Table of Contents

• Introduction

• Origins of Battlefield Acupuncture

• How is Battlefield Acupuncture Applied? 

• The Mechanics Behind Battlefield Acupuncture

• Current Research on BFA

• BFA Patient Testimonials

• Is BFA Better than Western Medicine?

• BFA Treatment vs Opioid Treatment

• Conclusion

• Further Resources

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.

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.

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.

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. 

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.

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.

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.

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.

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.

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.”

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.

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. 

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.

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. 

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.

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.

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/

On This Page

1. Introduction

2. Origins of Battlefield Acupuncture

3. How is Battlefield Acupuncture Applied? 

4. The Mechanics Behind Battlefield Acupuncture

5. Current Research on BFA

6. BFA Patient Testimonials

7. Is BFA Better than Western Medicine?

8. BFA Treatment vs Opioid Treatment

9. Conclusion

10. Further Resources