If you’ve spent any time researching Chinese medicine, you might have come across a therapy called moxibustion. In general, moxibustion doesn’t get as much press coverage as acupuncture or some Chinese herbal treatments, but this soothing technique has a wealth of health benefits – especially as an adjunct to regular acupuncture sessions.

It may be worth your while to find a clinic that offers moxibustion, particularly if you suffer from stubborn health problems. Huang Di Nei Jing Ling Shu, a Chinese medical text from around 100 BCE, states that “A disease that may not be treated by acupuncture may be treated by moxibustion.” Today, moxibustion is often used for those who have found no success with (or are too sensitive to) either drug treatments or acupuncture.

The following guide is intended to help you better understand moxibustion and its indications, so that you can make more informed decisions about your health care.

What is moxibustion?

There are so many different types of moxibustion that practitioners have many choices in the application and form of “moxa” used with patients. Moxibustion as a healing practice is as old as acupuncture itself; in fact, the Chinese word for acupuncture, zhenjiu, refers directly to this technique. Moxibustion is believed to have originated in China over 2,500 years ago, though it is likely that more rudimentary forms of moxibustion may actually predate acupuncture.

Like all traditional Chinese treatments, the goal of moxibustion is to bring the body into balance and ensure a consistent flow of qi. In this case, balance is achieved by the burning of moxa (ai ye in Chinese herbal medicine), or dried mugwort (artemesia vulgaris in Latin), close to or directly on the skin. This powerful medicinal herb has a long history in both China and the West, and is perhaps best known in America for its close association with the “witches” of Medieval Europe. This is because of its frequent use in folk remedies, particularly to ease stomach pain, menstrual irregularities, anxiety, and itchy skin.

Moxa is understood within a modern Western medical framework to be a natural diuretic, as well as a moderate stimulant. It is also an emmenagogue, which means that it can trigger an increase of blood flow to the pelvic area – especially the uterus. This is why it is often used to treat uterine cramps and scanty (light or absent) menstruation. It may also be indicated for breech babies (see: Who should consider moxibustion? below).

When used by a skilled practitioner of Chinese medicine, moxibustion can help stimulate sluggish, deficient or stagnated qi with the introduction of therapeutic heat. In so doing, it amplifies the healing effects of acupuncture and alleviates chronic stagnation.

Types of Moxibustion

Practitioners may use direct or indirect methods to administer a moxibustion treatment. There are benefits and drawbacks to both, and you may find that the modality you are offered will depend on the clinic’s and patient’s preference.

As the name suggests, direct moxibustion entails direct (or extremely close) contact with the skin. While a patient relaxes on the acupuncture table, a practitioner will ignite an incense stick to light the moxa “wool.” The herbal wool smolders, creating warmth, on the relevant acupoints, which vary depending upon the patient’s condition and other personal attributes.

In the US, practitioners often use indirect moxibustion, which is generally carried out in one of two different ways. In the first, the practitioner will hold the smoking end of a moxa stick very close to the skin, until the acupoint adequately warms. This signifies that blood and other vital fluids have been directed along the correct meridians, and can begin to heal the patient’s ailments. (Many modern clinics use slower-burning, smokeless moxa sticks, which may be a comfort if you’re concerned about smoke inhalation.) Indirect moxibustion may also be performed with a tiger warmer, or using something as a buffer between the stick and the skin, such as salt, aconite, or slices of ginger or garlic. This warms the body deeply.

Another indirect method is to wrap smaller balls of moxa around acupuncture needles and light them until smoking. The heat is driven down the needle shaft and into the acupuncture point, enhancing the effects of the needling. Usually, a ball of moxa wool will be placed on just one or two of the needles in each session. Many patients report a warm, soothing sensation during and even after a session of acu-moxibustion.

How does moxibustion work?

To date, there is no consensus on the exact mechanisms of moxibustion treatments. Some theorize that it works in a similar way to other heat-based therapies, like saunas, hot tubs, heat packs, and warming creams. Though most Westerners will be familiar with these treatments for localized pain, heat is a valuable ally in Chinese medicine to relieve more systemic, whole-body complaints.

Who should consider moxibustion?

Because fire (yang) is its central element, moxibustion is most often used to dispel cold stagnation (yin) and the conditions that arise as a result. Common problems from a Western medicine lens that may be loosely associated with cold stagnation include:

Gradually, Western medical research has begun to confirm that moxibustion effectively treats these ailments. In one placebo-controlled clinical trial, moxibustion was shown to be highly beneficial for those with osteoarthritis. At the end of the study, the researchers wrote this:

Moxibustion treatment is simple, easy to perform, and cost-effective. This modality is also more easily replicable than acupuncture, which is subject to variation caused by the different needling techniques of individual practitioners. Our findings suggest that traditional moxibustion is a safe, effective, and easy-to-use therapy that can be a useful adjunct to conventional medicine for alleviating pain and improving function in patients with osteoarthritis of the knee.

In another study, scientists used indirect moxibustion over two acupoints in 42 people with Hashimoto’s thyroiditis (autoimmune hypothyroidism). They found that the group that underwent moxa treatments in addition to taking prescription drugs had better thyroid function than the group that only took the drugs.

One of moxibustion’s most intriguing applications for women is its potential to turn breech babies (those that are upside down at term). About 90% of breech babies must be born via cesarean section, but most women would prefer to avoid this. Recent studies have shown that moxibustion, when combined with postural techniques and/or acupuncture, can turn babies over so that they are in a less dangerous position at birth. This may be because of moxibustion’s ability to stimulate uterine contractions that can gently turn breech babies around.

Final Thoughts

Like acupuncture, the healing properties of moxibustion have been supported by a good amount of clinical research to date. I believe that, with increased awareness of this ancient therapy, even more studies will soon be looking into its uses and mechanisms.

Moxibustion may be especially useful for people who have not seen adequate results with other treatments. It is therefore recommended for those who are still suffering from a variety of health issues after trying both conventional and alternative therapies. I often provide patients in my practice with moxa rolls and demonstrate how to treat themselves at home. Like with many traditional Chinese treatments, consistent, sustained application is key.

As always, I suggest looking for experienced practitioners of Chinese medicine who are willing to work with the wide array of modalities at their disposal, including moxibustion.