James A. Haley Veterans’ Hospital - Tampa, Florida

Dr. Nazimuddin Qazi inserts a tiny gold needle into a precise location in the ear of Veteran Luis Rosario as part of the Battlefield Acupuncture treatment for Rosario's chronic back and shoulder pain.

Veteran Luis Rosario left his doctor’s office July 21 showing off his new “bling,” 10 tiny gold studs piercing different parts of both ears.

This bling had more benefits than just catching the eye, though.  As a medical treatment, it also greatly eased his chronic back and shoulder pain in the few minutes it took to insert the tiny, solid gold needles into his ears.

Rosario was being treated in James A. Haley Veterans’ Hospital’s new Battlefield Acupuncture (BFA) Clinic, part of the hospital’s chronic pain management program.  The clinic, started by JAHVH Ambulatory Care Pain Clinic Lead Attending Physician Dr. Nazimuddin Qazi, began seeing patients in June.

Acupuncture, the practice of inserting thin needles into various parts of the body to treat a variety of medical ailments, has been practiced in traditional Chinese medicine for more than 2,000 years, but Battlefield Acupuncture is a relative newcomer.  It was developed in 2001 by Air Force physician Dr. Richard Niemtzow, and refers to the fact that BFA practitioners are concentrating on only one treatment course.

“We are not fully trained acupuncturists so we don’t do the whole body,” Qazi explained.  “We are targeting for pain because that’s what we do.”

The procedure itself is as simple as it has been effective.

“We sterilize the ear with alcohol and we use very small needles,” Qazi said.  “They are so tiny, and only the last part, maybe one or two millimeters, actually goes in. This is a Chinese art where they use energy fields in the body to activate it.  After each pair of piercings, we ask the patients to move their arms and walk a little bit to activate those fields.

“I must have done 30 or 35 procedures, and except for one patient who had a marginal response, we have had a uniformly positive response,” Qazi said.  “Like yesterday, I did a procedure on a patient and the pain level went from a nine or 10 on the pain scale down to a three.  The patient was all bent over and in severe pain and when he walked out he looked straight in my eyes and said, ‘I don’t know what you did, doc, but you made me feel great.  I don’t have the pain.’”

Each needle comes individually packed in a sterile applicator, which is used to quickly insert the needle into one of five predetermined points in each ear.  Once the needles are inserted in precise locations, the applicators – each with a small magnet in the end – are given to the patient with instructions to move the magnets over the needles occasionally to reactivate the fields.

The needles are usually taped over to prevent them from falling out prematurely or from being pulled out by things like clothing.  Patients are asked to avoid rubbing the needles or engaging in activities that could lead to the sites becoming infected, but otherwise sleep with them and carry on their regular activities.

The needles are designed to remain in the ear for three to five days before being removed by the patient, with the treatment being repeated as often as every two weeks depending on the patient’s desire and schedule.

Qazi said the treatment can be used for any type of pain but is extremely effective on musculoskeletal pain.

“Low back pain is the most common type of chronic pain, and it is phenomenally effective for that,” Qazi explained.  “Hip pains, knee pains, shoulder pains, so we have these pains that have been affected by it.”

BFA is “…a very useful tool” in the medical provider’s toolbox for treatment of chronic pain, Qazi said, although it is just one of the treatments available.  It is not designed to replace other forms of treatment or therapy, especially in light of VA’s emphasis on reducing the use of opioids, but to offer Veterans an alternative.

“It’s part of helping Veterans, not necessarily to avoid opioids although that is an overwhelming consideration, but people who are at risk (of opioid addiction) should be offered alternatives,” Qazi said.  “Those who are not at risk deserve to be given a non-chemical alternative.”

The only people who should avoid the BFA treatment are those who currently take blood thinning medication or those who are extremely needle phobic, Qazi said, but they also have non-invasive treatments involving placing small magnets at the acupuncture points rather than the needles.

While Qazi and another physician are providing the treatments in the weekly BFA Clinic, practitioners throughout the system have been trained in BFA and can provide treatments at the Community Based Outpatient Clinics and primary care clinics. 

For Rosario, the Veteran who was showing off his bling, the treatment has provided relief he wasn’t able to find anywhere else.  Before his July 21 treatment – his fifth so far – he estimated his pain to be at level six on a 10-point scale.  After the treatment, he said it was at zero.

“The only other treatments I’ve actually done was a chiropractor, and I didn’t like that,” Rosario, who has suffered from lower back and shoulder pain for 18 years, said.  “I hate pills, so this is much better.  I haven’t taken my medication in a while.”

He said he’d definitely recommend the BFA Clinic to other Veterans suffering from chronic pain.

“I walk in here and I feel the pain, and when I walk out I’m in good shape.”