Walk into an acupuncture clinic and catch a warm, earthy smell a little like incense, and there's a good chance someone has been using moxa. Moxibustion is one of the oldest parts of Chinese medicine, and I sometimes use it alongside acupuncture. Here's what it is, where it comes from and what to know before you try it.
What is moxibustion?
It's a traditional practice in which dried plant material is burned on or near particular points on the body, usually the same points used in acupuncture. The aim is warmth. The herb is crushed and often wrapped in special paper, then held or placed so that you feel a gentle heat.
In the past the skin was actually blistered. Modern practice only warms the area, and these days you're most likely to meet:
- Moxa sticks, which look like a thick cigar and are held a little above the skin.
- Small cones, placed on a point and removed before they get too hot.
- Indirect methods, where something such as a slice of ginger or a layer of salt sits between the moxa and the skin.
Mugwort, the plant behind moxa
Moxa is made from species of Artemisia, the group of plants that includes mugwort and wormwood. The word itself comes from mogusa, the Japanese name for the plant. In China, one widely used species is Artemisia argyi, a perennial herb of the daisy family also known as mugwort. It turns up as early as the ancient Book of Songs, and a Northern Song dynasty writer described it as mainly used for moxibustion.
Its European cousin, common mugwort (Artemisia vulgaris), is native to Europe and eastern Asia. It has papery leaves, green on top and white to grey underneath, with a scent a bit like sage or chrysanthemum.
The tradition
Moxibustion began in northern China and spread from there to Japan and other parts of Asia. Warmth has always carried a particular meaning in Chinese medicine. Some patterns are traditionally described as "cold" or "damp", and moxa was used to bring warmth to the points and channels involved. These are traditional explanations rather than a mechanism modern science has confirmed, but many people find real value in the practice itself: the gentle, spreading warmth is genuinely relaxing, especially on a cold day.
What about breech babies?
Turning a breech baby (lying bottom-first late in pregnancy) is one of the better-researched uses of moxibustion. A 2023 Cochrane review found moderate-certainty evidence that moxibustion, alongside usual care, probably increases the chances of your baby turning before birth, though it didn't show a clear effect on caesarean section rates. Reported side effects were generally mild, such as contractions, nausea or a headache, with burns rare when it's done carefully.
If you'd like to try it, the best first step is to speak to your midwife or obstetric team, who can talk you through timing and how it fits alongside the options available to you on the NHS.
Safety notes
Moxa is gentle when used carefully, but it's still a burning herb, so it isn't risk-free. A 2010 systematic review in Complementary Therapies in Medicine gathered reports of adverse events and concluded that moxibustion "is not entirely risk free", with burns, allergic reactions and infections among the problems reported. A few practical points follow from that:
- Tell me straight away if anything feels too hot. I can lift the moxa away in a moment.
- Mention any allergies, including to plants in the daisy family, and any breathing problems, as the smoke can be noticeable.
- Let me know if you have reduced feeling in your skin, for example from diabetes, since you may not notice heat building up.
- Tell me if you're pregnant.
Moxibustion isn't a replacement for medical care, so keep up any treatment your GP has recommended.
If you're curious about how moxa fits into a session, see how I work with Five Element acupuncture.