Battlefield Acupuncture

Basic patient information on Battlefield Acupuncture, a medical modality that promises to help patients with pain, mental health issues, and other problems.   

By Mark D. Harris

Where did it come from?

Acupuncture is a type of Traditional Chinese Medicine (TCM) that has been practiced for centuries. Battlefield acupuncture (BFA) is a variation of auricular acupuncture which was developed in the US Air Force by Dr. Richard Niemtzow. BFA includes dry needling and trigger point acupuncture which are used on other parts of the body outside the ear. Thousands of medical professionals have been trained in BFA.

What is it used for?[1]

  1. Musculoskeletal pain (muscles, bones, and joints)
  2. Migraine headaches
  3. Low back pain
  4. Sore throat
  5. Gallbladder pain
  6. Various other pain sites

How does it work?[2]

  1. Local – Reduces pain by stimulating nerve fibers in skin and muscle, thus blocking pain impulses from other sites in the area.
  2. Segmental – Decreases the response to painful stimuli of the dorsal horn, part of the spinal cord.
  3. Regional – Reduces pain at the spinal cord by decreasing the response to painful stimuli of areas immediately above the
  4. Central – Stimulates the hypothalamus and the limbic system to produce a generalized calming effect and sense of well-being. This is partly due to a release of endorphins, natural pain-killing and mood improving chemicals in the body.
  5. Myofascial – Stimulates inflammation and attracts cells that foster tissue repair

Does it hurt?

Acupuncture uses tiny needles, much smaller than needles used to draw blood. Most people don’t feel anything when the needles are inserted. Some feel a pinch which quickly goes away on its own.

Are there side effects?

All medical procedures have side effects, but BFA is very safe. Slight pain, bruising, and slight bleeding happen occasionally. Some people feel lightheaded, drowsy, dizzy, or nauseous. Rarely, patients get a local infection or scarring of the ear.

Will it help me?

Most people get some improvement in pain and other symptoms. According to results in US military facilities in Germany, about 15 percent of patients do not respond to acupuncture, but of those who do, their pain reduction often averages about 75 percent.[3] Different patients may need one treatment, several treatments, or continuing treatments to get the best possible effect.

What should I do to get the best chance of success?

Just before your appointment, sleep eight hours, eat a healthy diet, and continue all medications (unless told otherwise by your doctor. Keep a written record of your responses to therapy. BFA is best utilized as part of a comprehensive care plan, including medication, exercise (core, flexibility, endurance, and strength), sleep, healthy diet, and other interventions as needed.

Aftercare instructions


  1. Engage in only light activity only on the day of the procedure, avoiding alcohol for at least six hours after the procedure.
  2. Resume normal activity the day after the procedure.


  1. Look for excessive redness, warmth, pain, swelling, and drainage.
  2. If these occur, remove all of the needles immediately and apply a warm compress.
  3. If there is no improvement after several hours, seek medical help.

Medications – Continue all of your prescription medications unless otherwise instructed by your doctor.


  1. The ear needles will fall out on their own in two to four days. If they don’t fall out, remove them gently at four days. 
  2. If they cause discomfort, wash your hands and a pair of tweezers and pull them slowly and carefully out.
  3. Dispose the needles in a container with a sealable lid.

Radiology – If you are scheduled for an MRI, ensure that all of the needles are out, and tell the technologist

Showering – Pat ears dry instead of rubbing them

Treatments (Present)

  1. Keep a written log of your responses to treatment. This will include changes in pain, sleep, mood, energy, and changes in well-being.
  2. Bring the log with you to each treatment.
  3. If your ears get red, painful, swollen, or pus develops, remove the needle at the site and seek care with your doctor. An infection may be developing. 

Treatments (Future)

  1. BFA can be repeated every four weeks.

Contact your primary care provider, or follow up at the sports medicine clinic.

[1] Does Ear Acupuncture Have a Role for Pain Relief in the Emergency Setting? A Systematic Review and Meta-Analysis.,

[2] An Introduction to Western Medical Acupuncture (London: Elsevier, 2008), 8-9.

[3] Battlefield Acupuncture for the Clinical Practitioner,

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