Battlefield acupuncture, an emerging and promising alternative to risky pain relievers

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During the wars in Iraq and Afghanistan, a type of unconventional therapy known as “battlefield acupuncture” (BFA) gained traction at Walter Reed Army Medical Center to treat the pain of injured service members. “Western medicine was excellent at helping these patients, but has had its failures,” wrote BFA founder and retired Air Force Col. Dr. Richard Niemtzow in an essay published in the journal Medical Acupuncture. In recent years, VA has incorporated BFA – a type of acupuncture in which needles are placed at several specified points on each ear – as a choice for pain relief alongside conventional medications.

VA researchers studied the therapy and published an article with their findings in the August 2021 issue of the journal Pain Medicine. The article, titled “The Implementation and Effectiveness of Auricular Acupuncture in the Pain Battlefield,” discusses the promise and challenges of the approach.

“Pain is extremely prevalent among veterans and others, and there is a need for new approaches to pain management,” says Dr. Stephanie Taylor of VA, lead author of the article and director of the Center for Assessment of Pain. complementary and integrative VA health. “Not everything works for everyone. You need as many effective tools as possible in the toolbox.

The five ear points used in acupuncture on the battlefield. (Illustration courtesy of Niemtzow, et al.)

Short-term solution for a pervasive problem

Chronic (long-lasting) pain affects more than 50 million adults in the United States, according to the Centers for Disease Control and Prevention (CDC). And chronic pain is more prevalent and more severe among veterans than among Americans in general. Medication has long been the backbone of pain management. But these pharmaceuticals – including opioids, which are commonly prescribed for chronic pain – can be risky and have unwanted side effects. “I’ve spoken to so many veterans who have said they’re taking too much medication – over 30, in some cases,” Taylor says. “They were looking for other safe and effective pain management options.”

By reducing the pain of veterans while decreasing the risk, VA offers acupuncture on the battlefield among other non-drug alternatives. These approaches can be used instead of or with medication. BFA is a type of auricular (ear) acupuncture based on the “meridian system” of traditional Chinese acupuncture. In BFA, healthcare providers place up to five sterile needles shaped like tiny darts in each ear at specific points. These points are believed to affect the whole body. The needles are supposed to stay in the ears for several days. It is not clear how the therapy works exactly, but the needles can stimulate the central nervous system and reduce the sensation of pain by affecting parts of the brain such as the hypothalamus.

Over 75% of patients report immediate pain relief

As discussed in the article on Pain Medicine, BFA has been shown to provide immediate and short-term reductions in pain for many. “It’s not a long-term solution,” Taylor emphasizes. “But for some people, this is the first time in a long time that they have seen their pain reduced, if only for a moment.”

In Pain Medicine, Taylor and coauthors summarize their research into the effectiveness of BFA for pain relief. One study, led by Dr Steven Zeliadt of VA, looked at more than 11,000 BFA users across VA.

Research has found that a high proportion of patients have benefited, with over 75 percent of them reporting an immediate decrease in pain intensity after treatment. In another study, a research team led by Dr. Dan Federman of VA looked at patients attending an acupuncture clinic in high demand on the VA battlefield. Investigators found a decrease in pain in 82% of patients, on average, including patients seen in groups and those seen individually.

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