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Pins in Your Ears: How Acupuncture Can Help Relieve Your Pain

Image of Dr. Arnyce Pock, associate dean and medical acupuncturist at USU, oversees graduate nursing students at USU performing battlefield acupuncture for pain management, in February 2022. The course is intended to train health care personnel who are not physicians or acupuncturists, such as advanced practice nurses, to provide BFA to patients for pain management. (Photo: Uniformed Services University of the Health Sciences). Dr. Arnyce Pock, associate dean and medical acupuncturist at USU, oversees graduate nursing students at USU performing battlefield acupuncture for pain management, in February 2022. The course is intended to train health care personnel who are not physicians or acupuncturists, such as advanced practice nurses, to provide BFA to patients for pain management. (Photo: Uniformed Services University of the Health Sciences)

In Chinese medicine, acupuncture dates back more than 2000 years.

The Military Health System has developed a modern modification of this ancient practice, known as Battlefield Acupuncture, or BFA.

Military health care providers are finding that ear acupuncture, which involves inserting small needles into different areas of the ear, is successful in relieving pain of injured or ill service members.

"BFA is highly effective and markedly alleviates acute or chronic pain in approximately 80-85% of patients," regardless of the underlying cause, said Dr. Jeff Leggit, a professor and medical acupuncturist at the Uniformed Services University of the Health Sciences, in Bethesda, Maryland.

Leggit described it as an "invaluable tool." Providers can administer BFA quickly and safely. There's virtually no risk of drug interactions or side effects, he said.

BFA can also reduce the need for narcotics. "A modification of the protocol can also be exceedingly helpful in treating migraine and tension-related headaches," Leggit said.

Nearly every military hospital or clinic has at least one individual who has been trained in BFA, added Dr. Arnyce Pock, associate dean and medical acupuncturist at USU. "Moreover, the use of BFA in particular and acupuncture in general is becoming increasingly more common in [Department of Veterans Affairs] facilities as well," she said.

Twenty Years of Evidence

Retired Air Force Col. (Dr.) Richard Niemtzow developed BFA in the aftermath of Sept. 11, 2001, to deliver pain relief quickly and efficiently in combat and other military situations. He was the first full-time physician acupuncturist in the military after having been a radiation oncologist.

Leggit and Pock are part of the team that now teach BFA to military medical students, doctors, nurses, and others across the MHS.

The course lasts up to four hours. It includes lectures and hands-on practice, said Leggit.

In March, Leggit and Pock taught a BFA course to graduate military nursing students at USU. The course trained providers who are not physicians nor acupuncturists, such as advanced practice nurses, to provide BFA to patients for pain management.

"USU recognized the importance of giving its graduates training in BFA as a valuable tool in their analgesic 'toolbox', regardless of which specialty they decide to pursue," said Pock. "Being able to effectively treat pain is something every physician needs to be able to do."

Battlefield acupuncture involves placing a single, tiny, gold, semi-permanent needle into one or more of five key points on the external ear to relieve pain. (Photo: Uniformed Services University of the Health Sciences)
Battlefield acupuncture involves placing a single, tiny, gold, semi-permanent needle into one or more of five key points on the external ear to relieve pain. (Photo: Uniformed Services University of the Health Sciences) 

How Does It Work?

The BFA protocol involves placing a single, tiny, gold, needle into one or more of five key points on the external ear, Leggit said.

Providers insert the needles one at a time. "Patients are typically asked to take a short walk after the insertion of each needle," said Pock. "This activity seems to activate the neural pathways associated with the alleviation of pain."

After inserting a needle, the acupuncturist assesses the patient's pain level. If the patient is satisfied or their pain has decreased to a level of zero or one on a 10-point scale, the provider pauses the treatment. The needles remain in place for three to four days before falling out on their own, said Pock.

The acupuncturists can continue treatments for as long as needed.

"In some situations, depending on the underlying condition, one or two treatments may be all that's needed," said Leggit. "Other patients with more chronic conditions may require long-term treatment on a regular or recurring basis. Some may only need periodic maintenance treatments, say, one to two times a month."

Benefits

BFA can treat almost any type of acute or chronic pain. It works very quickly – usually within seconds or minutes, said Pock.

"The one caveat is that a conventional diagnosis must be made first, so that the attending clinician understands the underlying source of the pain," said Leggit. "In other words, it's important to treat the underlying cause as well as manage symptoms such as pain."

According to these experts, BFA can be particularly valuable for providing care in austere environments.

Demand for BFA has been steadily increasing, Pock added.

For more information, talk to your health care provider.

Battlefield Acupuncture Training

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Last Updated: July 11, 2023
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