Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20190050
Brazilian Journal of Pain
Review Article

Gua-sha: application and therapeutic results in musculoskeletal pain situations. Systematic review

Gha-sha: aplicação e seus resultados terapêuticos em condições dolorosas musculoesqueléticas. Revisão sistemática

Dérrick Patrick Artioli; Gladson Ricardo Flor Bertolini

Downloads: 2
Views: 1334

Abstract

BACKGROUND AND OBJECTIVES: Gua-sha is a Traditional Chinese Medicine technique, which consists of scraping the skin with a smooth and rounded edges object until the appearance of petechiae. Used domestically in Asia, it is described as capable of promoting the improvement of several conditions (e. g. respiratory, digestive, fever, and insomnia), such as painful conditions. However, there is a shortage of systematic reviews in this respect in Western literature, so this study aimed to analyze the common use of Gua-sha and the methodological quality of the studies.

CONTENTS: The PEDro, Pubmed, Scielo and LILACS Databases were consulted, searching for clinical trials with the following keywords and Boolean index: Gua-sha AND pain; Scraping therapy AND pain (English, Portuguese and Spanish). Thirty-two articles were pre-selected, but only six met the inclusion criteria (clinical trial, pain as one of the evaluation criteria, musculoskeletal pain). The disorders reported were related to the spine, with a mostly superior response or similar to the control group, being investigated in the short term (7-21 days). The studies methodological quality were considered moderate according to the PEDro scale.

CONCLUSION: Gua-sha is a simple, inexpensive alternative with short-term effects for the treatment of conditions involving the spine and surrounding areas, such as a single intervention or in combination. Its practice is already well referenced but requires studies of high methodological quality and analysis of its effects also in the appendicular skeleton.

Keywords

Chinese Traditional Medicine, Pain, Physical therapy modalities, Physical therapy speciality, Rehabilitation

Resumo

JUSTIFICATIVA E OBJETIVOS: Gua-sha é uma técnica da Medicina Tradicional Chinesa, que consiste em raspar a pele com objeto de bordas lisas e arredondadas até o surgimento de petéquias. De uso doméstico na Ásia, é descrita como capaz de promover a melhora de uma série de afecções (ex. respiratórias, digestivas, febre e insônia), como a de quadros dolorosos. Contudo, há escassez de revisões sistemáticas a esse respeito na literatura ocidental, assim o objetivo deste estudo foi analisar a aplicação usual de Gua-sha e a qualidade metodológica dos estudos.

CONTEÚDO: Foram consultadas as bases de dados PEDro, Pubmed, Scielo e LILACS, buscando por ensaios clínicos com as seguintes palavras chaves e índice booleano: Gua-sha AND pain; Scraping therapy AND pain (inglês, português e espanhol). Foram pré-selecionados 32 artigos, mas apenas 6 atenderam os critérios de inclusão (ensaio clínico, dor como um dos critérios de avaliação, quadros álgicos musculoesqueléticos). Os distúrbios registrados foram relacionados à coluna vertebral, com resposta superior em sua maioria ou semelhante ao grupo controle, sendo investigados em curto prazo (7-21 dias). A qualidade metodológica aponta para estudos moderados de acordo com a escala PEDro.

CONCLUSÃO: Gua-sha é uma alternativa simples, de baixo custo, com efeitos estudados em curto prazo para tratamento de afecções envolvendo a coluna vertebral e áreas próximas, como intervenção única ou em associação. Sua prática já se encontra bem retratada, porém necessitando de estudos de alta qualidade metodológica e análise de seus efeitos também no esqueleto apendicular.

Palavras-chave

Dor, Fisioterapia, Medicina Tradicional Chinesa, Modalidades de fisioterapia, Reabilitação

References

Yuen JWM, Tsang WWN, Tse SHM, Loo WTY, Chan ST, Wong DLY. 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;32:25-32.

Marion T, Cao K, Roman J. Gua Sha, or coining therapy. JAMA Dermatol. 2018;154(7):788.

Aprile A, Pomara C, Turillazzi E. Gua Sha a traditional Chinese healing technique that could mimick physical abuse: a potential issue with forensic implications. A case study. Forensic Sci Int. 2015;249:e19-20.

Ren Q, Yu X, Liao F, Chen X, Yan D, Nie H. Effects of Gua Sha therapy on perimenopausal syndrome: a systematic review and meta-analysis of randomized controlled trials. Complement Ther Clin Pract. 2018;31:268-77.

Lee MS, Choi T, Kim JI, Choi SM. Using Guasha to treat musculoskeletal pain: a systematic review of controlled clinical trials. Chin Med. 2010;5:5.

Verhagen AP, de Vet HC, de Bie RA, Kessels AG, Boers M, Bouter LM. The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. J Clin Epidemiol. 1998;51(12):1235-41.

Braun M, Schwickert M, Nielsen A, Brunnhuber S, Dobos G, Musial F. Effectiveness of traditional Chinese "gua-sha" therapy in patients with chronic neck pain: a randomized controlled trial. Pain Med. 2011;12(3):362-9.

Wang Y, Yang L, Yang J, Yang J, Liu Z, Chen F. Curative effect of scraping therapies on lumbar muscle strain. J Tradit Chin Med. 2013;33(4):455-60.

Lauche R, Wübbeling K, Lüdtke R, Cramer H, Choi KE, Rampp T. Randomized controlled pilot study: pain intensity and pressure pain thresholds in patients with neck and low back pain before and after traditional East Asian "gua sha" therapy. Am J Chin Med. 2012;40(5):905-17.

Xiao LM, Meng XP, Han ML, Yang JJ, Du SB, Zhang W. Controlled observation of clinical efficacy on cervical spondylosis of neck type treated with scraping and acupuncture. Zhongguo Zhen Jiu. 2014;34(8):751-4.

Wang LQ. Observation on therapeutic effects of scraping therapy and warming acupuncture-moxibustion on 50 cases of fasciitis of back muscles. Zhongguo Zhen Jiu. 2006;26(7):478-80.

French SD, Cameron M, Walker BF, Reggars JW, Esterman AJ. Superficial heat or cold for low back pain. Cochrane Database Syst Rev. 2006:CD004750.

Nielsen A, Kligler B, Koll BS. Safety protocols for gua sha (press-stroking) and baguan (cupping). Complement Ther Med. 2012;20(5):340-4.

Moghaddam BA. Immediate effects of Maitland mobilization and Mulligan techniques on flexion and extension range of motion in patients with chronic nonspecific low back pain: a randomized pilot study. J Mod Rehabil. 2017;11(2):127-32.

Lee KS, Lee JH. Effect of Maitland mobilization in cervical and thoracic spine and therapeutic exercise on functional impairment in individuals with chronic neck pain. J Phys Ther Sci. 2017;29(3):531-5.

Ju S. The effects of short-term lumbar stability cross taping on muscle strength of trunk extension and lumbar pain level in patients with chronic back. J Phys Ther Sci. 2017;29(10):1757-9.

Halski T, Ptaszkowski K, Slupska L, Paprocka-Borowicz M, Dymarek R, Taradaj J. Short-term effects of Kinesio taping and cross taping application in the treatment of latent upper trapezius trigger points: a prospective, single-blind, randomized, sham-controlled trial. Evid Based Complement Alternat Med. 2015;2015:191925.

Oosterhof J, Wilder-Smith OH, Oostendorp RA, Crul BJ. Different mechanisms for the short-term effects of real versus sham transcutaneous electrical nerve stimulation (TENS) in patients with chronic pain: a pilot study. J Pain Palliat Care Pharmacother. 2012;26(1):5-12.


Submitted date:
10/29/2018

Accepted date:
02/18/2019

5f24875a0e88253e03e56d7d brjp Articles

BrJP

Share this page
Page Sections