Japanese style tools, moxibustion and treatment techniques… What is the difference?

Japanese style moxibustion and treatment tools are unique…


You may be familiar with the moxibustion (moxa) stick that looks like a big cigar frequently used in Traditional Chinese Medicine treatments. The most common forms of moxa used in this specific Japanese style are direct rice grain (okyu), warm needle (kyutoshin), cone (chinetskyu), moxa box, stick on moxa cylinders (kamaya-mini) and warming metal tools such as elephant warmer and tiger warmer that use special moxa incense.  Different forms have different functions.


Okyu is the most common form applied in the Gateways Oriental Medicine Clinic. A very high grade moxa is used, which is made of the tiny hairs of the mugwort leaf, skimmed and gathered together to form the soft fluffy material you can see in the green bowls above. This is gold grade punk. It is rolled into fine threads and tiny sesame seed sized portions are pulled off to burn onto a traditional herbal anti-burn liniment.  This is a dynamic way to treat a point, invigorating the yang to move qi and blood effectively. You may feel momentary pinches of heat as the moxa burns down to the cream but it does not burn the skin. See the images below.

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The elephant warmer (below) provides penetrating warmth to reduce muscular tension or trigger points and move qi and blood to improve circulation. Moxa incense inside warms the stainless steel end so heat is evenly dispersed. It is deeply relaxing and can be static or moving. It can be used over light clothing or with oil applied to skin as a massage.

elephant warmer


The tiger warmer (below) is similar to the elephant warmer but treats a smaller area and is especially effective on the neck, over glands, areas on the head, feet or around the navel. The heat is more condensed and targets points more specifically. It is often used in paediatric treatments to replace the direct moxa, or on sensitive patients.

tiger warmer



Kamaya mini (below) stick onto the skin and warmth from the moxa burning at the top of the hollow cylinder transmits down into the point slowly. These are quite stimulating and enhance qi and blood movement through treating specific points.


Kyutoshin (below) involves rolling a ball of moxa punk and securing it to the top of a needle to gently warm the surrounding area. Heat conducted though the needle penetrates into the point deeply. It is often described as being a relaxing and nourishing sensation. Muscular tension and trigger points tend to unwind with this technique. If there are cold internal areas this is also a good way of sending warmth into the tissues.



Chinetsukyu (below) can be formed into different sizes and densities to suit the application needed. When burnt down to 80% before removal they can infuse quite a strong heat and yang sensation into the treatment zone or they can be burnt down to the level where the patient feels the heat gently arriving at the point. These techniques are used to create different therapeutic effects, according to diagnosis.

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Moxa Box is a wooden tool with fine mesh inside that loose moxa punk is placed on to burn and transmit a gentle warmth down to cover a larger area. This is used when there is cold stagnation in a particular area mostly. It is described as being very relaxing.

moxa box.jpg


Non-Insertive Needles

Teishin are sometimes referred to as “needleless needles”.  They are made of different metals with different properties that create different effects on the qi. Copper is cooling, titanium and stainless steel are neutral, silver is slightly warming and gold is more warming. According to the pattern diagnosed and response in real time of the body to treatment different teishin are used in different ways. There is a spring loaded teishin, which is rhythmically pressed into a point to stimulate it. The ball the teishin can be placed on a point and held still or lightly stroked along the channel to move qi along the meridian. Teishin are often used to treat paediatric, elderly or highly sensitive patients.



Japanese Style Needles

Press needles (below) are tiny needles secured in a plastic base set in a sticker to be left on the skin. They deliver a subtle stimulation to the point for the duration they are left on during or after treatment. I often describe them as take away needles. On the right point they can exert noticeable effects and continue the treatment. They are not generally felt. The smallest and most commonly used at Gateways is only 0.3mm long!

press needle.JPG


Inserting needles in Japanese style acupuncture is often a subtle and delicate art-form. Emphasis is placed on minimising physical discomfort and avoiding pain. Depending on diagnosis and body feedback needles are inserted at different depths and angles. Often they are relatively superficial and there is minimal stimulation.

High quality Japanese style needles are used at Gateways Oriental Medicine Clinic. These are crafted with fine shafts and very sharp tips to avoid pain on insertion.

0.14 mm needles copy


Contact Needling (below) is a technique where the base hand forms a “circle of qi” called an oshide and the guiding hand directs the needle so the tip is lightly resting on the surface of the skin on the point. within the oshide qi sensations can be felt to determine when qi arrives at the point or heat dissipates. Sometimes tightness or firmness under the point softens. Sometimes a soft area firms up. This technique requires great focus and attention on what is happening at the tip of the needle in the present moment.

contact needle


Traditional Chinese Medicine (TCM) dietary therapy advice is included in all consultations as part of the holistic treatment plan, as is lifestyle advice to continue therapy outside the clinic. Preventative medicine is an underlying foundation of oriental medicine and often there are simple changes that can be strongly beneficial.

TCM patent herbal formulas and herbal liniments are available at an extra cost for supplementing physical treatment and dietary therapy. All other therapies are included in the consultation price. (See fees section)



Consultations are generally up to an hour and twenty minutes long for adults returning.

The initial consultation involves a comprehensive health history and a thorough diagnosis formed during the interview, inspection and palpation. Then treatment is applied.

Diagnosis is formed freshly in each session, as patterns shift and we are ever-changing. Even within a session signs from the body and response of the patient present feedback that can change the course of treatment from moment to moment.

The practitioner stays with the patient though the whole consultation, being highly attentive to the outcomes of the treatment process plus the comfort and wellbeing of the patient. It is a zen approach…. responding to what is happening in the present moment.

Paediatric consultations are up 45 minutes long minutes, depending on how long it takes to treat the child (varies with age and constitution).

Pensioner and concession consultations are 45 minutes long.

15 minutes is allotted between consultations to allow adequate time to sanitise the clinic and bathroom plus sterilise equipment. Safety protocols are in place to minimise cross infection risk in the clinic.

Your Comfort and Safety                                                                                                                              Much care is taken to ensure you are comfortable during your consultation. Please feel free to ask Fiona questions if you have any concerns.

This includes:

  • temperature control,
  • physical comfort,
  • privacy and confidentiality,
  • physical and emotional safety,
  • a peaceful relaxing atmosphere,
  • attention on pain free techniques,
  • your choice of removing or retaining clothing (underwear is always kept on and towels or blankets draped),
  • building trust and rapport.


After the Consultation

Feedback on how you feel or changes in symptoms is always welcome any workday by text, phone or email. Follow up is important and any questions or reports are appreciated so we can work together to create the most beneficial outcome during the treatment plan.

How Often Should Treatment be Applied?

This varies from case to case but generally for acute conditions it may be advised you come twice in the first week and then reassess the treatment plan if possible. For chronic conditions often starting with weekly visits, then spacing out fortnightly, then every third week and so on as signs change and symptoms resolve. Each treatment has a progressive accumulative effect on previous treatments, so the treatment tends to “hold” longer each time. Recommended changes in daily living will generally support treatments and reduce frequency or length of treatment plans. Working together as a team engenders best results.

Many people come semi-regularly for check ups, “tune ups” or preventative health care. This is the optimal condition to be in. In Oriental Medicine we look for the subtle signs of imbalance forming and harmonise the system to avoid disease occurring. Often signs show during diagnostic examination that are subclinical (not yet detected in medical tests). This is significant in that disease can be prevented before it develops into a condition that is difficult to resolve.

In ancient times Chinese doctors were only paid for preventative treatments. If the patient became sick it was seen as a flaw in the course of treatment and the doctor did not charge to treat illness, as they believe it was their job to avoid it forming.