Objective: To evaluate the clinical efficacy of Aina Xiang moxibustion in thermized acupuncture for degenerative lumbar spinal stenosis, providing a more optimized treatment protocol. Methods: A total of 60 patients with degenerative lumbar spinal stenosis admitted between January 2025 and December 2025 were randomly divided into two groups using a random number table method, with 30 patients in each group. The conventional thermized acupuncture group received moxa cones made from coarse mugwort wool, while the Aina Xiang moxibustion group received Aina Xiang sticks. Both groups underwent 7-day treatment courses for four consecutive sessions. Clinical outcomes were assessed using ODI scale scores, JOA scores, VAS scores, and clinical response rates at baseline, 2 weeks post-treatment, and 3 months post-treatment. Statistical analysis was performed using SPSS 13.0 software. Results: Pre-treatment comparisons of ODI scale scores, JOA scores, and VAS scores between the two groups showed no statistically significant differences (P > 0.05). At both 2-week post-treatment and 3-month follow-up, both groups demonstrated improvements in these metrics. Specifically, the Aina Xiangjiu Warm Needle Therapy group exhibited lower ODI scores (10.5 ± 2.8 points at 3-month post-treatment) and VAS scores (1.5 ± 0.8 points) compared to the conventional warm needle therapy group (15.8 ± 3.2 points vs 2.8 ± 0.9 points). The Aina Xiangjiu group also showed higher JOA scores (25.6 ± 1.8 points vs 22.1 ± 2.0 points) and a significantly greater clinical response rate (93.3% vs 76.7%) than the conventional group, with all differences reaching statistical significance (P < 0.05). Conclusion: Aina Xiangjiu demonstrates superior efficacy in improving lumbar function, alleviating pain, and enhancing clinical outcomes for degenerative lumbar spinal stenosis treated with warm needle therapy. This evidence-based approach provides valuable clinical guidance for managing such conditions and holds potential for broader application.