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Objectives: This study aims to assess the efficacy of local heat therapy (Kaiy) in alleviating symptoms of mild to moderate idiopathic carpal tunnel syndrome (CTS). Methods: A single-blind clinical trial was conducted involving patients with mild and moderate idiopathic carpal tunnel syndrome. A total of 120 patients were randomly assigned to either the intervention or control group. Both groups utilized a medical wristband during nighttime. The intervention group received pen moxa as a local heat therapy tool (Kaiy) applied to the wrist region. The Boston questionnaire was employed for assessment. Results: Heat therapy using Kaiy (pen moxa) significantly improved symptom severity (P≤0.0001), functional status (P≤0.0001), and pain scores (P≤0.0001) in patients with mild to moderate CTS compared to those in the control group without heat therapy. Conclusion: This study demonstrates the positive impact of heat therapy (Kaiy) as a non-surgical approach for reducing pain, symptom severity, and functional impairment in CTS patients. Integrating complementary and alternative medicine with conventional treatment modalities could enhance symptom management with minimal side effects.