Pickett - Usafp Battlefield Acupuncture (pptminimizer)

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 patient’s 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?