In fire needling the shaft is heated until it glows and then inserted rapidly to the required depth and withdrawn at once. The contact is brief, so the burn is limited, and the technique is said to carry the warming effect of moxibustion with the penetrating effect of the needle.
Its indications are cold bi syndrome, chronic joint pain, nodules, warts, and some skin conditions. It requires a steady hand and a clear understanding of depth, since the needle cannot be manipulated once it is hot. The classical instruction is to thrust and withdraw quickly and to take the number of repetitions from the response.