IANM Institute

Diffuse Moxibustion for Areas of Muscle Tension

Fukushima Tetsuya

Type Of Study: Information about clinical use of Moxibustion

Name Of Journal: North American Journal of Oriental Medicine

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Epilogue:
Diffuse Moxibustion for Areas of Muscle Tension by Fukushima Tetsuya Direct moxibustion is ordinarily performed on specific acupuncture points. On the contrary, there is an approach in which thread moxibustion is applied at intervals of 1-1.5cm over a diffuse area (over the area of muscle tension). I would like to introduce the method I have been using clinically. Chinetsu-kyu Chinetsu-kyu is a type of non-scarring moxibustion. The moxa is placed on an acupuncture point, then removed as soon as the patient feels a sensation of heat. However, in my clinical practice, for new patients or as a preliminary treatment before moving onto acupuncture, I apply thread moxa over diffuse areas of tension such as shoulders or the upper back. In the Tang Dynasty classic Zhou Hou Bei Ji Fa it is stated: “In case of strained mouth and eyes, moxibustion is placed between the striated muscles of the corners of the mouth, and when the heat is perceived, the moxa is removed and the ailment is cured. Do not burn the moxa” (ie we should not burn the moxa right down to the skin). Chinetsu-kyu also refers to the method of placing multiple threads of moxa on the point Li Neiting (Ventral ST-44) to treat food poisoning. The moxa is applied until the heat is perceived by the patient. Chinetsu-kyu Basics Chinetsu-kyu is applied in the same manner as direct moxibustion. The difference is that you need to time the removal of the moxa according to your purpose (tonification or dispersion). In chinetsu-kyu, I work with a fingertip-sized or pyramid-shaped cone approximately 1cm in diameter at the base. This is similar in size to that used by Dr Inoue Keiri (1903-1967), a meridian therapist during the Showa Era. On the other hand, some clinicians use rice-grain or half-rice grain-sized moxa. This method is called hachibukyu (hachibu means 80 percent): the moxa cone is either lifted off of the skin or extinguished by pressing the moxa onto the skin surface with finger tips. High grade chinetsu-kyu or kyuto-shin moxa is recommended for this method. Tonifying or Draining Method In the Lingshu, “Bei Shu Bian” (Chapter 51, “The Transport Openings of the Back”), it is written, “In order to tonify with fire, do not blow out the fire. Wait for it to extinguish naturally. In order to drain with fire, blow on the fire to encourage a faster burn.” In Dan Xi Xin Fa Shi Yi Za Lun it is stated, “to tonify, the fire reaches the flesh. To drain, remove the moxa before the fire reaches the flesh.” Gauze Moxibustion Gauze moxibustion, devised by Dr Maruyama Mamoru of Kumamoto prefecture, was originally used to treat the swelling and pain in joints of patients with rheumatoid arthritis. Unlike direct moxibustion, its focus is diffuse surface areas rather than specific points. It is used not only to remove heat due to the inflammation and pain of joints, but also to relax muscle tension. It can also be used on the face for eye strain and for facial rejuvenation. It is a method that my patients (especially those with chronic knee and low-back pain) are able to administer on themselves. A standard grade moxa product is sufficient for gauze moxibustion. Instructions for Basic Gauze Moxibustion 1. Cut a piece of gauze matching in size the area where it will be applied. For example, 15cm x 15cm for the lumbar region and 15cm x 7.5cm (or 15cm x 10cm) for the knee joints. Stack three layers and soak them in warm water. 2. Lightly squeeze this gauze with one hand and place it on the affected area. 3. Stand moxa cones 1-1.5cm apart on the gauze. 4. Depending on patient’s sensitivity and moxibustion site, the cone size can range from halfrice grain to rice-grain size, or more than twice that. 5. Use an incense stick to ignite one cone after another. 6. When all the moxa has burned, remove the gauze (no repetition necessary). It is a good idea to practice on your own knee joint to experience the heat. By the way, if you throw away only the top of the three gauze layers and save the remaining two, you can add one the next time and reuse the other two. Bamboo Tube Moxibustion Bamboo tube moxibustion is not to be confused with the Fukaya moxibustion method. The device is shorter and thicker. It is a form of indirect moxibustion in which a bamboo tube (3-5cm in length with an inner diameter of 3-4cm) is filled with moxa and ignited. The bamboo tube gives a thermal stimulus to the skin. Basic Bamboo Tube Moxibustion Method 1. Slide method: Move the tube so it slides on the skin. 2. Rolling method: Roll the tube on the skin. Light pressure may be applied. 3. Tapping method: Tap the tube lightly and rhythmically on the skin. In my clinical practice, I mainly use the bamboo tube moxa in the acute phase of swelling from bruising or sprains or after bloodletting. In addition, bamboo tube moxa is recommended as a pre-emptive treatment to relax muscle tone, alleviate edema, for facial rejuvenation, general relaxation, and to finish up any given treatment. The range of applications is further expanded by the inclusion of different meridian systems and Mr Hirata’s twelve reaction zones. I have not gone into detail with this, since it has been covered in other articles written by or about Oran Kivity’s Ontake method. Home-made Moxibustion Device Here, I would like to introduce the moxibustion device I developed. The only materials needed are a ball-shaped tea strainer with a handle, a stainless-steel hemispherical cap, and carbonized moxa (or shortened smokeless stick moxa). It is cheap (the material cost is $5 or less) and anyone can do it. Fukushima Tetsuya graduated from the Japan Central Acupuncture College in 1988. Since 2002, he has been a part-time lecturer in the department of teacher training at the Tokyo Medical College. He teaches at the Moxibustion Research Clinic and Tokyo Iryo Senmon College. He is also an instructor with the Tokyo Traditional Nine Needles Research Group and presents workshops and hands-on seminars. Since 2017, he has been practicing at the Shonan Kei-iku Hospital and at the outpatient clinic of the Ishikawa Memorial Hospital. He has been a member of the SFC Research Centre at Keio University since 2016 and, as of 2019, Dr Fukushima has been a part-time lecturer in the Kampo Medical Center within the medical school of Keio University, in charge of the acupuncture outpatient department. His publications include Fukaya Moxibustion Method for Moxa Treatment by Illness and Symptom – Listen to the Patient’s Body (with Midori Shobo), the DVD Fukaya Moxibustion Method Practical Course – From Basic Techniques to Actual Treatment (with Midori Shobo), Quiet Tales of Moxa Treatments – The Moxibustionist’s Bedside Story, Vols 1 and 2 (Human World) and Nine Illustrated Practical Acupuncture Skills and Explanations (co-authored with Midori Shobo).