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Moxibustion: Acupuncture Without Needles

By Denise Cicuto

Acupuncture is about more than just needles. In fact, the Chinese word that typically gets translated as acupuncture, zhenjiǔ, actually means “acupuncture and moxibustion.”

So, what the heck is moxibustion?

Acupuncture goers may know moxibustion, or moxa, as the smoky-smelling stuff that sometimes appears during a treatment. More specifically, moxa is an herb—known as mugwort or Artemisia vulgaris—that gets burned on or near an acupuncture point.

Burned?! Stay with me. It’s not as scary as it sounds.

Moxa is a soothing addition to any acupuncture treatment, and it’s especially useful for patients who are not fans of needles.

At my acupuncture practice in San Francisco, I use moxa frequently with great success. I also get a lot of questions about this relatively unknown healing technique.

Here are answers to some of the most common questions about moxa.

Why do acupuncturists use moxa?

Acupuncturists use moxa to warm the body and to bring more qi and blood flow to an area. Moxa typically is applied to places where there is stuck energy or pain, or where the body feels cold. Moxa is used to strengthen the immune system as well.

Often, the placement of moxa coincides with acupuncture points, which is why moxa is said to enhance the effects of acupuncture needles. A classical Chinese text about acupuncture says, “When a disease fails to respond to medication and acupuncture, moxibustion is suggested.”

Does moxa hurt?

Moxa should not hurt. Before using moxa directly on the skin, acupuncturists apply a burn cream that prevents any pain or scarring. As the moxa burns down to the level of the cream, at worst, the patient may experience a mild mosquito-bite feeling.

There are also several forms of indirect moxa, which create a warming effect without ever coming in contact with the skin. For an example, an acupuncturist may hold a burning moxa stick around an acupuncture needle, raised a few inches from the skin. Or he may put some moxa on the handle of a needle and place a metal shield on the skin to catch any falling ashes.

If moxa ever feels too hot, tell your acupuncturist and he or she will remove it immediately. Either an acupuncturist or an assistant should stay with you in the treatment room whenever moxa is burning.

What does moxa look like?

There are many different types of moxa. There is loose moxa, moxa that has been molded into sticks, and okyu (moxa that’s rolled into small pieces about the size of a rice grain). There are also moxa boxes, moxa sticks, smokeless moxa sticks, tiger warmers, and “belly bowls” (see picture at right).

Certain moxa types are better suited for smaller areas (okyu, for example) while others, such as tiger warmers, are selected to bring heat to a larger area on the body.

Occasionally moxa is combined with another herb, such as ginger or garlic, to produce complementary effects. For example, to treat someone with a cold and achy stomach, an acupuncturist might place a slice of ginger over the patient’s navel and then burn some loose moxa on top of the ginger.

Is moxa always smoky?

Burning moxa can create smoke in the treatment room. Certain types of moxa are smokier than others, and some contain herbs that produce a pleasant smell. Some people enjoy this while others find it overpowering.

If you prefer a smoke-free treatment, tell your acupuncturist. He or she may be able to offer you smokeless moxa. There are also moxa ointments and self-warming moxa patches that produce no smoke. Many acupuncturists have these options available because some buildings do not permit the burning of smoke-producing moxa.

Can I do moxa on myself?

Yes. One of the safest ways to do moxa on yourself is to use a tiger warmer. A tiger warmer does not get applied directly to the skin. It is a metal device about the size of a pen that is held above the skin to produce a warming effect on the general area (see picture at right).

If you buy your own tiger warmer, instructions on the box will guide you through how to use it. If your acupuncturist sends you home with one, he or she will explain the process. In either case, it’s a good idea to get advice from an acupuncturist about where to apply the tiger warmer.

For example, a tiger warmer can be safely used on any of the acupuncture points in this article if you want to boost your immunity. An acupuncturist can provide additional point recommendations for immunity, chronic pain, and more.

Especially this time of year, when we’re still feeling the lingering chill of winter, a little moxa can go a long way.

Featured photo by Sara Calabro
Embedded photos by Denise Cicuto

Denise Cicuto is a licensed acupuncturist and Chinese herbalist who specializes in women’s health and immunity. Her private practice, Cicuto Acupuncture, has offices in San Francisco and Alameda, California. Read another article by Denise here.

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Joy Healey

That’s very interesting thanks. The thought of anything warming is comforting at this time of year!

Maruti Shanbhag

TCM believes more in prevention of the diseases than in a cure. Moxibustion is one technique used for prevention of diseases. To have good digestive system and the health people above 40 are recommended to moxa st36 every day and to prevent asthma in winter moxibustion is done during the summer. The protocol to prevent asthma is:
1. Moxa DU14 and BL13 (both sides) with 3 moxa cones and wait for ten days

2. Moxa DU12 and BL12 (both sides) with 3 moxa cones and wait for 10 days

3. Moxa St36 (both sides) with 3 moxa cones.

Using the above three treatments in 30 days time during the summer days one can prevent or reduce the possibility of asthma in winter.

Courtesy: TCM videos (1 to 30) by Chinese Medical Association.


[…] People with true needle phobias can ease into acupuncture with treatments that emphasize non-needling techniques such as acupressure, cupping and moxibustion. Again, Japanese acupuncture is a good option because it frequently incorporates moxibustion. […]

[…] Traditional Chinese acupuncture emphasizes strong stimulation of needles to achieve a “qi sensation.” In contrast, Western style is much gentler and less intrusive. There is a trust between the acupuncturist and patient that eventually leads to the body decreasing resistance and comfortably accepting treatment. There are also options for needle-less methods such as acupressure, cupping, and moxibustion. […]

Andrew Mulvenna

Having undergone a successful course of acupuncture for neck pain and relaxation, I have been fascinated by the process for some time. I am amazed at the range of ailments that acupuncture can be used to treat. I am also interested in the subject of non-needle therapy, acupressure etc. and I am curious to know what experienced practitioners make of electronic stimulation of acupoints and particularly the use stimulators that can be purchased online for home use.

I am in the process of developing a website that explores these techniques and devices.

kind regards Andrew Mulvenna

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