Moxa: The Warming Side of Acupuncture That Not Everyone Knows About
Most people think acupuncture is all about the needles. But sometimes, the thing that takes a treatment from good to great is something else entirely: moxa.
What Is It Actually?
Moxa is dried mugwort (Artemisia vulgaris) that gets burned during treatment. It creates this deep, penetrating warmth that's completely different from a heating pad or hot pack. The heat seems to sink in and spread through tissue in a way that other heat sources just don't.
A Bit of History
Moxa has been used in traditional medicine for thousands of years—there are references to it in texts dating back to around 500 BCE. It was often used alongside acupuncture or as a standalone treatment, especially in colder regions where warming therapies were particularly valued.
What's interesting is that different cultures developed similar warming therapies using local herbs, but mugwort became the standard because of its unique properties. It burns steadily, generates consistent heat, and contains compounds that seem to enhance its therapeutic effects.
How We Use It in Practice
I don't use moxa with every patient or every treatment. But when it's the right fit, it's incredible. The warming effect is one thing, but there's also this remarkable calming that happens. I'm not going to lie - I sometimes feel like I'm getting a contact high just from being in the room with it. It's that relaxing.
There are actually several different ways to apply moxa:
Direct Moxa: Small cones placed directly on the skin (with protective substance in between). This is traditional but rarely used in the US.
Indirect Moxa: Held near the skin without touching it.
Needle-top Moxa: Placed on the handle of an inserted acupuncture needle, sending warmth down into the point.
Moxa Sticks: Cigar-like sticks that can be held near treatment areas for broader warming. Sometimes we will send you home with one of these!
Smokeless Moxa: Modern varieties that produce less smoke while maintaining therapeutic effects.
Stick-on Moxa: Pre-made discs that adhere to the skin and generate heat when activated.
The Sensory Experience
Moxa has a distinct smell when it burns—earthy, herbaceous, and a bit like sage or incense. Some people find it immediately calming; others need a session or two to get used to it. It's never overwhelming in the treatment room, though I was always a little worried it might set off smoke alarms when I first started using it. (Spoiler: it hasn't, it's about the same as burning incense.)
As the moxa burns, you'll feel a gradually building warmth that's uniquely satisfying. It's not the sharp heat of a hot pack—it's deeper and more penetrating, like warmth that reaches places that have been cold for a long time.
When I Typically Use It
I reach for moxa in specific situations:
- Stubborn muscle tension that needles alone aren't fully releasing
- Cold conditions (especially chronically cold hands, feet, abdomen)
- Menstrual cramps (it works amazingly well for this)
- When someone needs deeper relaxation than they're getting from needles
- For certain digestive issues where warmth helps
The Breech Baby Connection
One of the most well-researched uses of moxa is actually for turning breech babies. There's a specific point on the outside corner of the little toe (Bladder 67) that, when warmed with moxa daily for 1-2 weeks around weeks 33-36 of pregnancy, has been shown to increase the chance of a baby turning from breech to head-down position.
I've seen this work numerous times with pregnant patients. It's not guaranteed, but the research shows it improves the odds significantly, and it's completely non-invasive.
Benefits Beyond Just Warmth
People notice different effects from moxa treatments:
- Pain relief that lasts longer
- Improved sleep that night
- Better digestion
- Mental clarity and focus
- A deeper sense of relaxation overall
Is It Right For Your Treatment?
Moxa isn't for everyone or every condition. I don't use it during most pregnancies (except for the specific breech treatment mentioned above), with fever, or on broken skin.
If you're curious whether it might help with what you're working on, just ask at your next appointment. I'm always happy to explain whether I think it would be beneficial for your specific situation.
What makes moxa special isn't that everyone needs it - it's that when it fits the situation, it can make a surprising difference in how your body responds to treatment. Sometimes it's that missing piece that helps everything else work better.
