Battlefield Acupuncture: The Military's Secret Weapon Against Chronic Pain (2024)
Battlefield Acupuncture Key Takeaways © 2024 by HOPE Neuro-Acupuncure Rehab is licensed under CC BY-SA 4.0
Introduction
Almost half of the returning soldiers from Afghanistan and Iraq experience pain that doesn't go away for months, or even years. Out of the 2,597 brave soldiers who served, 44% battle pain that lasts for more than 3 months, with half of them reporting pain for more than a year.
Considering the current opioid epidemic, traditional pain relief strategies often fall short and carry the risk of drug-related consequences.
Classic Example of BFA
This lack of effective treatment has propelled the Department of Defense (DoD)and the Veterans Administration (VA) to test alternative, drug-free methods, among which Battlefield Acupuncture (BFA) has emerged as a compelling option.
Unlike conventional acupuncture (which uses thin needles), BFA utilizes gold, aiguille semi-permanent (ASP) needles inserted at specific sites in one or both ears.
Battlefield Acupuncture Needles
Traditional Acupuncture Needles
Over the past two decades, auriculotherapy has gotten much attention for its speed and effectiveness in pain relief, with BFA research showing great potential in reducing pain for conditions ranging from broken bones to phantom limb pain.
Initiatives like the 3-year, $5.4 million acupuncture education and training program by the VA Administration demonstrate a significant commitment towards integrating BFA into the military. The adoption of BFA also reflects a shift towards a more holistic healthcare approach for veterans and active military personnel.
U.S. Army Maj. Ronovan Ottenbacher teaches a Battlefield Acupuncture class to Task Force Bayonet Soldiers at Camp Lemonnier Djibouti, Dec. 14, 2020. (U.S. Air Force photo by Tech. Sgt. Dana J. Cable)
Let's explore further how Battlefield Acupuncture is making strides in the military, offering a beacon of hope for those in need for chronic pain relief.
Origins of Battlefield Acupuncture
In 2001, acupuncturist and Air Force Colonel Dr. Richard Niemtzow began developing BFA in response to the urgent need for alternative pain relief solutions in combat.
For context, Dr. Niemtzow established the medical acupuncture clinic at Andrews Air Force Base, delivers medical acupuncture to service members at Andrews, the Pentagon, and the White House, and consults on Complementary and Alternative Medicine (CAM) to the Air Force Surgeon General.
Safe to say, he knows a thing or two.
Retired Col. Richard Niemtzow shows observing healthcare professionals how to properly apply the acupuncture needle into Master Sgt. Michelle Tancrede's ear during the battlefield acupuncture course Aug. 12, 2011, at Joint Base Andrews, Md.
According to Dr. Niemtzow, BFA is rooted in auriculotherapy, an ancient form of acupuncture that targets the ear.
"The concept that the ear has a connection to all parts of the body dates back to the origins of traditional French, German, and Chinese medicine," explains Dr. Niemtzow.
Niemtzow's innovation was to simplify and standardize this knowledge for combat purposes, enabling quick deployment and immediate relief on the battlefield.
Lt. Col. Douglas Maurer feels the small needles enter his ear as he receives battlefield acupuncture at the Special Troops Battalion
The procedure's efficacy turned out to be impressive, as Dr. Niemtzow reported relief in "80 to 90 percent of cases; typically is immediate; and may last from minutes to months". This method has proven effective across a wide range of pain conditions from fibromyalgia to arthritis, often succeeding where traditional Western medications have failed.
Dr. Niemtzow's revolutionary approach motivated the VA to complete a 3-yr $5.4 million BFA program in 2016, which trained over 2800 medical providers (around 60% of Air Force bases) to provide BFA for military personnel and veterans. This program continues to serve thousands of patients in 2024.
How is Battlefield Acupuncture Applied?
The BFA procedure involves the gentle insertion of up to five temporary needles at specific points. Following the insertion of needles, patients walk for about 10 minutes to enhance the treatment's effect.
Five needles sit in a patient’s ear after being inserted by U.S. Army Maj. Ronovan Ottenbacher, deputy joint force surgeon – Horn of Africa (U.S. Air Force photo by Tech. Sgt. Dana J. Cable)
This is a very similar process to how scalp acupuncture utilizes the combination of acupuncture and physical therapy to help stroke patients walk again.
ASP ear needles now remain in place for several days. Once it falls out, new needles can quickly be inserted again for continual treatment.
The Mechanics Behind Battlefield Acupuncture
As Battlefield Acupuncture (BFA) operates on the principles of auriculotherapy. This approach focuses on the ear, taking advantage of its direct connections to the body's nervous system. The ear is seen as a small map of the entire body, with each area of the ear corresponding to a different part or function of the body.
The exposed and easily accessible aspect of the ear makes it an effective means to influence the nervous system.
To influence the nervous system, BFA utilizes the strategic placement of small needles into five predetermined sites in one or both ears. Each of these points were specifically selected for their role in pain processing within the central nervous system. These five points are known as cingulate gyrus, thalamus, omega 2, point zero, and Shen Men.
Credit: Generations Magazine
Once inserted, they tell the brain to release special molecules known as β-endorphins, which are like the body's homemade Advils. At the same time, it also encourages the release of anti-inflammatory cytokines, which are substances that help reduce swelling and irritation in the body.
This mechanism results in a dual effect: providing short-term pain relief and contributing to longer-term reduction in swelling and irritation.
Students practice the application of Battlefield Acupuncture on each other at Camp Lemonnier Djibouti, Dec. 14, 2020. A medical technician can learn the procedure in a single day's training session. (U.S. Air Force photo by Tech. Sgt. Dana J. Cable)
Current Research on BFA
To be transparent, the evidence base for BFA is still growing, but points to significant potential benefits. Many studies on BFA highlight its effectiveness in managing both acute and chronic pain.
In one study, a research team led by VA’s Dr. Dan Federman looked at patients attending an in-demand VA battlefield acupuncture clinic. The investigators found a decrease in pain in 82% of patients, on average, including patients seen in group settings and those seen in individual settings.
In another study, led by VA’s Dr. Steven Zeliadt, examined more than 11,000 BFA users across VA. The research found that a high proportion of patients benefited, with more than 75 percent of them reporting some immediate decrease in pain intensity after the treatment.
Battlefield Acupuncture Pain Relief Statistic © 2024 by Jesse Lu is licensed under CC BY-SA 4.0
BFA Patient Testimonials
Obviously, due to the nature of war, veterans are more prone to intense chronic pain after battle. Medications have traditionally provided pain relief, but these pharmaceuticals—including opioids—can be addictive and dangerous. “I’ve spoken to so many Veterans who said they were on too many medications—more than 30, in some cases,” Dr. Taylor says. “They were looking for other safe and effective pain relief options.”
Veterans receive battlefield acupuncture treatment at the Washington DC VA Medical Center. An eye mask and soothing music in the background help create a relaxing environment. (Photo by Robert Turtil)
Luckily, BFA has been found to provide immediate, short-term reductions in pain for many. “It’s not a long-term fix,” Taylor emphasizes. “But for some people, it represents the first time in a long time they’ve had their pain reduced for even a moment.”
Here are some testimonials collected from past BFA seminars.
Master Sgt. Michelle Tancrede, the 779th Aerospace Medical Squadron mission operations NCO in charge, visited a BFA seminar with back pain. After just two hours of training, the BFA trainees were able to alleviate some of the pain she experienced. "I definitely felt a difference," said Tancrede.
U.S. Army Maj. Ronovan Ottenbacher teaches a Battlefield Acupuncture class to Task Force Bayonet Soldiers at Camp Lemonnier Djibouti, Dec. 14, 2020 (U.S. Air Force photo by Tech. Sgt. Dana J. Cable)
Mitchell said a small crick in his neck was feeling better. "You feel a surge. It's interesting. It's very interesting” Mitchell noted.
However, results at another workshop were mixed. Maj. Thomas Weme, a doctor in the Royal Norwegian Air Force, didn't notice any difference in his back pain after getting the procedure. "I just feel warmth on the ears," he said.
But Sylvain Hourlier, a physician from France who was a BFA workshop volunteer, said his chronic back pain from a motorcycle accident 20 years ago, had "vanished."
"I feel the pressure where I have the pain, but the pain is gone," he said. "It's crazy."
Is BFA Better than Western Medicine?
According to Dr. Niemtzow,"It is not better than Western medicine, but it is a technique to relieve pain without any side effects that allows you to return back to duty much more rapidly than using medication.” In other words, it offers a secure alternative for military and veteran patients, especially for those with an inclination towards substance abuse.
Tech Sgt. Jessie Sosa receives a Battlefield Acupuncture treatment from Dr. Thomas Piazza at the Air Force Acupuncture Center at the Malcolm Grow Medical Clinic, Joint Base Andrews, Oct. 6, 2017. (U.S. Air Force photo by J.M. Eddins Jr.)
Furthermore, Dr. Stephanie Taylor, director of the VA’s Complementary and Integrative Health Evaluation Center points out that “Not everything works for everybody. You need as many effective tools in the toolbox as you can get.”
BFA Treatment vs. Opioid Treatments
When considering the financial impact of treating chronic pain in military personnel and veterans, the comparison between Battlefield Acupuncture (BFA) and traditional opioid treatments reveals stark contrasts.
According to this study, The U.S. Department of Defense requires considerable funding for opioid treatments, treatments which can range from $115.00 to $294.13 per week for just one veteran. These figures take into account the medication costs and long-term monitoring for potential addiction and side effects.
Synthetic & Common Rx Opioid Deaths between 2000 & 2020 Visualizing the Impact of the Opioid Overdose Crisis (nihcm.org)
Conversely, a $81.00 box of 200 needles can treat 20 veterans at a mere $4.05 per veteran, efficiently administered in a group setting with approximately 10 minutes per treatment. Annually, this equates to $210.60 per veteran for weekly treatments. For the cost of one week of opioid treatment, a veteran could receive an entire year of BFA treatments.
U.S. Air Force Maj. Jennifer Salguero 377th Medical Group, family practice clinic medical director, performs combat acupuncture on Jim Fisher, 377th Air Base Wing public affairs specialist (U.S. Air Force photo by Staff Sgt. J.D. Strong II)
The operational costs of BFA clinics are remarkably low, especially when considering the potential to treat 15–20 veterans in a single 3-hour group clinic session.
Including the total expenses for licensed physicians, needles, and administrative tasks, the cost per week for such a BFA clinic hovers around $240, or roughly $14 per week per veteran. This cost efficiency is even more pronounced in states where registered nurses are authorized to administer BFA, potentially lowering the implementation costs further.
CORPUS CHRISTI, Texas (Jan. 27, 2017) Lt. Rachael D. Wheelous (right) and Lt. Brent D. Pavell, both Navy nurses, practice Battlefield Acupuncture (BFA) under the watchful eye of visiting instructor Colonel Dean Hommer, U.S. Army, Brooke Army Medical Center, chief, Department of Pain Management.
In a report published by The Joint Commission Journal on Quality and Patient Safety in 202, researchers stated that veterans were “twice as likely” to die from an accidental opioid overdose compared to the general population. Thus, not only does BFA represent significant savings, but also greatly reduces the risk of addiction for veterans.
By offering BFA, military healthcare can provide a safe and effective chronic pain solution, ensuring that price doesn’t disrupt recovery for those who have served.
Conclusion
Battlefield Acupuncture emerged as a revolutionary approach to holistic pain relief for military personnel and veterans. As BFA continues to be studied, it holds the promise of offering extremely affordable pain relief to those who have long sought pain-killer alternatives.
D’Arcy Neller, wife of U.S. Marine Corps Gen. Robert B. Neller, Commandant of the Marine Corps, watches as U.S. Navy HN Patrick L. Dewilde, a corpsman, receives battlefield acupuncture at Intrepid Spirit Center of Excellence on Camp Lejeune, N.C., Feb. 13, 2017. (U.S. Marine Corps photo by Cpl. Kelly L. Street)
Further Resources
Watch this interesting mini-documentary on how the military trains Battlefield Acupuncture!
For more information on acupuncture and holistic healing, explore our sections on Traditional Chinese Medicine (TCM), Dry Needling and Neuro-Acupuncture. Your holistic health journey is just beginning, and there's a wealth of knowledge and support waiting for you.
Lastly, a study by Dr. Taylor’s research team found that patients who used BFA had more than 10 times the chance (compared to the general population) of using traditional acupuncture within the following three months, signifying that the acupuncture holds great potential for those who try it.
So if you live near San Jose, California, come visit our clinic for some battlefield acupuncture! We also offer injury recovery, medical massage, and unique acupuncture services, just for you.
References
Airman 1st Class Bahja J Jones. (2011, August 25). Battlefield acupuncture offers alternative pain relief for deployed service members. Air Force. https://www.af.mil/News/Article-Display/Article/112510/battlefield-acupuncture-offers-alternative-pain-relief-for-deployed-service-mem/
Battlefield Acupuncture (BFA) Handbook. (2021). https://jts.health.mil/assets/docs/education/Battlefield_Acupuncture_Handbook.pdf
Dave Spiva. (2023, December 1). VA Lacks Sufficient Opioid Addiction Treatment. Www.vfw.org. https://www.vfw.org/media-and-events/latest-releases/archives/2023/12/va-lacks-sufficient-opioid-addiction-treatment
Jennifer H. Svan. (n.d.). Acupuncture Becomes Popular As Battlefield Pain Treatment. Www.awcof.com. Retrieved February 16, 2024, from https://awcof.com/news-acupuncture-becomes-popular-as-battlefield-pain-treatment.html
Melanie Moore 79th MDW PA. (2010, November 16). Complementary and Alternative Medicine - A profile on Dr. Richard C. Niemtzow. Www.79mdw.af.mil. https://www.jba.af.mil/News/Features/Display/Article/460993/complementary-and-alternative-medicine-a-profile-on-dr-richard-c-niemtzow/
Montgomery, A. D., & Ottenbacher, R. (2020). Battlefield Acupuncture for Chronic Pain Management in Patients on Long-Term Opioid Therapy. Medical Acupuncture, 32(1), 38–44. https://doi.org/10.1089/acu.2019.1382
Tamar Nordenberg. (2021a, August 26). Battlefield acupuncture. Www.research.va.gov. https://www.research.va.gov/currents/0821-Battlefield-acupuncture.cfm
Tamar Nordenberg. (2021b, September 8). Battlefield acupuncture an emerging and promising alternative to risky pain medications - VA News. Https://News.va.gov/. https://news.va.gov/94087/battlefield-acupuncture-an-emerging-and-promising-alternative-to-risky-pain-medications/
