Moxibustion is one of the less familiar techniques of Traditional Chinese Medicine (TCM), though it is as old as acupuncture and is often taught alongside it. The Chinese term usually translated as "acupuncture," zhenjiu, literally means "needle and moxibustion." This article explains what moxibustion is, how it has been used, what research has found, and what is known about its safety. It is an educational overview, not a recommendation for treatment.
What moxibustion is
Moxibustion involves burning dried mugwort (Artemisia), called moxa, on or near the skin. In indirect moxibustion, the most common form today, a stick of moxa is held a short distance above the skin, or a small cone is placed on a layer of ginger, salt or another material so that only warmth reaches the skin. Moxa may also be attached to the handle of an acupuncture needle. Direct moxibustion, where moxa burns on the skin itself, is used less often.
In TCM theory, moxibustion is described as warming the channels and supporting the flow of Qi and blood, and it was traditionally favoured for conditions described as "cold" or "deficient" patterns. That is a traditional framework, not a modern scientific explanation. How TCM identifies such patterns is covered in How Traditional Chinese Medicine Diagnoses Illness.
The best-known research question
The use of moxibustion that has received the most research attention is an unusual one: whether moxibustion at an acupuncture point on the little toe can help turn a baby in the breech position before birth. A Cochrane review has examined this question several times. Its 2012 version found that moxibustion alone did not clearly reduce the number of babies in a non-head-first position, though there was some evidence it might help when combined with other methods. The review's 2023 update concluded that moxibustion added to usual care probably reduces the number of breech babies at birth compared with usual care alone or sham moxibustion. The authors noted the difficulty of blinding participants to a hands-on treatment.
Research on moxibustion for other conditions exists but is mostly small, often from a single country, and of variable quality. As with acupuncture and cupping, designing a convincing placebo version is difficult. For context on how this kind of research is read, see What Does Research Say About Acupuncture?
Safety
Because it involves burning material near the skin, the main risk of moxibustion is burns. A 2014 systematic review of published case reports collected 64 cases of adverse events from six countries. Most were burns, along with infections and allergic reactions, and the review identified the distance between moxa and skin and the practitioner's skill as important factors. Moxa smoke can also be irritating for some people, which is one reason smokeless moxa sticks were developed. Anyone pregnant is advised to consult their midwife or physician before considering any such technique.
Why it endures
Moxibustion has been part of the same tradition as acupuncture for most of its history, and it remains part of TCM training today. The history of how acupuncture and its related techniques came to Canada is covered in A Short History of Acupuncture.
Sources
- Coyle ME, et al. Cephalic version by moxibustion for breech presentation. Cochrane Database of Systematic Reviews. 2012, Issue 5. CD003928.
- Cochrane. Moxibustion for turning a baby in breech position. Plain-language summary of the 2023 update.
- Safety of moxibustion: a systematic review of case reports. 2014. PubMed 24976851.