MOD006 – Acupuncture – Moxibustion

Definition

Moxibustion is a traditional Chinese medicine technique that involves burning dried mugwort (Artemisia vulgaris) on or near specific acupuncture points on the body to stimulate healing, promote balance, and enhance overall well-being.

Explanation

Moxibustion practitioners use the heat generated from burning mugwort to warm and invigorate the flow of qi (vital energy) and blood through the body’s meridians. This ancient therapy can be performed in several ways:

1. Direct moxibustion: A small cone of moxa is placed directly on the skin and burned until the patient feels warmth. This method is less common due to the risk of burns.
2. Indirect moxibustion: The most common form, where the burning moxa is held close to, but not touching, the skin. This can be done using moxa sticks, which resemble cigars, or by placing the moxa on an insulating medium like salt or garlic slices.
3. Needle moxibustion: Combining acupuncture and moxibustion, where moxa is burned on the handle of an acupuncture needle inserted into a point.

Moxibustion is believed to address a wide range of health conditions, including:

• Chronic pain
• Arthritis
• Digestive disorders
• Menstrual cramps
• Breech presentation in pregnancy

The therapy aims to expel cold and dampness from the body, strengthen the immune system, and restore balance to the body’s energy pathways. While more research is needed to fully understand its mechanisms and efficacy, moxibustion remains an important component of traditional Chinese medicine, often used in conjunction with acupuncture and herbal remedies to promote holistic healing and wellness.

 Evidence to Efficacy

Moxibustion has shown promising results in several areas of health and well-being:

Breech Presentation: A review published in the British Journal of Midwifery found that moxibustion may reduce the number of breech presentations at birth, caesarean section rates, and syntocinon use. The study by Vas et al. (2013) demonstrated that the rate of cephalic presentation at birth for true moxibustion was 58.1%, compared to 43.4% for sham moxibustion and 44.8% for routine care.

Ulcerative Colitis: A systematic review protocol published in BMJ Open highlights the potential of moxibustion in managing ulcerative colitis. The review aims to synthesise evidence from randomised controlled trials on the clinical efficacy and safety of moxibustion for this condition.

Various Health Conditions: A comprehensive review published in Evidence-Based Complementary and Alternative Medicine examined 47 randomised controlled trials on moxibustion. The review found that moxibustion was superior to control treatments in 14 out of 54 control groups across 46 studies, covering conditions ranging from breech presentation to digestive disorders.

Physiological Effects: Research published in Evidence-Based Complementary and Alternative Medicine indicates that moxibustion can affect both shallow and deep tissues of the skin. The study also found that moxibustion thermal stimulation can activate specific neurons, potentially explaining its effects on pain management.

These findings suggest that moxibustion offers a range of potential benefits across various health conditions, supporting its use as a complementary therapy in holistic healthcare approaches.

The Neuroscience

Anti-inflammatory Effects: Moxibustion significantly decreases levels of pro-inflammatory cytokines, particularly IL-6, in the hippocampus. This anti-inflammatory action may help alleviate exercise-induced fatigue and protect against neuroinflammation.

Neuroprotection: Moxibustion exerts neuroprotective effects, particularly in Parkinson’s disease models. It reduces the death of substantia nigra neurons and increases tyrosine hydroxylase activity, supporting dopaminergic neuron survival.

Antiferroptosis: In Parkinson’s disease models, moxibustion suppresses ferroptosis, a form of regulated cell death. It increases the expression of glutathione peroxidase 4 (GPX4) and ferritin heavy chain 1 (FTH1), key proteins in preventing ferroptosis.

Mitochondrial Protection: Moxibustion decreases mitochondrial damage in neurons, which is crucial for maintaining cellular energy production and preventing neurodegeneration.

Meridian System Activation: According to traditional Chinese medicine, moxibustion stimulates the body’s meridian system, facilitating the flow of qi and blood. This may influence neural pathways and promote overall neurological health.

Thermal Stimulation Effects: The heat from moxibustion activates warm receptors and polymodal receptors in the skin, potentially influencing pain perception and neuronal activation patterns.

Neurotransmitter Regulation: While not directly stated in these results, other studies suggest moxibustion may influence various neurotransmitter systems, contributing to its therapeutic effects on neurological conditions.

Moxibustion offers a multifaceted approach to neurological health, combining anti-inflammatory, neuroprotective, and cell-death preventive mechanisms to support brain function and protect against neurodegenerative processes.

Governing Body

While there is no specific regulatory body for moxibustion practitioners in the UK, several organisations provide training, certification, and oversight for complementary therapies that include moxibustion:

British Acupuncture Council (BAcC): The BAcC is the leading self-regulatory body for the practice of traditional acupuncture in the UK. Many of its members are trained in moxibustion as part of their acupuncture education. The BAcC sets standards for education, ethics, and safe practice.

Association of Traditional Chinese Medicine and Acupuncture UK (ATCM): This organisation represents practitioners of Traditional Chinese Medicine, including those who practice moxibustion. They provide a register of qualified practitioners and set standards for practice.

Acupuncture Association of Chartered Physiotherapists (AACP): While primarily focused on acupuncture, some members may incorporate moxibustion into their practice. The AACP provides training and maintains standards for physiotherapists using acupuncture and related techniques.

These organisations contribute to maintaining standards, providing training, and offering certification in moxibustion and related practices, ensuring a level of professionalism and safety in the field.

What Good Looks Like

In the context of moxibustion, a positive and effective experience should encompass several key elements:

• You should feel welcomed into a calm, comfortable environment. The treatment room should be clean, warm, and have a pleasant, earthy aroma from the burning moxa.
• The practitioner should take time to explain the moxibustion process, including the specific points they’ll be treating and why these are relevant to your condition.
• During the treatment, you should experience a deep, penetrating warmth that feels soothing and relaxing. This warmth should never become uncomfortably hot or cause pain.
• You might notice a gentle tingling or buzzing sensation at the treatment sites. This is often described as the movement of ‘qi’ and is considered a positive sign.
• The practitioner should be attentive to your comfort throughout the session, regularly checking in and adjusting the intensity of the heat as needed.
• You should feel free to communicate any sensations or concerns during the treatment. A good practitioner will welcome this feedback and respond appropriately.
• For indirect moxibustion, you might observe the practitioner skilfully manipulating the moxa stick, maintaining a consistent distance from your skin. For direct moxibustion, you should be fully informed and consent to the procedure.
• Throughout the session, you should experience a gradual sense of relaxation spreading through your body. Many people report feeling a pleasant heaviness or lightness in their limbs.
• After the treatment, you should feel a lingering warmth and a sense of well-being. You might notice improved flexibility in the treated areas or a reduction in pain or discomfort.
• The practitioner should provide aftercare advice, such as keeping the treated areas warm and avoiding cold foods or drinks for a short period following treatment.

Remember, while some effects may be felt immediately, the full benefits of moxibustion often develop over a course of treatments. A good practitioner will explain what to expect and how to maximise the benefits of your moxibustion therapy.

 What to Ask a Practitioner

Here are some key questions to help you identify an exceptional moxibustion practitioner in the UK, along with the desired responses:

How do you personalise moxibustion treatments for individual patients?

Desired Answer: Detailed explanations of how they assess your specific condition, constitution, and energy balance. They should mention tailoring the type of moxa, treatment points, and duration based on your unique needs.

What specific techniques do you use for indirect moxibustion, and why?

Desired Answer: Knowledge of various indirect techniques such as stick moxa, moxa boxes, or salt-insulated moxa. They should explain the benefits of each and why they might choose one over another for different conditions.

How do you integrate moxibustion with other Traditional Chinese Medicine practices?

Desired Answer: A holistic approach that combines moxibustion with acupuncture, herbal medicine, or dietary advice. They should explain how these work synergistically.

Can you describe your approach to using moxibustion for breech presentation?

Desired Answer: Specific knowledge about the BL67 point, timing of treatment (around 34 weeks), and frequency of sessions. They should mention collaborating with your midwife or obstetrician.

How do you manage smoke and odour during treatments?

Desired Answer: Mentions of proper ventilation, use of smokeless moxa, or alternative techniques like infrared lamps for heat-sensitive patients.

What aftercare advice do you provide following moxibustion treatments?

Desired Answer: Specific recommendations about keeping treated areas warm, avoiding cold foods or drinks, and any lifestyle adjustments to enhance the treatment’s effects.

How do you determine the appropriate ‘dosage’ of moxibustion for each patient?

Desired Answer: Explanations about assessing your heat tolerance, the specific condition being treated, and adjusting the duration and intensity of heat application accordingly.

What precautions do you take when using moxibustion on sensitive areas or with heat-sensitive patients?

Desired Answer: Mentions of using gentler techniques, such as warming needle moxibustion or very brief applications, and careful monitoring of skin response.

A practitioner MUST include:

• A thorough initial assessment of your condition and overall health
• Clear explanations of the treatment process and what to expect
• A commitment to using high-quality, pure moxa materials
• A clean, well-ventilated treatment space
• Proper hygiene practices, including hand washing and equipment sterilisation

Remember, an exceptional practitioner will welcome your questions and provide clear, detailed answers that demonstrate their expertise and commitment to your well-being.

 Related Therapies

Acupuncture (MOD007): A traditional Chinese medicine practice that involves inserting thin needles into specific points on the body to balance energy flow (Qi) and promote healing. Acupuncture can complement Reiki by addressing energetic blockages.

Acupressure (MOD003): A therapeutic tool with thousands of plastic spikes that stimulate acupressure points to relieve pain and promote relaxation.

Cupping Therapy (MOD005): Related to acupuncture, and often used in conjunction with it. Cupping involves placing cups on the skin to create suction, promoting blood flow and healing.

Traditional Chinese Medicine (MOD167): An ancient medical system that includes various forms of herbal medicine, acupuncture, massage, exercise, and dietary therapy.

Herbal Medicine (MOD067): The use of plant-based remedies to treat various health conditions. Herbal medicine can complement flower essence therapy by addressing physical symptoms alongside emotional imbalances.

Shiatsu (MOD150): A Japanese technique that uses finger pressure on specific points along the body’s meridians to balance energy flow

Reflexology (MOD141): A practice involving the application of pressure to specific points on the feet, hands, or ears.

Qi Gong (MOD102): A holistic system of coordinated body posture and movement, breathing, and meditation used for health, spirituality, and martial arts training.

Tai Chi (MOD157): A Chinese martial art practiced for both defence training and health benefits, including stress reduction and improved balance.

Aromatherapy (MOD015): The use of essential oils to promote physical and emotional well-being, which can complement the effects of crystal healing.