Warm-needle moxibustion (needle moxa)
What warm-needle moxibustion is, how moxa is attached to an acupuncture needle, which conditions systematic reviews have studied (osteoarthritis, back pain, osteoporosis, stroke spasticity, Alzheimer's) and the safety points.
Short answer: in warm-needle moxibustion, a small ball of moxa, or a short moxa tube, is attached to the handle of an acupuncture needle that has already been inserted. It is then lit so that warmth passes down the needle into the point [1]. In Japan the technique is called kyu to shin [1]. It is one of the most studied moxibustion methods for joint and back pain.
Warm-needle moxibustion is a practitioner technique involving acupuncture needles. It is not for self-treatment.
How it is done (as described in sources)
- An acupuncture needle is inserted at a point [1].
- Moxa is attached to the needle handle and ignited [1].
- The practitioner protects the skin below from falling ash and controls the heat; burns from falling embers are a recognised risk with burning moxa [2].
Trials also use charcoal moxa for this. A French breech trial heated the needle “with an igniting charcoal moxa stick” [3].
What systematic reviews report
| Condition | Source | Reported finding | Caveat |
|---|---|---|---|
| Osteoarthritis | Overview of reviews, 2023 [4] | More effective than control treatments | Low methodological quality of reviews |
| Osteoarthritis | Meta-analysis, 2022 [5] | “May have some distinct advantages” | Larger, well-designed RCTs needed |
| Knee osteoarthritis vs drugs | Meta-analysis, 2022 [6] | Better function and pain scores than oral drugs | Small trials |
| Lumbar disc herniation | Meta-analyses [7][8] | Better than acupuncture, manipulation and traction; similar to NSAIDs and electroacupuncture | High-quality RCTs still needed |
| Primary osteoporosis | Meta-analysis, 2018 [9] | May improve bone density and pain scores | All trials high risk of bias, low quality |
| Spasticity after stroke | Review, 2018 [10] | “Promising” | Not conclusive |
| Alzheimer’s disease | Review, 2022 [11] | Improved cognition and daily living scores | Nursing journal review; trial quality limits apply |
| Post-prostatectomy incontinence | Network meta-analysis, 2026 [12] | Among top-ranked options | Needs detailed RCTs |
Smokeless considerations
Clinics that use warm needles indoors face the same smoke issues as with any burning moxa. Charcoal moxa tubes reduce smoke [13], and ventilation is still recommended [14][15]. See Clinic ventilation for moxa.
Related pages
FAQ: related questions
What is warm-needle moxibustion?
An acupuncture technique in which a small ball or tube of moxa is fixed to the handle of an inserted needle and lit, so warmth passes down the needle into the point. Japanese practitioners call it kyu to shin.
Is warm-needle moxibustion done at home?
No. It involves inserted acupuncture needles and burning moxa above the skin and is performed by trained practitioners.
Sources for this page
- The Case for Moxibustion for Painful Syndromes: History; principles and rationale (PMC9491495). pmc.ncbi.nlm.nih.gov/articles/PMC9491495/
- Safety of Moxibustion: A Systematic Review of Case Reports (PMC4058265). pmc.ncbi.nlm.nih.gov/articles/PMC4058265/
- Coulon et al. Version of breech fetuses by moxibustion with acupuncture: a randomized controlled trial. Obstet Gynecol 2014. pubmed.ncbi.nlm.nih.gov/24901279/
- Jun et al. Warm needle acupuncture for osteoarthritis: An overview of systematic reviews and meta-analysis. Front Med (Lausanne) 2023. pubmed.ncbi.nlm.nih.gov/36999074/
- Jun et al. Warm needle acupuncture for osteoarthritis: A systematic review and meta-analysis. Phytomedicine 2022. pubmed.ncbi.nlm.nih.gov/36030745/
- Li et al. Comparison of Warming Needle Moxibustion and Drug Therapy for Treating Knee Osteoarthritis: A Systematic Review and Meta-analysis. Comput Math Methods Med 2022. pubmed.ncbi.nlm.nih.gov/35936371/
- Li et al. Efficacy of Warm Needle Moxibustion on Lumbar Disc Herniation: A Meta-Analysis. J Evid Based Complementary Altern Med 2016. pubmed.ncbi.nlm.nih.gov/26378088/
- Wang et al. Comparison of Needle-Warming Moxibustion and Other Physical Therapies for Lumbar Disc Herniation: A Meta-analysis. Comput Math Methods Med 2022. pubmed.ncbi.nlm.nih.gov/35936359/
- Luo et al. Warm needle acupuncture in primary osteoporosis management: a systematic review and meta-analysis. Acupunct Med 2018. pubmed.ncbi.nlm.nih.gov/29986901/
- Yang et al. Warm-needle moxibustion for spasticity after stroke: A systematic review of randomized controlled trials. Int J Nurs Stud 2018. pubmed.ncbi.nlm.nih.gov/29631145/
- Chen et al. Warming needle moxibustion for Alzheimer's disease: A systematic review of randomized controlled trials. Geriatr Nurs 2022. pubmed.ncbi.nlm.nih.gov/34953330/
- Tang et al. Comparative efficacy and safety of acupuncture and moxibustion in the treatment of postprostatectomy urinary incontinence: A systematic review and network meta-analysis. Medicine (Baltimore) 2026. pubmed.ncbi.nlm.nih.gov/41559977/
- Study of the Density of Smoke and Harmful Gases of Adhesive Indirect Moxibustion (J Korean Med 2012). jkom.org/upload/33-1-4.pdf
- Controlling Indoor Air Pollution from Moxibustion (IJERPH 2016). www.mdpi.com/1660-4601/13/6/612
- Moxa Smoke and the Need for Ventilation or Filtration (CCAOM position paper). www.ccahm.org/images/ccaom/Documents/Position-Papers/Moxa-Be
Last reviewed: . Editorial note: this guide re-edits published sources; it does not provide medical advice or new research.
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