Air Force To Train Battlefield Doctors

Chief Warrant Officer James Brad Smith broke five ribs, punctured a lung and shattered bones in his hand and thigh after falling more than 20 feet from a Black Hawk helicopter in Baghdad last month. While he was recovering at Walter Reed Army Medical Center in Washington, his doctor suggested he add acupuncture to his treatment to help with the pain. On a recent morning, Col. Richard Niemtzow, an Air Force physician, carefully pushed a short needle into part of Smith's outer ear. The soldier flinched, saying it felt like he "got clipped by something." By the time three more of the tiny, gold alloy needles were arranged around the ear, though, the pain from his injuries began to ease. "My ribs feel numb now and I feel it a little less in my hand," Smith said, raising his injured arm. "The pain isn't as sharp. It's maybe 50 percent better. Acupuncture involves placing very thin needles at specific points on the body to try to control pain and reduce stress.

There are only theories about how, why and even whether it might work. Regardless, the ancient Chinese practice has been gradually catching on as a pain treatment for troops who come home wounded. Now the Air Force, which runs the military's only acupuncture clinic, is training doctors to take acupuncture to the war zones of Iraq and Afghanistan. A pilot program starting in March will prepare 44 Air Force, Navy and Army doctors to use acupuncture as part of emergency care in combat and in frontline hospitals, not just on bases back home. They will learn "battlefield acupuncture," a method Niemtzow developed in 2001 that's derived from traditional ear acupuncture but uses the short needles to better fit under combat helmets so soldiers can continue their missions with the needles inserted to relieve pain. The needles are applied to five points on the outer ear. Niemtzow says most of his patients say their pain decreases within minutes.

The Navy has begun a similar pilot program to train its doctors at Camp Pendleton in California Niemtzow is chief of the acupuncture clinic at Andrews Air Force Base. He's leading the new program after training many of about 50 active duty military physicians who practice acupuncture. The U.S. military encountered acupuncture during the Vietnam War, when an Army surgeon wrote in a 1967 edition of Military Medicine magazine about local physicians who were allowed to practice at a U.S. Army surgical hospital and administered acupuncture to Vietnamese patients. Niemtzow started offering acupuncture in 1995 at McGuire Air Force Base in New Jersey. Several years later, he became the first full-time military medical acupuncturist for the Navy, which also provides health care for the Marines. Later, he established the acupuncture clinic at the Malcolm Grow

Medical Center at Andrews, and he continued to expand acupuncture by treating patients at Walter Reed and other Air Force bases in the country and in Germany. Niemtzow and his colleague Col. Stephen Burns administer about a dozen forms of acupuncture — including one type that uses lasers — to soldiers and their families every week. Col. Arnyce Pock, medical director for the Air Force Medical Corps, said acupuncture comes without the side effects that are common after taking traditional painkillers. Acupuncture also quickly treats pain. "It allows troops to reduce the number of narcotics they take for pain, and have a better assessment of any underlying brain injury they may have," Pock said. "When they're on narcotics, you can't do that because they're feeling the effects of the drugs." Niemtzow cautions that while acupuncture can be effective, it's not a cure-all. "In some instances it doesn't work," he said. "But it can be another tool in one's toolbox to be used in addition to painkillers to reduce the level of pain even further."

Smith says the throbbing pain in his leg didn't change with acupuncture treatment but that the pain levels in his arm and ribs were the lowest they've been since he was injured. He also said that he didn't feel groggy afterward, a side-effect he usually experiences from the low-level morphine he takes. Ultimately, Niemtzow would like troops to learn acupuncture so they can treat each other while out on missions. For now, the Air Force program is limited to training physicians. He says it's "remarkable" for the military, a "conservative institution," to incorporate acupuncture. "The history of military medicine is rich in development," he said, "and a lot of people say that if the military is using it, then it must be good for the civilian world."