ANDREWS AIR FORCE BASE - Using ancient Chinese medical techniques, a small team of military doctors here has begun treating wounded troops suffering from severe or chronic pain with acupuncture. The technique is proving so successful that the Air Force will begin teaching "battlefield acupuncture" early next year to physicians deploying to Iraq and Afghanistan, senior officials will announce tomorrow. The initiative marks the first high-level endorsement of acupuncture by the traditionally conservative military medical community, officials said.
Using tiny needles that barely penetrate the skin of a patient's ear, Air Force doctors here say they can interrupt pain signals going to the brain. Air Force Dr. Stephen M. Burns Photo Their experience over several years indicates the technique developed by Col. Richard Niemtzow, an Air Force physician, can relieve even unbearable pain for days at a time. That enables badly wounded patients who arrive here by medevac aircraft to begin to emerge from the daze of pain-killer drugs administered by surgeons in the field.
"This is one of the fastest pain attenuators in existence - the pain can be gone in five minutes," said Niemtzow, a physician, acupuncturist and senior adviser to the Air Force surgeon general. He and others stressed that tiny needles cannot replace morphine and other powerful drugs used in combat medicine. And they acknowledged that acupuncture doesn't work for everyone.
But neither does acupuncture provoke the kind of adverse side effects, allergic reactions and potential addiction associated with powerful psychotropic drugs often used to dull the pain of the severely wounded. "We use acupuncture as an adjunct" to traditional therapy, said Niemtzow. "The Chinese have used it for 5,000 years. It works, and it's powerful." The procedure developed by Niemtzow is a variation of traditional Chinese acupuncture in which long, hair-thin needles are inserted into the body at any of hundreds of points to ease pain.
Niemtzow's variation uses one or more needles inserted into any of five points on the ear. The needles, which penetrate about a millimeter (or 4/100ths of an inch) into the skin, fall out after several days. The procedure can be repeated. The ear acts as a "monitor" of signals passing from body sensors to the brain, he said. Those signals can be intercepted and manipulated to stop pain or for other purposes. Even 18th-century pirates were convinced of the value, piercing their lobes with earrings "to improve their night vision," Niemtzow said with a grin.
He calls his procedure battlefield acupuncture because it's easily learned and requires no cumbersome equipment. A pack of needles can easily be carried in a pocket. The method can be taught in a few hours to doctors, medics and combat troops, most of whom already have learned traditional battlefield first aid.
Col. Anyce Tock, chief of medical services for the Air Force Surgeon General, said yesterday that the service has authorized 32 active-duty physicians to begin "battlefield acupuncture"' training. Doctors at Ramstein Air Force Base in Germany are using the practice to treat severely wounded troops in transit from the battlefield to Andrews and on to Walter Reed Army Medical Center or the Bethesda Naval Hospital for long-term care. Battlefield acupuncture has been especially effective among patients suffering from a combination of combat wounds, typically a brain injury or severed limbs, burns and penetrating wounds along with severe disorientation and anxiety. For these patients, the alleviation of pain is a critical step in their eventual healing and recovery.
"We get damaged and psychologically troubled people here, and our approach is to turn down their pain, let them relax, get some sleep, and then they can focus on their healing," said Air Force Col. Stephen M. Burns. Burns, a physician who is chief of the acupuncture clinic here, makes weekly rounds treating wounded troops at Walter Reed. He said badly injured patients might be coping with three or four levels of painkillers, "and all they can do is sit in bed or in a chair."
"God bless 'em, they've already had too many surgeries and too much pain," he said. "We can knock down that pain so they can begin to get on with their lives." "Acupuncture has been very helpful for people for whom other treatment has failed," said Lt. Col. Terri L. Riutcel, an Air Force psychiatrist who deployed to Iraq last year where she treated victims of roadside bomb blasts, among other injuries. Acupuncture "is very well tolerated and there are very few side effects," apart from occasional bruising, she said. "I think it has tremendous potential for military medicine."
Battlefield acupuncture caught the eye of U.S. Army Rangers, who often operate in remote locations. At their invitation, Niemtzow and his team trained some Rangers last summer. Nonetheless, advocates of the practice recognize that they must overcome skepticism within the ranks of military doctors. "Oh, sure, some haven't gotten the word," said Burns, the clinic chief. "We are very much ahead of the curve."