The provision of nonpharmacological pain management options is gaining increased attention that is due in part to the high prevalence of pain and the serious problems associated with using opioids to manage that pain. One such evidence-based [1] option, acupuncture, is included in the American College of Physicians clinical guidelines for low back pain [2] and in the pain management strategy recommended by the U.S. Department of Health and Human Services [3]. Although providers may refer patients to many evidence-based nonpharmacological pain management approaches, providers have relatively limited pain management options outside of opioids or analgesics for patients presenting with pain during the clinic visit.

Given the prevalence of pain among the military and veteran populations, the U.S. Department of Defense (DoD) and Veterans Health Administration (VA) have committed to offering safe and practical nonpharmacological options for pain management. One emerging, potentially effective therapy offered in the DoD and VA settings for immediate, short-term pain relief is battlefield acupuncture (BFA). BFA is a form of auricular acupuncture developed by Colonel (Retired) Richard C. Niemtzow, MD, PhD, a radiation oncologist, for use among military personnel as an adjunct therapy to manage pain [4, 5]. It is notable for its ease of administration and for the fact that it can be learned and administered by a wide variety of non-acupuncturist clinicians [6–9]. The BFA protocol involves inserting semipermanent needles at each of five points in succession into each ear (see Figure 1) until pain relief is elicited or until all needles are inserted. Between needle insertions, the patient, if ambulatory, walks around for a few minutes to assess pain relief. The needles then remain in the ear for several days.