BAGRAM AIRFIELD, Afghanistan -- Doctors at Craig Joint Theater Hospital and its outlying clinics are implementing a pain treatment that reduces or eliminates opioid prescriptions. It is also fast and effective and allows personnel to continue working without being sent home.

The treatment is called Battlefield Acupuncture and stems from Eastern medicine practiced 5,000 years ago. It was developed in 2001 by Air Force Dr. (Col.) Richard Niemtzow, who was seeking to streamline treatment to quickly reduce pain in a fast-paced environment like during a deployment. He retired in 2010.

He learned that the ear has five powerful "auricular" or ear acupuncture points that, when connected into, can dramatically reduce pain.

The up-to-10 needles, five per ear, used are only 1 millimeter in length and are either gold-plated or made of steel. Minimal pain is experienced when they are placed in the outer ear and when worn. Eventually they fall out after three to seven days on average.

"The ear is complex," said Air Force Dr. (Capt.) Carl Bryce. "It's innervasion, meaning where it derives the nerves from, is multi-faceted. It has nervous input at multiple levels. It's unique in that aspect."

Air Force Maj. Kyle Johnston, a physician assistant and colleague of Bryce's, said Battlefield Acupuncture isn't completely understood.

"We don't know exactly why it works, but just the documented history of 5,000 years of it having benefit has some sort of validity," Johnston said.

Johnston specializes in emergency medicine and Bryce in family medicine. Johnston deployed from Elgin Air Force Base, Florida, and Bryce from Offutt Air Force Base, Nebraska.

Johnston said Battlefield Acupuncture's treatment initially started on those wounded warriors recovering back home but has since spread to the rank-and-file of the deployed military workforce.
Natural painkiller

"The teaching is that perhaps 80 percent of patients will experience at least a 50 percent reduction in pain, which I think is very good," Bryce said, adding in some cases there are non-responders.
Bryce said it is believed that in those cases, there often is a baseline of chronic opioid use, which evidently diminishes the body's sensitivity to acupuncture. He explained that opioids are naturally produced in the body.

"We think that's one potential mechanism for how Battlefield Acupuncture helps is your own body's natural painkillers that it is producing. When we manipulate that with acupuncture medicine, we're altering the natural production of these things in the body," Bryce said.

This treatment advantage of not having to rely on medication is important for military personnel, the doctors said.

For instance, a pilot is restricted in the types of medications they can be prescribed that would allow them to continue to fly. But with Battlefield Acupuncture, the pilot may not need any medication to allow him to continue flying with reduced pain.

Some military personnel work in sections only two or three people deep, Bryce said, and if someone is prescribed a narcotic for pain, that can result in that person not being able to carry their weapon, and not being able to complete their jobs because of the mental incapacitation of the drug's effect, he said. "So, the mission is significantly degraded."

"I really don't want to oversell acupuncture," Bryce said. "I call it a nudge toward healing. I believe it recruits your body's natural healing mechanisms."

Battlefield Acupuncture, rather, is part of the overall treatment plan which includes adequate nutrition, exercise, rest, and possible medication, he said, integrated with Western medical care.
In the emergency room, Johnston said that Battlefield Acupuncture is one of his "go to" tools.

"I actually use it frequently in the ER for anyone with most musculoskeletal-type pain, as well as headaches or migraines. I've used it for both very successfully," Johnston said, adding that that he's had patients wheeled in with back pain because they could not stand up and after Battlefield Acupuncture treatment, walked out unassisted.

Likewise, Johnston said he's experienced similar results with those suffering from migraine headaches who couldn't open their eyes or needed sunglasses to lessen the pain.

"You do the [battlefield] acupuncture on them and then they walk out and they're smiling and they can look up at the sun," he said.

One patient in total agreement is Army Chief Warrant Officer 2 George Scott. He with the 109th Medical Detachment, Veterinary Services, a Reserve unit from Garden Grove, Calif.

Scott, an 18-year-veteran, is a big man standing 6 feet, 2 inches, weighing 240 pounds. He is the sole Afghanistan theater food safety officer who travels frequently inspecting dining facilities, warehouses, and even the Afghan businesses where locally produced bottled water comes from.

As Scott found out, wearing the double extra-large individual body armor weighing nearly 60 pounds and designed to protect him while traveling in various modes of land and air transportation throughout theater, took its toll on his shoulder and lower back.

"So I decided to try this," Scott said. "This is an amazing thing, because what it did, it allowed me to be free enough of pain to go to gym and practice those physical therapy exercises."

Prior to Battlefield Acupuncture, Scott said he was in a lot of pain and had limited mobility.

"It's very difficult to rehab an injury. When you can't get out of bed it's hard to get motivated to actually make it to the gym and do your stretching exercises and physical therapy exercises," he said.

Surprised by how quickly the treatment worked, Scott said he started to think it was all in his mind.
"For me and my experience, it just blocked the pain enough to give me the range of motion; to give me ability to be able to stretch and strengthen up that area where I was having the problem," he said.

Scott first started treatment in October and is something he will continue, if needed, when he redeploys next spring.
"This is my third treatment and I'm way better," he said. "This treatment allows you to do just about 100 percent" stretching and warming up, he said.

"I'm very happy to see the level of services that the hospital is providing now for our troops. I mean this is great," Scott said. "It allowed me to continue to do my job."

With ongoing training is taught with certification at the hospital, more and more caregivers here and in theater will be offering Battlefield Acupuncture treatment. With all its advantages, it's becoming very popular with patients.

"I can treat you before you've even had a chance to pick up the medicine at the pharmacy," Bryce said. "It's easy, patients love it, it's not just another medicine, and it's very safe."