The Skeptic Next Door

The Baltimore Sun is reporting that the US Air Force has begun using Battlefield Acupuncture.  There is lots of evidence that acupuncture reduces pain.  It is a very effective placebo, but it has not been reliably shown to reduce pain more than any other placebo.

The claims that this “… can relieve even unbearable pain for days at a time” seems suspicious.  If I were in unbearable pain I would want more than a few little pins in my ear.

Is there a proper scientific study that justifies this?  The Baltimore Sun is quoting from Col. Richard Niemtzow who has published numerous papers.  Unfortunately he appears to have mainly published in acupuncture journals and the published studies on his website appear to be primarily anecdotal in nature.

I did find the following abstract for one of his papers, Auricular acupuncture in the treatment of acute pain syndromes: A pilot study by Goertz CM, Niemtzow R, Burns SM, Fritts MJ, Crawford CC, Jonas WB., Military  Medicine. 2006 Oct;171(10):1010-4

This pilot study used a randomized controlled clinical trial design to compare the effects of standard emergency medical care to auricular acupuncture plus standard emergency medical care in patients with acute pain syndromes. Eighty-seven active duty military personnel and their dependents with a diagnosis of acute pain completed the study, which was conducted in the emergency room (ER) at Malcolm Grow Medical Center, Andrews Air Force Base, Maryland. The primary outcome measure was change in pain level from baseline, as measured by the Numerical Rating Scale. Participants in the acupuncture group experienced a 23% reduction in pain before leaving the ER, while average pain levels in participants in the standard medical care group remained basically unchanged. (p < 0.0005). However, both groups experienced a similar reduction in pain 24 hours following treatment in the ER.

So there was no blind, neither single nor double.  The subjects were given a treatment that is known to have a placebo effect, and it initially reduced the perceived amount of pain but after 24 hours there was no difference.

It is not too surprising that the study was not single or double blinded.  Acupuncture is hard to single blind, and nearly impossible to double blind.  See Barker Bausell’s Snake Oil Science: The Truth about Complementary and Alternative Medicine for a good description of some of the problems.

As always it ends with the:

More research is needed to elucidate treatment effects and to determine mechanisms.

I also found the first page of  Battlefield Acupuncture, Niemtzow, R., Med Acup Vol.19 Issue 4 pp. 225-228.

The name “Battlefield Acupuncture” coined by the author, …

The technique delivers significant attenuation of pain in just a few minutes.  The length of the pain-free period does vary from minutes, hours, days, weeks and months depending on the presenting pathology and the duration of the stimulate….

I interpret this as the technique gives pain relief for a random amount of time.

Neither of these small chunks of web information appear to match the efficacy described in the Baltimore Sun.

I wish I could find more information on this.  This is definitely not proper review of Dr. Niemtzow’s work, I do not have access to many of the papers he has published, though many of them are in regards to acupuncture treatments for other ailments.  He appears to be a dedicated concerned practitioner who has published numerous papers based on his work.