TCM Therapies Explained: Acupuncture, Cupping, Gua Sha and More

Outside China, people usually meet TCM therapies one at a time: acupuncture at one clinic, cupping at a spa, a gua sha stone in a skincare routine. In a Chinese TCM hospital they are combined by one doctor. One patient living in China tried that after a fall down the stairs left him in pain that ordinary painkillers had not touched.

Here is what each therapy is, followed by the questions people most often ask about acupuncture, gua sha, acupressure and qigong.

Is acupuncture more effective than dry needling for pain?

Neither is reliably better for everyone. Both use the same fine, solid needle, but they rest on different reasoning, and people respond differently to each.

Dry needling, usually done by physiotherapists, puts the needle into a tight, tender knot in a muscle, often moving it in and out to release it, and treats mainly the painful spot. Acupuncture, as practised in TCM, chooses points according to your overall pattern, so it may include points far from where it hurts, and the needles usually stay in place while you rest.

In Chinese hospitals, acupuncture for pain is commonly given as a course of sessions close together, often daily or every other day, and is frequently combined in the same visit with electro-acupuncture, moxibustion, cupping or tui na. A routine session at a Fujian provincial public hospital is listed at CNY 70 (≈ USD 10) (2025 price list), which is why a daily course is realistic.

The TCM view is that the same pain can come from different patterns. Low back pain that eases with warmth is read as a cold pattern and may be treated with moxibustion; pain after a strain is read as stagnation and may be treated with needling and cupping over the area. That is why two people with similar pain may get quite different treatment.

Experiences really do vary, as this patient found.

So the honest answer is to try what is available and judge it over several sessions. In China, acupuncture is used alongside medical care rather than instead of it. New, severe or unexplained pain should be diagnosed first, and anyone on blood thinners, with a pacemaker or who is pregnant should say so before needling starts.

What should you put on the skin before gua sha?

Use something that lets the tool glide rather than drag: a face oil, balm or rich serum for the face, and an oil or ointment for the body.

In a TCM clinic, body gua sha on the back, neck or shoulders uses oil or a medicated ointment and firm strokes until faint red speckles, called sha, appear; these fade over several days. Facial gua sha is a much lighter beauty practice. Any non-irritating oil works, and if you are prone to clogged pores or milia, a lighter, non-comedogenic oil or serum is a sensible choice. Doing it on dry skin tends to pull and irritate.

Keep the tool flat, use light pressure on the face, and avoid broken skin, rashes, active breakouts, sunburn and fresh injuries. People who bruise easily or take blood thinners should keep pressure light and ask a doctor first.

Does facial gua sha lift the face?

Do not expect facial gua sha to lift or contour the face the way a cosmetic procedure does. What people commonly notice is less puffiness and a more relaxed jaw and face for a while afterwards, and that effect fades.

In China, facial gua sha is mostly a beauty-salon and home practice. In a TCM hospital, gua sha is used on the body for tension and stiffness, and the doctor decides whether it suits your pattern. In TCM terms, it is meant to move stagnation and release heat from the surface, which is why it is often paired with other treatment rather than used as a stand-alone fix.

Results differ from person to person. If facial tightness comes with jaw pain, headaches or clenching, it is worth getting that assessed by a doctor or dentist rather than relying on a stone tool.

What are the main acupressure points, and can you use them at home?

A handful of points are widely taught for self-massage, and pressing them gently at home is low-risk, but it supports rather than replaces medical treatment.

• Hegu (LI4): the fleshy web between thumb and index finger, traditionally used for headache and tension. It is traditionally avoided in pregnancy.
• Zusanli (ST36): below the kneecap, just outside the shin bone, traditionally used for tiredness and digestion.
• Neiguan (PC6): on the inner forearm, a short way above the wrist crease, traditionally used for nausea.
• Taichong (LR3): on the top of the foot between the first and second toes, traditionally used for tension and irritability.
• Chengshan (BL57): in the middle of the back of the calf, traditionally used for leg cramps.

In China, tui na doctors press these and many other points during treatment, and patients are often shown a few to work on at home between visits. TCM chooses points by pattern, so the best ones for you depend on how a doctor reads you. Press firmly but comfortably, without bruising. For high blood pressure, diabetes or numbness in the feet, acupressure is not a substitute for your medicines or for checks with your doctor.

Can qigong help with chronic pain, and how often should you practise?

Many people with chronic pain use qigong as gentle, regular movement alongside their other care, and the usual advice is little and often: a short session most days rather than a long one once a week.

In China, you will see people practising Baduanjin, the "eight pieces of brocade", and tai chi in parks in the early morning. These are slow sequences of movement, posture and breathing that can be learned in a few sessions and kept up at home. Beginners usually start with a few minutes a day and build up slowly. In TCM terms, qigong keeps qi and blood moving, which is why it is used for stiffness and pain from stagnation.

Benefits differ between people, and qigong does not replace a diagnosis. Stop any movement that causes sharp pain, and if you have sciatica, nerve pain or a recent injury, ask a doctor or physiotherapist which movements to avoid.