April 1, 2008

US Army and Battlefield Acupuncture

A medical procedure dating back thousands of years was introduced to patients and medical staff for one week in March at Landstuhl Regional Medical Center (LRMC). The hospital, located near Ramstein Air Base, Germany, is the largest and most modern US military medical facility outside the United States.

A limited form of acupuncture, called battlefield acupuncture, was introduced to LRMC doctors who applied the procedure to war- wounded servicemembers and local patients for pain relief, and often with significant results.

Major (Dr.) Conner Nguyen was exposed to acupuncture as both a patient and physician and was equally impressed in both roles. As a patient, Major Nguyen experienced 25 percent increased range of motion and a 50 percent reduction in pain for chronic shoulders and upper back pain he endured for several years.

As a pain physician specialist at LRMC, Major Nguyen recruited his most challenging patients with whom traditional pain treatment offered limited relief. Within minutes of the short golden studs inserted on their ears, many said they enjoyed a pain reduction of up to 75 percent.

A reduction of 25 percent would be considered a success with traditional pain medications, Major Nguyen said. In one case, a patient broke into tears when the severe pain he had been suffering from for more than a year subsided within moments.

When the military acupuncturists who introduced battlefield acupuncture return to conduct the follow-up certification training required to practice ancient form of medicine, Major Nguyen will be among the list of LRMC physicians desiring to add acupuncture as another tool in their medical kit.

"It allows a provider like me to confidently complete a treatment and expect a good result within minutes," Major Nguyen said. Other advantages he noted are virtually no significant complications, patients are subjected to little or no discomfort, and immediate results that can be "quite spectacular sometimes."

Major Nguyen received his interim hands-on training during the weeklong visit by Col. (Dr.) Stephen Burns and Col. (Dr.) Richard Niemtzow, two of the 40 Department of Defense doctors trained as a licensed acupuncturist.

Colonel Niemtzow developed and named the battlefield acupuncture technique in 2001. It is a radical departure from classical Chinese, French and German ear acupuncture. He said he realized its possible military value and the events of the World Trade Center influenced him to name it battlefield acupuncture.

As an Air Force acupuncturist, Colonel Niemtzow has trained hundreds of his military counterparts. Battlefield acupuncture focuses on locations on the ear that he said have been known for hundreds of years as effective areas for pain control. The ear is also practical because it can be readily accessed whether on the battlefield or in a hospital bed.

Acupuncture can also be a practical means for treating pain in the military, he said, in instances such as a Soldier who develops a migraine headache at the onset of a mission. Where pain medication could cloud the mind and compromise the mission, acupuncture could offer long-lasting relief within minutes.

Introducing acupuncture to doctors trained in traditional Western medicine often meets with raised eyebrows, but the reception is warming.

"In the beginning, many people were skeptical, but after seeing it demonstrated on patients and the benefits achieved -- especially in the area of pain -- the majority of physicians embraced it and learned how to use it in their practice as an adjunctive therapy," said Colonel Niemtzow, who is the consultant for alternative and complimentary medicine to the Air Force surgeon general.

The ancient form of medicine was readily received at LRMC, said Col. (Dr.) Stephen Princiotta, the deputy commander for clinical services here.

"The doctors who saw it in action and heard about it have been very excited about the opportunity to add acupuncture as an adjunctive therapy to what we already have been able to accomplish with western medicine," Colonel Princiotta said.

One LRMC doctor previously trained under Colonel Niemtzow as well as well attending the Helms Medical Institute at the University of California in Los Angeles for an additional 300 hours of acupuncture training. Maj. (Dr.) Teri Simpson is an anesthesiologist by trade, but uses acupuncture one day a week at the LRMC pain clinic with great success.

"I love it," Major Simpson said. "It can be life-changing when the patient responds immediately and looks at you like you're a magician."

Major Simpson said she tells them she doesn't completely understand how it works but is always happy to see a patient break into a smile who was in misery only minutes before.

In addition to using the small studs that resemble a small pierced earring, Major Simpson uses the longer needles more commonly associated with acupuncture. The frequency of application and the duration of relief vary with each patient, but treatment can progress from about two times a week to as little as once a month or longer. In some cases, further acupuncture treatment may not be required.

Acupuncture doesn't work for all of her patients; however. About 15 percent do not respond to acupuncture, Major Simpson said, but of the patients that do, their pain reduction often averages about 75 percent.

One of those patients was Army Spc. Bradley Phillips, an Army scout whose back pain while deployed to Iraq increased to the point where he required treatment at LRMC. Specialist Phillips, a 21 year old with the 3rd Armored Cavalry Regiment out of Fort Hood, Texas, had successfully received acupuncture treatment before by an Army medic and enthusiastically agreed to for the opportunity to be a part of the battle acupuncture program.

Specialist Phillips said he preferred acupuncture because it allowed him to avoid taking pain medications and their side effects. As Major Simpson applied two studs in his left ear and five in his right, as well as a few probes into his lower back with a longer needle, Specialist Phillips' pain slowly eased away.

"While I'm just standing here I feel a lot better," he said. In addition, the young Soldier edged the closest he'd been to touching his toes in six months.

For Senior Airman Jillian Sandbothe, traditional pain medication could never ease the headaches and upper back pain resulting from whiplash caused by a rear-end collision last April.

"It was amazing," she said of her initial acupuncture treatment that provided total relief from her headache. "I couldn't believe it the first time it happened. I could almost function like a normal person again."

Studs used for battlefield acupuncture barely penetrate the skin and fall out in about three days. When that occurred, her headaches returned and Airman Sandbothe arrived at the LRMC pain clinic for follow-up treatment. As before, the pain diminished as Simpson plied her acupuncture craft.

"I don't know how it works and I don't really care as long it keeps working," said Airman Sandbothe, who is assigned to the 52nd Component Maintenance Squadron at Spangdahlem Air Base, Germany.