Thalamus Omega 2 Point Zero Shen Men CONCLUSIONS Auricular

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BATTLEFIELD ACUPUNCTURE

• Heather R. Pickett, COL (s), USAF, MC, SFS
• Jiffy C. Seto, MAJ, USAF, MC

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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.

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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

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INSERTION OF NEEDLES
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ASP GOLD NEEDLES
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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)

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Battlefield ImplicationsAuricular Acupuncture
well suited for harsh environments
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Battlefield ImplicationsRapid insertion and
minimal prep time
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Battlefield ImplicationsLittle On-Site Medical
CareConducive to Self-Aid/Buddy CareEars
Readily Accessible
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Battlefield ImplicationsNeedles remain in place
1-3 days
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TEACHING OBJECTIVE PLACE NEEDLES INTO VERY
SPECIFIC POINTS ON THE EARIN SEQUENCE

• CINGULATE GYRUS
• THALAMUS
• OMEGA 2
• POINT ZERO
• SHEN MEN

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RATIONALE

• fMRI RESEARCH
• CLINICAL RESEARCH

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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

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Cingulate Gyrus
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Cingulate Gyrus

• Function
• Coordinates Sensory Input With Emotions
• Emotional Responses to Pain
• Regulates Aggressive Behavior

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Thalamus
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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).

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Pain Stimulation
Acupuncture Pain Stimulation
Cingulate Cortex (DM , AN, D.sf, IL,CM)
Cingulate Cortex (DM , AN, D.sf, IL,CM)
Thalamic Nuclei (DM , AN, D.sf, IL,CM)
Thalamic Nuclei (DM , AN, D.sf, IL, CM)
cACC
dACC
(ACG II)
dACC
(ACG I)
(ACG I)
M
,S
M
,S
rACC
rACC
(ACG III)
(ACG III)
PG
PG
TA
TA
Pain Stimulation
Acupuncture Pain Stimulation
0
0
(a)
(b)
Fig. 3
Cortical Activation due to Pain Stimulation and
Acupuncture Pain stimulation,respectively
seen at Cingulate.
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PATIENTSALL 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
•  

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CLINICAL RESULTSPAIN
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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

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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.

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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.

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RESULTS

• Participants in the acupuncture group experienced
  a 23 reduction in pain compared to the
  non-acupuncture group. - medications
• - compliance

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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
  patients bedside has been extremely effective
  with many amputees who have not responded
  sufficiently to other traditional techniques.

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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.

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SEQUENCE OF NEEDLES (both ears)

• 1. CINGULATE GYRUS
• 2. THALAMUS
• 3. OMEGA 2
• 4. POINT ZERO
• 5. SHEN MEN

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CONCLUSIONS

• Auricular Acupuncture
• Efficient, Versatile, and Cost Effective
• lt 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

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QUESTIONS?