3.2.1. Moxibustion vs. Active Control Group

As a result of a search for RCTs comparing moxibustion and active control treatment for LHIVD, one study [66] was found, but a sufficient sample size was not secured. There were no significant differences in terms of the effect (RR: 1.15, 95% CI: 0.97–1.36, *p* = 0.10).

In the classical literature contained in the textbooks of the College of KM [67], moxibustion is applied for cold back pain among the 10 classes of LBP. In the classical literature of Singugyeonglon, moxibustion is presented for waist and knee pain, which is similar to LBP and radiating pain. In addition, Donguibogam offers moxibustion for LBP, including when the waist cannot be bent or stretched with LBP.

In a questionnaire study that surveyed the treatment status of LHIVD among KM doctors, 102 of 373 respondents (27.3%) answered that they used moxibustion [7]. Additionally, in a survey on the current status of moxibustion for musculoskeletal disorders in KM doctors in Seoul, 135 of 234 respondents (57.7%) answered that they used moxibustion for LBP, indicating that the utilization of moxibustion in actual clinical practice is high [68].

The clinical evidence for the effect of moxibustion for LHIVD was found to be insufficient. However, based on the evidence from classical literature according to the development strategy of our guidelines, the level of evidence was assessed to be CTB. Considering the high utilization of moxibustio, the GPP grade was assigned through a clinical expert consensus process.

In conclusion, moxibustion is recommended for improving pain with LHIVD based on the consensus of the expert group (CTB/GPP).
