Combat Acupuncture: How the Military Uses Acupuncture for Pain Relief
Advantages of acupuncture over medcines for pain relief explained in an article on military medicine:
“Imagine being a military medic on a combat patrol that is ambushed and suffers casualties. Although several of your wounded troops have painful injuries, their trigger fingers still work and you need them to continue fighting.
Instead of morphine, you grab your acupuncture needles and quickly stimulate the appropriate auricular acupoints. Pain relief is an essential component of combat casualty care; however, the use of narcotics risks taking the service member completely out of the fight.
Beyond pain control, the potential advantages of BA (battlefield acupuncture) to the injured warrior include staying in the fight with no alteration in sensorium and no nausea or vomiting. In addition, the use of narcotics would force the transport of patients on litters. More combat team members would be required to carry a patient than are required to provide ambulatory assistance for a patient still lucid enough to walk.”
Imagine treating a wounded soldier in the middle of a combat zone.
You need to control their pain. But you also need them to remain alert, functional and able to respond to what is happening around them.
That creates a very different problem from treating pain in a hospital or clinic.
It’s one of the reasons military doctors became interested in an unexpected tool for pain relief: acupuncture.
Known as Combat Acupuncture or Battlefield Acupuncture, the technique was developed to provide rapid pain relief without relying solely on conventional pain medication.
Why would the military use acupuncture?
In ordinary healthcare, pain medication can be an important part of treatment. But in a military environment, there are additional considerations.
A medication that causes significant sedation or affects alertness may not be ideal for someone who needs to remain operational. There can also be practical difficulties around transporting, storing and administering medicines in remote or rapidly changing environments.
This led military clinicians to investigate whether acupuncture could provide another way of controlling pain.
The idea wasn’t to replace modern medicine.
It was to give clinicians another tool.
What is Combat Acupuncture?
Combat Acupuncture is a specialised form of auricular acupuncture, which uses acupuncture points on the ear.
One of the best-known approaches, Battlefield Acupuncture, was developed by Dr Richard Niemtzow, a US Air Force physician and medical acupuncturist.
The technique uses very small needles inserted into specific points on the ear. In some protocols, semi-permanent needles are used so that stimulation can continue after the initial treatment.
The approach was designed to be relatively simple and portable, making it particularly interesting in military and emergency settings.
Does Combat Acupuncture actually relieve pain?
There is clinical evidence suggesting that acupuncture can reduce pain, although the strength of evidence varies depending on the type of pain and the particular acupuncture technique being studied.
A large individual-patient-data meta-analysis examined 29 randomised controlled trials involving almost 18,000 patients with chronic pain. The researchers found that acupuncture was associated with better outcomes than both sham acupuncture and no acupuncture for several common chronic pain conditions, including back and neck pain, osteoarthritis and chronic headache.
The differences between acupuncture and sham acupuncture were relatively modest, but they were consistent across the conditions studied.
This is important because it suggests that the effects of acupuncture cannot simply be explained by people believing they are receiving treatment.
Acupuncture compared with morphine
One of the more interesting studies comes from an emergency department rather than the battlefield.
Researchers conducted a randomised trial involving 300 patients with acute moderate-to-severe pain. Patients received either acupuncture or intravenous morphine.
A reduction in pain of at least 50% was achieved in 92% of patients receiving acupuncture compared with 78% receiving morphine.
These results are interesting, but they need to be interpreted carefully.
This was a single study involving acute pain. It does not mean that acupuncture is generally equivalent to morphine, or that people should stop using prescribed pain medication.
What it does demonstrate is that acupuncture can produce substantial pain relief in some acute pain situations and deserves consideration as part of the wider range of approaches available for pain management.
What about side effects?
Another reason acupuncture has attracted interest in pain management is that its risk profile is different from that of many analgesic medicines.
In the emergency department study comparing acupuncture with morphine, adverse effects were reported much more frequently in the morphine group.
That doesn’t mean acupuncture has no risks.
Minor effects such as temporary soreness, bruising or a small amount of bleeding can occur. Serious complications are uncommon when acupuncture is performed appropriately, but they can occur.
The important point is that acupuncture and medication aren’t interchangeable treatments with identical risks and benefits.
They are different tools.
Why is this useful on the battlefield?
Consider the environment in which Combat Acupuncture was developed.
A soldier may be injured, in significant pain and far from a hospital. At the same time, they may need to remain awake and responsive.
In that setting, having a treatment that doesn’t depend on systemic medication can be useful.
This is one reason the US military has incorporated acupuncture into aspects of military healthcare.
The US Navy has reported the use of Battlefield Acupuncture in military medical facilities, particularly as part of approaches to managing pain without relying solely on medication.
It is a fascinating example of how a treatment that might once have seemed unconventional can become useful when clinicians are faced with a very practical problem.
Does Combat Acupuncture replace pain medication?
No.
And that’s not really the point.
Severe pain can have many causes, and some injuries require urgent medical assessment and conventional treatment. Medication can also be entirely appropriate in many situations.
The value of Combat Acupuncture is that it demonstrates something broader:
Effective pain management doesn’t always have to rely on medication alone.
That principle is relevant well beyond the battlefield.
From the battlefield to everyday pain
Most people who come to an acupuncture clinic aren’t soldiers in a combat zone.
They’re dealing with back pain, neck pain, headaches, migraines, joint pain, pelvic pain, sports injuries or pain that has persisted long after an injury should have healed.
For these patients, the question is usually much simpler:
“Is there another way to manage my pain?”
Acupuncture may provide one option.
Depending on the condition, it can be used on its own or alongside other forms of care. The evidence is stronger for some types of pain than others, which is why the approach should be matched to the individual and the underlying problem.
What the evidence tells us
Combat Acupuncture is interesting not because it proves that acupuncture is better than medication.
It is interesting because military medicine had a very practical reason to investigate it.
When clinicians need to control pain while preserving alertness and function, having a non-drug option can be valuable.
That same idea is increasingly relevant in modern pain management, where treatment is often about more than simply suppressing a pain signal.
For persistent pain, a broader approach may include physical activity, rehabilitation, psychological strategies and other non-drug treatments alongside conventional medical care.
Acupuncture can form part of that approach.
Acupuncture for pain at Dr Vitalis
At Dr Vitalis, we use acupuncture as part of an evidence-informed approach to pain management.
We don’t believe acupuncture needs to be presented as an alternative to everything else. The more useful question is whether it makes sense for your particular type of pain.
If you’re living with ongoing pain and want to explore whether acupuncture may be appropriate, our main guide explains how we approach different types of pain and the evidence behind acupuncture treatment.
Learn more about acupuncture for pain →
References
- Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture for chronic pain: individual patient data meta-analysis. Archives of Internal Medicine. 2012;172(19):1444–1453. PubMed.
- Grissa MH, Boubaker H, Fehri H, et al. Acupuncture vs intravenous morphine in the management of acute pain in the emergency department. American Journal of Emergency Medicine. 2016.
- National Institute for Health and Care Excellence. Chronic pain (primary and secondary) in over 16s: assessment and management. NICE guideline NG193. NICE recommendations.
- Academic Consortium Pain Task Force. Acupuncture Therapy as an Evidence-Based Nonpharmacologic Strategy for Comprehensive Acute Pain Care. Pain Medicine. 2022;23(9):1582–1596.
Acupuncture remarkably improves exercise tolerance in patients with heart failure says Dr Johannes Backs from University Hospital of Heidelberg in Germany.
