Objective: To investigate the clinical efficacy of adjacent-needling electroacupuncture combined with heat-sensitive moxibustion in the treatment of lumbar disc herniation (LDH), as well as its impact on pain relief, improvement of lumbar function, and levels of inflammatory factors. Methods: A total of 120 LDH patients who sought treatment at our hospital from January 2023 to December 2024 were selected and randomly divided into two groups using the envelope method. The two groups received different treatment modalities: the adjacent-needling electroacupuncture plus heat-sensitive moxibustion group (observation group, 60 cases) and the conventional acupuncture group (control group, 60 cases). Both groups underwent treatment for two courses. Changes in the Visual Analogue Scale (VAS) for pain, the Japanese Orthopaedic Association (JOA) score for lumbar function, the straight leg raise (SLR) angle, and serum inflammatory factors IL-6 and TNF-α were compared between the two groups before and after treatment. Results: After two courses of treatment, both groups showed improvements in pain and functional indicators compared to before treatment (P < 0.05), but the observation group demonstrated more significant improvements. Compared to the control group, the observation group had a more pronounced decrease in VAS scores, a greater increase in JOA functional scores, and a more substantial improvement in the SLR angle (all P < 0.05). Both groups exhibited a marked decrease in serum IL-6 and TNF-α levels, but the reduction in the observation group was significantly greater than that in the control group (P < 0.05). After treatment, the total effective rate in the observation group was 93.33%, while in the control group it was 78.33%, with the observation group demonstrating a significantly higher overall effectiveness (P < 0.05). Conclusion: Electroacupuncture combined with heat-sensitive moxibustion can significantly alleviate pain and improve lumbar function in patients with LDH, offering advantages such as ease of operation and reliable efficacy, making it suitable for clinical promotion.