Battlefield Acupuncture for the Treatment of Low Back Pain

Low Back Pain (LBP) is a significant health concern for military readiness and quality of life.  In the deployed setting, LBP resulted from 2/3 of all injuries sustained and is one of the most prevalent non-battle reasons for medical evacuation from theater.  Rehabilitation is costly and long-term consisting of ambulatory care visits, time from work, rest and recuperation, medications, and medication side effects treatment.  Correlating factors for military personnel with LBP include older age, enlisted rank, Army service, female gender and married. Despite the economic burden and negative impact of LBP on mission readiness, some interventions remain ineffective. There remains a dire need for integrative LBP interventions that are not only efficacious, but non-pharmacological, safe, inexpensive, less invasive, and rapid acting.

One innovative non-pharmacological intervention that meets these requirements is Battlefield Acupuncture (BFA).  BFA is a form of auricular acupuncture that uses five semi-permanent needles (known as ASP needles) in a predetermined pattern of acupuncture points that typically remain in place for two-five days. BFA is an acute and chronic pain intervention that allows healthcare personnel who are not acupuncturists to provide BFA for their patients. Some of the non-physician, non-acupuncturist personnel trained in BFA are nurses.

The purpose of this study is to determine the effect of BFA on reported outcomes for pain, disability rating, quality of life, sleep, balance, physical activity level, and trunk flexion mobility in an active duty military population with reported subacute or chronic LBP. The proposed study is a randomized control trial that will compare outcomes between subjects treated with BFA to subjects who have the introducer touch their ear (control group) at the predetermined sites. Otherwise, all the procedures will be the same for both groups.

The novelty of this study is that it will focus on the effect of pain reduction on objective measurements: sleep and activity patterns (using an actigraphy wrist device), trunk flexion mobility and balance. These components are necessary in LBP rehabilitation to improve confidence to re-engage in physical fitness activity. Additional military specific outcomes will include medication use and military duty readiness.