http://www.estripes.com/article.asp?section=104&article=35732


By Leo Shane III, Stars and Stripes
Mideast edition, Wednesday, March 15, 2006




Col. Jeff Gambel admits that sometimes it's tough to convince soldiers
that the pain in their arms and legs can be eased by sticking needles in
their ears.

"We do end up having to give patients some education along with the
treatments," said Gamble, chief of Walter Reed Army Medical Center's
Amputee Clinic and one of several acupuncturists on staff. "Often
patients only know a little about it. But most of ours have been
receptive, and we've seen good results with their pain management."

Since the 1980s, specialists at Walter Reed have been using
acupuncture as an alternative treatment approach, using needles and
an intricate knowledge of the nervous system to help certain patients
manage chronic pain.

Only a handful of other military medical centers offer the treatments,
and Tricare benefits don't cover outside acupuncture sessions.

But recently, the practice has gained new attention as physicians have
used it to help wounded patients returning from Iraq and Afghanistan
deal with the severe pain of shrapnel wounds, deep burns and
amputated limbs.

Gambel said over the past three years several hundred wounded
servicemembers have used the practice, along with aggressive
medication regimens and other physical therapy techniques, in their
recovery.

"There are side effects to pain medications that a lot of these patients
don't want: drowsiness, lack of focus, things like that," he said. "This
gives them an alternative."

The Walter Reed staff has collaborated with Air Force Col. Richard
Niemtzow, chief of Andrews Air Force Base's Acupuncture Clinic, to
develop approaches specifically for those severe injuries.

Niemtzow, who specializes in wound-distant techniques, has charted a
series of ear and scalp points that can help ease throbbing in an injured
limb. In a typical session, he pushes tiny gold pins about the size of a
small earring just into a patient's earlobe, and leaves them there for
several days to suppress the pain sensors.

Treating those areas doesn't compromise the relief benefits, he said,
but does lessen fears patients might have about sticking a pin near the
wound site.

"The same thing doesn't work for everyone all the time," said
Niemtzow, editor of several acupuncture medical journals. "I had a
patient (injured in Iraq) who we used the ear needles on, and it didn't
help him at all.

"When he came back, he said, `Don't bother with my ears.' Instead we
tried rubbing his hands with some metal plates. Five minutes later, he
said he felt much better."

Other approaches include the larger, 6-inch needles most people
associate with acupuncture, and placing them one-eighth of an inch or
deeper in patients' skin.

Niemtzow said most of his patients don't even notice the slight prick that
comes with the visit, and those who do are willing to sacrifice the quick
stab for greater pain relief.

Gambel warns that the acupuncture isn't a panacea for all pain. About
85 percent of the patients they've treated have reported feeling better,
but all of them are also on pharmaceuticals as well. And the group
usually only recommends the treatments for patients who aren't
receptive to traditional pain-management treatments.

But, he said, officials are trying to train more specialists in the hopes of
expanding opportunities for treatment at the center.