Ancient Heat vs. Modern Hands: Why Moxibustion May Revolutionize Physical Rehabilitation – Evidence from a Systematic Review

BackgroundMoxibustion, a traditional Chinese medicine technique involving the application of heat to acupoints, has been increasingly integrated into rehabilitation protocols for musculoskeletal and neurological conditions. This systematic review aims to compare the effectiveness of moxibustion (particularly heat-sensitive variants) against conventional physical therapy (PT) in improving pain management, functional recovery, and quality of life in patients undergoing rehabilitation.MethodsFollowing PRISMA guidelines, we systematically searched PubMed, Embase, Cochrane Central, Web of Science, CINAHL, and CNKI from inception to December 2025. Eligibility criteria included randomized controlled trials (RCTs) or comparative studies evaluating moxibustion (alone or combined with PT) versus conventional PT. Data were extracted on pain (VAS), function (FMA, BI), quality of life, and adverse events. Risk of bias was assessed using RoB 2.0. A narrative synthesis was performed due to heterogeneity.ResultsFrom 30 records, 15 studies met inclusion criteria (n=1,200 participants; conditions: post-stroke hemiplegia, rheumatoid arthritis [RA], total knee arthroplasty [TKA], myofascial pain syndrome [MPS], ankylosing spondylitis). Moxibustion + PT outperformed PT alone in 12/15 studies for pain reduction (mean VAS decrease: 1.5–3.0 points; p<0.05) and functional mobility (FMA improvements: 10–20%; p<0.01). Adjunctive moxibustion showed superior early recovery in TKA (e.g., faster straight-leg raise by 12–24 hours). Heterogeneity was high (I²>75%); low-moderate risk of bias in most trials. Adverse events were rare (burns <2%).ConclusionsMoxibustion enhances the effectiveness of conventional PT for pain relief and functional recovery in rehabilitation settings, particularly as an adjunct. Limitations include study heterogeneity and small sample sizes. High-quality RCTs are needed for meta-analysis.