Gua Sha for Fibromyalgia
by Bob Flaws
Fibromyalgia can be a very difficult and frustrating condition to treat. Sometime, regular acupuncture can even make the symptoms of body pain worse. On pages 108-109 of issue #7, 2008 of Si Chuan Zhong Yi (Sichuan Chinese Medicine), Tang Su-min et al. published an article titled “Clinical Research on the Treatment of Fibromyalgia Syndrome with Guasha.” This study was a randomly divided two-wing comparison study in which some of the patients got regular fine-needle acupuncture at standard acupoints while other received guasha. Altogether, there were 120 confirmed cases of FMS who were 25-45 years of age enrolled in this study which was carried on from July 2005 to November 2007. Diagnostic criteria consisted of the American Rheumatological Society’s 1990 three-fold criteria, including at least 11 out of 18 specific trigger points sore to the touch. Twenty-eight of these patients were male and 92 were female. Their average age was 34.5 years. These 120 patients were randomly divided into two groups of 60 cases each. In terms of sex, age, disease duration, and number of trigger points, they were comparable for the purposes of this study. While the acupuncture group were treated once per day for 15 days with 30 minute needle retention per treatment, the guasha group was guashaed along the inner and outer tai yang bladder channel and Hua Tuo paravertebral points on the upper and low back. This was done once every three days for a total of five treatments (also over 15 days).
Outcomes were assessed via a visual analog scale (VAS) for pain that was administered before and after treatment and then compared for changes. In the guasha group, 29 out of 60 cases were cured, 16 got a marked effect, 10 got some effect, and eight got no effect, for a total effectiveness rate of 92.6%. In the acupuncture group, 10 cases were cured, eight got a marked effect, 12 got some effect, and 20 got no effect, for a total effectiveness rate of 66.6%. On six-month follow-up, six of the 45 cases who were either cured or got a marked effect in the guasha group had relapsed for a relapse rate of 13.3% In the acupuncture group, of the 18 cases who had either been cured or experienced a marked effect, 10 relapsed for a relapse rate of 55.5%. Therefore, the guasha appeared to be considerably more effective than the fine-needle acupuncture.
In their closing discussion, the Chinese authors state that guasha quickens the blood and transform stasis, dispels stasis and engenders the new. In other words, by quickening the blood and eliminating blood stasis, new or live blood is engendered. Personally, I find this interesting because the Chinese medical pattern discrimination of the pain at specific trigger points which is a defining characteristic of FMS is nothing other than blood stasis in the network vessels. In Chinese acupuncture, it is said that the fine needle treats diseases in the channels but not diseases in the network vessels. Guasha, on the other hand, does. Static blood hinders the engenderment of new or live blood. Since the blood is the mother of the qi, blood stasis can cause and/or aggravate qi and blood vacuity. Thus guasha not only eliminates the body pain but can also indirectly relieve the fatigue, lack of strength, and insomnia associated with qi and blood vacuity common in FMS sufferers. As the authors also note, guasha is not associated with fear of needles, does not cut or injure, is not painful, and has no adverse reactions. Its technique is simple and easy to do, and, therefore, they believe it merits broader application in the treatment of FMS.
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