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Fresh Five: Cupping and Gua Sha, what are they and when to use them

Updated: Feb 10

Over the last year, I’ve gotten a lot of inquiries about cupping and gua sha, as modalities that have highlighted on various social media platforms.  To keep it short and sweet…YES, I use both of these techniques in my acupuncture treatments, in fact, I have used cupping, gua sha and Asian bodywork, exclusively, to great success for patients that are needle sensitive and/or phobic!


As an overview, both cupping and gua sha serve to break up myofascial adhesions in the body, which is basically a fancy way of saying these techniques untangle the knots in your tissue to increase movement and blood flow.  This will ultimately help increase range of motion and reduce pain in the areas of treatment.


Also, I've included a couple of videos on home routines for facial cupping and body cupping and gua sha for elbow pain at the end of the article. That said, here are my Fresh Five tips regarding Cupping and Gua Sha!

#1: Cups comes in various forms, shapes and sizes:

Glass Cups: these cups come in a number of sizes, are my preferred option (along with the fire cupping technique, described below) for body treatments, and ultimately are the easiest to clean and sanitize.  So, for clinical purposes, these are my go to option.  They are a bit harder to use if you don’t have proper training, however, so they may not be the best for home/self treatments. 

Bulb/Suction glass Cups: These are typically glass cups, with a plastic bulb that creates suction.  I use these frequently for my facial cupping treatments, and also for smaller body regions, where I am unable to get sufficient coverage over an area with the glass cup, or if the suction is too intense with the glass cup.

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Silicone Cups: these cups come in many different sizes and shapes and are typically used for facial cupping. I have not found these to be particularly useful in body treatments, even in the larger sizes, so I typically will use the bulb/glass cups instead of these. However, for particularly sensitive individuals and/or kiddos, these might be a great option.

#2: It’s all in the Techniques:

Fire Cupping vs suction: 

Fire cupping, back pain, natural pain management
Fire Cupping

I use primarily use Fire Cupping when doing body treatments in the clinic, which involves using cotton ball soaked in isopropyl alcohol to create a flame, then putting this cotton ball in the cup to create a vacuum. This will create the suction, which I can modify to the patient’s comfort level.

The alternative is using a bulb or pump to create suction.  While I do use this technique at times, particularly with my facial cupping or if I am doing home visits, I find this to be slightly less individualized, and the cups are a bit harder to sanitize.  That said, I LOVE these cups for home use for my patients, particularly for those dealing with tennis and/or golfer’s elbow. 

Moving vs stationary cupping

While many folks may be used to seeing those perfectly spherical bruises, (e.g. Michael Phelps, Olympics circa 2016), I often utilize a “moving cupping” technique, in which I create suction in the cups, and with the assistance of some form of oil or salve, I move the cups along the area of the body we are treating.  This essential acts as a myofascial release technique, similar, yet stronger, then skin rolling in massage. 

Alternatively, stationary cupping involves leaving the cups in one place for 5-10min at a time.  While I do employ this technique in particular circumstances, I find my patients generally respond much better to moving cupping, so that is my preferred method of treatment. 

#3: What the heck is Gua Sha (and how do you say it?!)

As an alternative myofascial release technique, I love gua sha.  Similar to “blading” or “Graston technique” gua sha utilizes a tool to scrape the surface of the skin and increase blood flow to the area of treatment. I often use an oil or salve, which I individualize to the person and the purpose of the treatment, to make the process a little more comfortable.

Gua sha, back pain, natural pain relief
Gua sha to upper back

There are many different techniques and tools to utilize for gua sha. These include different stone and/or metal tools, and shapes. For a quick and dirty option for a home body treatment tool, grab a rounded edge spaghetti sauce or baby food jar lid.  You can grip the lid with the lip under your finger tips and get going. Oh yeah, you pronounce it “gwah shah.” “Gua” as in guana fruit and “shah," as in Chaka Khan.

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#4: Go with the flow:

I like to go with the muscle fibers of the area on which you are working.  There are exceptions, but typically, you can google image the body area on which you want to work, and go with the lines they’ve sketched in.

#5: Cupping vs Gua Sha: 

This is very much an individualized decision, and definitely depends on the techniques employed.

I typically use both cupping and gua sha for facial treatments.  I typically prefer the middle size, bulb suction cups and the jade square tools for my facial treatments, but there are many varieties out there.  I hope to have a better overview of these options coming soon, but for now, here is a video to demonstrate how to use cups and gua sha for an at home facial! 

Body treatments:

Generally, most people respond well to both cupping and gua sha for body treatments, but this may depend on the specific complaint with which that person is dealing. That said, I like to describe cupping as creating space and gua sha as deep tissue pressure.  So, some folks just need a little more space (in their body treatments and in life), while others respond better to pressure. Basically, try them both and see what feels right to you! 


I love both cupping and gua sha for many of my patients, and I love that there are ways for folks to incorporate these modalities at home. Of course, if you're not gaining some relief or seeing results, you'll want to consult a licensed practitioner, to make sure your are using proper techniques and to rule out a more significant cause for your symptoms.

You can schedule a full cupping/bodywork consultation by booking online or calling/texting 231-492-0046.

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