BATTLEFIELD

ACUPUNCTURE

Heather R. Pickett, COL (s), USAF, MC, SFS

ffy C. Seto, MAJ, USAF, MC

BATTLEFIELD
ACUPUNCTURE

Term and methodology developed by Colonel (Dr)

Niemtzow in 2002 to achieve very rapid pain relief
(Acute or Chronic).
Employs French semi-permanent (ASP) gold
needles in very specific points in the ear: Cingulate

Gyrus, Thalamus, Omega 2, Point Zero and

Shen Men.

WHAT DO YOU USE IT FOR?

PAIN!
Ambulatory Care/Emergency Room:

Acute Sprains/Strains

Back, Neck, Ankle, Arms, Legs

Migraine Headaches
Post OP pain
Battlefield pain when narcotics are not desired

INSERTION OF NEEDLES

ASP GOLD NEEDLES

SPECIFICATIONS
Easy to Teach
Sealed Sterilized Needles Can be Carried in Pocket
Rapid: Seconds to Insert
Designed for Hostile Environment
No Need to Disrobe/Expose Body Parts
Needle Disposal Not Problematic
Results: 1-3 Day Pain Reduction (conservative)

Battlefield Implications:
Auricular Acupuncture well suited for
harsh environments

Battlefield Implications:
Rapid insertion and minimal prep time

Battlefield Implications:
Little On-Site Medical Care
Conducive to Self-Aid/Buddy Care
Ears Readily Accessible

Battlefield Implications:
Needles remain in place 1-3 days

TEACHING OBJECTIVE: PLACE

NEEDLES INTO VERY SPECIFIC
POINTS ON THE EAR
IN SEQUENCE

CINGULATE GYRUS
THALAMUS
OMEGA 2
POINT ZERO
SHEN MEN

RATIONALE

fMRI RESEARCH
CLINICAL RESEARCH

fMRI
fMRI Research of Professor Z.H. CHO
University of California, Irvine
Limbic System associated with mood and emotions
Involvement of the posterior cingulate gyrus and
thalamus in phasic pain processing in humans

Cingulate Gyrus

Cingulate Gyrus
Function:
Coordinates Sensory Input With Emotions
Emotional Responses to Pain
Regulates Aggressive Behavior

Thalamus

Thalamus
Thalamus = Discriminative Pain & Phantom Limb Pain
The thalamus perceives the pain but it is not able to localize
it. It then sends that information on to the cerebral cortex.
Pain perception is so important to survival that almost the
whole brain is involved.
Areas of future auriculotherapy research could entail other
CNS structures: thalamus, putamen, caudate nucleus,
hypothalamus, amygdala, periaqueductal grey matter,
hippocampus, red nucleus, pulvinar, and vermis of the
cerebellum (Wall,1996).

Pain Stimulation
Cingulate Cortex

Thalamic
Nuclei

(DM , AN, D.sf, IL,CM)

dACC

cACC

(DM , AN, D.sf, IL,CM)

(ACG II)

rACC

Cingulate Cortex

M ,S

Thalamic
Nuclei

(DM , AN, D.sf, IL,CM)

dACC

(ACG I)

(ACG I)
S.M

Acupuncture + Pain Stimulation

rACC

cACC

(ACG II)
S.M

(DM , AN, D.sf, IL, CM)

M ,S

(ACG III)

(ACG III)

PG

PG

TA

+0

Pain Stimulation

(a)

TA

+0

Acupuncture + Pain Stimulation

(b)

Fig. 3 Cortical Activation due to Pain Stimulation and Acupuncture + Pain stimulation,respectively seen at Cingulate.

PATIENTS
ALL FAILED WESTERN PAIN MEDICATIONS
(data developed by Niemtzow)
40 y/o M Sciatic LBP 10/10 4 weeks TX: 1/10 F/U: 3 days: 9/10
52 y/o M Lt Shoulder Pain Bursitis 7/10 1 month TX: 0/10 F/U: 10 days: 2-3/10
36 y/o F 6 years Elbow and Leg Pain 7/10 TX: 1/10 F/U: 8 days: 3/10
43 y/o F 9 years TMJ 4/10

TX: 0/10

F/U: 2 days: 5/10

77 y/o F 10 months Fibromyalgia 6/10 pain TX: 2/10

F/U: 2 days: 3/10

24 y/o F 5 years Carpal Tunnel bilat 4-5/10 TX: 0/10 F/U: 4 days: 4/10
21 y/o F 2 years TMJ 4/10 TX: 1/10 F/U: 2 days: 2/10
78 y/o F 7-8 years Left Hip / DJD pain 8/10 TX: 2/10 F/U: 3 days: 1/10
50 y/o F 17 years Fibromyalgia Pain 9/10 TX: 0/10

F/U: 5 days: 6.5/10

CLINICAL RESULTS
PAIN

Auricular Acupuncture in the Treatment of

Acute Pain Syndromes (AATAPS)
Richard C. Niemtzow, MD, PhD, MPH
Colonel, USAF, MC, FS

Stephen M. Burns, MD
Colonel, USAF, MC, FS
Malcolm Grow Medical Center
Andrews AFB, MD

Christine Goertz, DC, PhD

Director of Clinical Research, Samueli Institute
Alexandria, Virginia

AATAPS

The purpose of this study was to conduct a

scientifically rigorous investigation of
auricular acupuncture for the treatment of
acute pain in the emergency room setting at a
military hospital using a clinical trial design.

Study Design

Randomized clinical trial of E.R. patients

100 Participants (N = 50 per group)
Gold ASP needles were inserted in the ear at
the Cingulate Gyrus and the Thalamus points
bilaterally.

RESULTS

Participants in the acupuncture group

experienced a 23% reduction in pain
compared to the non-acupuncture group.
- medications
- compliance

Walter Reed Army Medical Center

The Amputee Care Team at Walter Reed Army

Medical Center (WRAMC) has treated approximately
600 new traumatic amputees due to blast injuries
from the current war in the Middle East.
For the last several years, USA physicians have
teamed up with their AF acupuncture colleagues. This
unique approach to pain management at the patients
bedside has been extremely effective with many
amputees who have not responded sufficiently to
other traditional techniques.

WRAMC

In particular, ear acupuncture is performed

away from the healing zone of injury (for
instance, leg or arm). Therefore, our surgical
colleagues are not concerned about infection
or delayed wound healing when employing
auriculotherapy. We hope to elaborate better
treatment for our fallen comrades.

SEQUENCE OF NEEDLES
(both ears)
1. CINGULATE GYRUS
2. THALAMUS
3. OMEGA 2
4. POINT ZERO
5. SHEN MEN

Cingulate
gyrus

Thalamus

Omega 2

Point Zero

Shen Men

CONCLUSIONS
Auricular Acupuncture:

Efficient, Versatile, and Cost Effective

< 50 Cents /ASP needle
Total Cost: 10 needles (max) per Patient = $ 5.00

Conducive to Operational Environment

Next Steps:
Expanded Clinical Trial
Continue to Collect Data

QUESTIONS?