpreter during an interview with an English-speaking reporter.) “We saw the parents do it in the family. . . . When you are sick or tired, that’s what we use.” The materials for the treatment — a spoon and, to lubricate it, a bit of gin or white flower oil.

Tran’s explanation of how gua sha works is simple if unscientific. “When you get sick, the sickness inside your body can’t get out,” Tran says. Gua sha’s strokes let the sickness escape, she says. Though Hamacher and Luu likely won’t take a spoon to their child’s back when she gets sick, they don’t have a problem with her grandmother’s treatment.

Says Hamacher: “It would be the same if you were at a Jewish person’s house and they were like, ‘Do you want some matzo ball soup?’ “

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