Gua Sha therapy reduces thoracolumbar fascia thickness and improves lumbar flexibility: A pilot randomized controlled trial

Abstract

Background: Chronic low back pain (LBP) is associated with changes in the thoracolumbar fascia (TLF) structure. Gua Sha is a traditional manual therapy that can relieve LBP, but there is a lack of clinical evidence on whether it can affect fascial properties. Objectives: To investigate the immediate effects of Gua Sha on TLF thickness and functional parameters in healthy adults. Methods: In this pilot randomized controlled trial, 24 healthy participants were randomly assigned to a Gua Sha group (n = 12) or a control group (n = 12). The intervention group received a single 15-minute Gua Sha session, while the control group rested in a prone position. Outcomes, including TLF thickness, tissue hardness, pressure pain threshold , skin temperature, and lumbar flexibility, were measured before and immediately after the intervention. Results: Compared to the control group, the Gua Sha group showed a significant reduction in bilateral TLF thickness (right: mean difference -0.40 mm, 95% CI -0.71 to -0.09, p = 0.017; left: -0.36 mm, 95% CI -0.68 to -0.05, p = 0.027). Significant improvements were also observed in skin temperature (p < 0.001), left-side pressure pain threshold (p <0.01), and lumbar flexibility (p <0.001). Tissue hardness slightly increased post-intervention, but not significantly. Conclusion: A single Gua Sha session reduced TLF thickness and enhanced lumbar flexibility in healthy adults, supporting its potential as a fascia-targeted intervention. Further studies in LBP populations are warranted.