What's that Moxa smell all about?

Moxibustion, or moxa as it’s commonly know is a herbal therapy used in Chinese medicine, often alongside acupuncture, where the herb is burned to warm acupuncture points.

There are several types of moxa, and two main uses known as direct and indirect Moxa. Although Moxa smells similar to marijuana when it’s burning, there is no similarity in its effects or properties of the herbs! Lots of people have made comment over the years entering our clinic and shopfront that "oh someone is toking up back there" as I'm sure many other TCM practitioners would have been confronted with these comments too.

The most common types of moxa used are the needle-head moxa, Japanese moxa cones (stick-on moxa) and Moxa sticks.

When Moxa is in it’s natural state, it looks like a pile of green herbal fluff – known as “moxa punk”. The punk can be condensed into sticks, cones or the rougher grades of moxa punkare used in baths or externally applied.

Moxa sticks are most commonly used by practitioners – holding them over points, or the sticks can be put into a moxa box and applied to the acupuncture points.  Parts of the sticks can be used on the needles, known as needle-head moxa.

Moxa can be used as the whole or part of the treatment in many conditions. It’s particularly useful when cold has invaded into the body. A common example is cold-obstruction type arthritis. Moxibustion is used routinely in China for knee pain. Several studies on osteoarthritis of the knee have been done, although small sample sizes and other inconsistencies make it hard to draw definitive conclusions using a western medical research model¹.

In my clinic, treatment of knee pain is one of the most common uses of moxa. Usually four points around the knee are used with needle-head moxa. This can expel cold and stimulate local blood flow, and stop pain.

Moxa works by the application of heat to acupuncture points. Actually it causes a very minor burn on the skin (First degree burn, which is simply redness), which stimulates the bodies inflammatory response. This inflammatory response is a complex process where blood vessels change to allow cells to exit into the inflamed area, and increased blood supply in general. While inflammation is normally considered a negative or unwanted thing, it is perhaps the “short burst” /localized activation of this response that is involved in the Moxibustion treatment of pain.

Breech Presentation is another routine use of moxa. The moxa cones or moxa stick is applied to the points at the end of the toes, which can cause the breech baby to turn into the correct position. The point used is BL 67 – it is known as the point which turns Yin into Yang. 

When the yin (Growth, nourishment, sedintary) reaches it’s maximum , it will transform into Yang (activity, birth, moving). In treating breech presentation, this is best applied sooner rather than later, around 34 weeks is good to start. Usually a course of treatment over 10 days is given, the practitioner can instruct the patient how to appy the moxibusion themselves (usually a partner can help do it at home), with 2 or 3 treatments of moxibustion, usually combined with acupuncture given in the clinic over this 10 day period. Increasing numbers of midwives and clinicians in hospital environments are using moxibustion for breech presentation. As recently suggested in letters to the editor of Acupuncture in Medicine Journal of Brittish Medical Acupuncture Society², many hospitals could save money on cesareans and obstetric procedures if moxibustion was used as a protocol.  

Next time you visit your acupuncturist, ask if moxibustion is appropriate for your case.

References:

1. Choi, T, Kim, T, Kang, J, Lee, M, & Ernst, E 2011, 'Moxibustion for rheumatic conditions: a systematic review and meta-analysis', Clinical Rheumatology, 30, 7, pp. 937-945, MEDLINE Complete, EBSCOhost, viewed 19 November 2013.
2. Michael, W 2013, 'Letter to the editor on obstetric acupressure and acupuncture', Acupuncture In Medicine: Journal Of The British Medical Acupuncture Society, 31, 2, pp. 257-258, MEDLINE Complete, EBSCOhost, viewed 19 November 2013.