ClinicalTrials.gg
CompletedNCT04464954Updated Apr 4, 2024Results posted

BFA Treatment of Pain

An interventional study of Auricular semi-permanent (ASP gold) needles and Intradermal (long) needles using J-type No. 2 (.18)x 15mm in Musculoskeletal Pain and Acute Pain, sponsored by Paul Crawford. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-04-04.

Sponsored by Paul Crawford · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
30
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The aim of this pilot study is to conduct an unblinded pilot randomized clinical study on the effectiveness and tolerability of auricular semi-permanent (ASP) vs intradermal (long), and pyonex needles in Battlefield Acupuncture (BFA) for the treatment of pain.

Read the detailed description
  1. Begin to identify which of 3 needles is most efficacious for BFA treatment of pain;
  2. Identify patient experiences and tolerance of three commonly used acupuncture needles at Mike O'Callaghan Military Medical Center at Nellis Air Force Base. This study will compare 30 patients (10 per needling group) and will serve as a pilot study for a potential larger randomized control trial (RCT) across multiple MTFs in the Defense Health Agency (DHA) to establish better BFA care practices. We will be recruiting a total of 39 subjects, which is inclusive of a 30% drop out rate to accommodate those that may be lost to the study or have missing data to achieve a final total of 30 subjects.
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Conditions studied

  • Musculoskeletal Pain
  • Acute Pain

Keywords

  • acupuncture
  • battlefield acupuncture
03

In context

Musculoskeletal Pain

511 studies on the registry are indexed under Musculoskeletal Pain; 113 are open to participants now.

This study's enrollment of 30 is below the median of 66 across 358 interventional studies indexed under Musculoskeletal Pain.

Browse Musculoskeletal Pain studies →

Lead sponsor

Paul Crawford is the lead sponsor of 6 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

**Patients must be able to get care at Nellis Air Force Base (a military installation) in order to participate in this study**

Inclusion criteria

Inclusion Criteria:

  • Active duty and DoD Beneficiaries aged 18 years or older
  • Acute (0-4 days) musculoskeletal injury
  • Injuries eligible for inclusion include all acute non-fracture related musculoskeletal injuries of the axial or peripheral skeleton.

Exclusion criteria

Exclusion Criteria:

  • Taking any opioid medications daily
  • Rheumatologic and autoimmune conditions which may be creating pain, such as rheumatoid arthritis, advanced osteoarthritis, or spinal stenosis
  • Contra-indication to needle use including known bleeding disorder and psychogenic issues related to needle use (e.g., needle-phobia)
  • Evidence or history of clinically significant immune deficiency, hematological, oncological, renal, endocrine, pulmonary, gastrointestinal, cardiovascular, hepatic, psychiatric, neurologic, or severe allergic disease (including to metals and adhesive tapes) which could interfere with this study
  • Individuals with progressive radiating pain with motor-sensory changes (including weakness or numbness) related to their presenting pain complaint
  • Women who are pregnant, may be pregnant, or attempting to become pregnant
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
30 participants (actual)

Study arms

  • Experimental
    Auricular semi-permanent (ASP gold) needles

    Device: Auricular semi-permanent (ASP gold) needles

  • Experimental
    Intradermal (long) needles using J-type No. 2 (.18)x 15mm

    Device: Intradermal (long) needles using J-type No. 2 (.18)x 15mm

  • Experimental
    Pyonex needles (Seirin Yellow 0.2 x 0.6mm)

    Device: Pyonex needles (Seirin Yellow 0.2 x 0.6mm)

Interventions

  • DeviceAuricular semi-permanent (ASP gold) needles

    ASP semi-permanent Battlefield Acupuncture needles are semi-permanent needles that will remain in subject ears for 2-8 days and will be allowed to fall out on their own

  • DeviceIntradermal (long) needles using J-type No. 2 (.18)x 15mm

    Intradermal (long) needles will remain in subject ears for 15-30 minutes and will be removed by a member of the study staff.

  • DevicePyonex needles (Seirin Yellow 0.2 x 0.6mm)

    Pyonex needles will remain in subject ears for 2-21 days and allowed to fall out on their own.

06

What researchers measure

Primary outcomes

  1. Effectiveness: Scale

    Defense and Veterans Pain Rating Scale (DVPRS).DVPRS is an 11-point numerical rating scale with 0 indicating no pain and 10 indicating severe pain. It has been confirmed for reliability and validity in measuring both acute and chronic pain, and is currently the standard for pain measurement throughout DoD and VA health systems. The DVPRS demonstrates linear scale qualities allowing parametric methods to be used.

    Time frame: repeated measurements of change in the DVRPS. (Pre-acupuncture, 10-15 minutes post-acupuncture, 24 hours post-acupuncture, and 1 week post-acupuncture)

  2. Needle Tolerance: Questionnaire

    Measured using an in-house developed questionnaire. It employed a 5-point (1-5) ordinal scale to evaluate pain at needle site. Lower score (1) is no pain. Higher score (5) is constant pain.

    Time frame: average pain at needle site 1-week post insertion

07

Results

Posted Apr 4, 2024

Participant flow

Participant flow — Overall Study
MilestoneAuricular Semi-permanent (ASP Gold) NeedlesIntradermal (Long) Needles Using J-type No. 2 (.18)x 15mmPyonex Needles (Seirin Yellow 0.2 x 0.6mm)
Started101010
Completed101010
Not completed000

Outcome measures

PrimaryEffectiveness: Scale

Defense and Veterans Pain Rating Scale (DVPRS).DVPRS is an 11-point numerical rating scale with 0 indicating no pain and 10 indicating severe pain. It has been confirmed for reliability and validity in measuring both acute and chronic pain, and is currently the standard for pain measurement throughout DoD and VA health systems. The DVPRS demonstrates linear scale qualities allowing parametric methods to be used.

Time frame:
repeated measurements of change in the DVRPS. (Pre-acupuncture, 10-15 minutes post-acupuncture, 24 hours post-acupuncture, and 1 week post-acupuncture)
Reported as:
Mean · score on a scale
Effectiveness: Scale
score on a scaleAuricular Semi-permanent (ASP Gold) NeedlesIntradermal (Long) Needles Using J-type No. 2 (.18)x 15mmPyonex Needles (Seirin Yellow 0.2 x 0.6mm)
DVPRS preacupuncture4.2 (3 to 6)5.1 (2 to 6)4.9 (2 to 7)
DVPRS postacupuncture (10-15 minutes post)3.2 (2 to 4)3.7 (1 to 7)4.0 (0 to 7)
DVPRS postacupuncture 24 hours3.0 (1 to 6)2.8 (0 to 6)3.1 (0 to 7)
DVPRS postacupuncture 1 week3.3 (1 to 5)2.9 (0 to 8)3.5 (0 to 8)
PrimaryNeedle Tolerance: Questionnaire

Measured using an in-house developed questionnaire. It employed a 5-point (1-5) ordinal scale to evaluate pain at needle site. Lower score (1) is no pain. Higher score (5) is constant pain.

Time frame:
average pain at needle site 1-week post insertion
Reported as:
Mean · score on a scale
Needle Tolerance: Questionnaire
score on a scaleAuricular Semi-permanent (ASP Gold) NeedlesIntradermal (Long) Needles Using J-type No. 2 (.18)x 15mmPyonex Needles (Seirin Yellow 0.2 x 0.6mm)
Needle Tolerance: Questionnaire2.0 (1 to 5)1.0 (1 to 5)1.8 (1 to 5)

Adverse events

Collected over through study completion, 1 week. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Auricular Semi-permanent (ASP Gold) Needles0/10 (0%)0/10 (0%)1/10 (10%)
Intradermal (Long) Needles Using J-type No. 2 (.18)x 15mm0/10 (0%)0/10 (0%)1/10 (10%)
Pyonex Needles (Seirin Yellow 0.2 x 0.6mm)0/10 (0%)0/10 (0%)1/10 (10%)
Most frequent other events
Most frequent other events
EventAuricular Semi-permanent (ASP Gold) NeedlesIntradermal (Long) Needles Using J-type No. 2 (.18)x 15mmPyonex Needles (Seirin Yellow 0.2 x 0.6mm)
Adverse EventEar and labyrinth disorders0/100/101/10
Adverse EventEar and labyrinth disorders0/101/100/10
Adverse EventSkin and subcutaneous tissue disorders1/100/100/10

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Auricular Semi-permanent (ASP Gold) NeedlesIntradermal (Long) Needles Using J-type No. 2 (.18)x 15mmPyonex Needles (Seirin Yellow 0.2 x 0.6mm)Total
<=18 years0000
Between 18 and 65 years89926
>=65 years2114
Age, Continuous
Age, Continuous(years)Auricular Semi-permanent (ASP Gold) NeedlesIntradermal (Long) Needles Using J-type No. 2 (.18)x 15mmPyonex Needles (Seirin Yellow 0.2 x 0.6mm)Total
Mean51.2 (37 to 66)41.1 (27 to 69)42.7 (26 to 67)45 (41.1 to 51.2)
Sex: Female, Male
Sex: Female, Male(Participants)Auricular Semi-permanent (ASP Gold) NeedlesIntradermal (Long) Needles Using J-type No. 2 (.18)x 15mmPyonex Needles (Seirin Yellow 0.2 x 0.6mm)Total
Female710724
Male3036
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Auricular Semi-permanent (ASP Gold) NeedlesIntradermal (Long) Needles Using J-type No. 2 (.18)x 15mmPyonex Needles (Seirin Yellow 0.2 x 0.6mm)Total
American Indian or Alaska Native0000
Asian0000
Native Hawaiian or Other Pacific Islander0000
Black or African American0000
White0000
More than one race0000
Unknown or Not Reported10101030
Region of Enrollment
Region of Enrollment(participants)Auricular Semi-permanent (ASP Gold) NeedlesIntradermal (Long) Needles Using J-type No. 2 (.18)x 15mmPyonex Needles (Seirin Yellow 0.2 x 0.6mm)Total
United States10101030
08

Study locations

1 site
  • Mike O'Callaghan Military Medical Center
    Nellis Air Force Base, Nevada 89191, United States
09

References and documents

Publications

  • Chen YM. Clinical application of lower He-Sea points for abdominal pain [presentation] 28th Annual International Symposium on Acupuncture, Electro-Therapeutics Researches, Columbia University Faculty House, New York, NY, October 27, 2012.
  • Melzack, Ronald. Pain Forum. Volume 5 (2). Summer 1996. Pages 128-138.
  • Madsen MV, Gotzsche PC, Hrobjartsson A. Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups. BMJ. 2009 Jan 27;338:a3115. doi: 10.1136/bmj.a3115. PubMed 19174438 ↗
  • Vickers AJ, Vertosick EA, Lewith G, MacPherson H, Foster NE, Sherman KJ, Irnich D, Witt CM, Linde K; Acupuncture Trialists' Collaboration. Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. J Pain. 2018 May;19(5):455-474. doi: 10.1016/j.jpain.2017.11.005. Epub 2017 Dec 2. PubMed 29198932 ↗
  • Yuan QL, Wang P, Liu L, Sun F, Cai YS, Wu WT, Ye ML, Ma JT, Xu BB, Zhang YG. Acupuncture for musculoskeletal pain: A meta-analysis and meta-regression of sham-controlled randomized clinical trials. Sci Rep. 2016 Jul 29;6:30675. doi: 10.1038/srep30675. PubMed 27471137 ↗
  • Devitt M. Research Finds Acupuncture Effective for Chronic Pain [Internet]. AAFP Home | American Academy of Family Physicians. 2018 [cited 2020Apr1]. Available from: https://www.aafp.org/home. html
  • Center for Medicare and Medicaid Services. Decision Summary: Proposed Decision Memo for Acupuncture for Chronic Low Back Pain (CAG-00452N). Center for Medicare and Medicaid Services. July 15, 2019. https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decisionmemo. aspx?NCAId=295
  • Pain management task force final report77. (2010). Office of the Army Surgeon General. Retrieved from http://www.armymedicine.army.mil/reports/Pain_Management_Task_Force.pdf.
  • Walker PH, Pock A, Ling CG, Kwon KN, Vaughan M. Battlefield acupuncture: Opening the door for acupuncture in Department of Defense/Veteran's Administration health care. Nurs Outlook. 2016 Sep-Oct;64(5):491-8. doi: 10.1016/j.outlook.2016.07.008. Epub 2016 Jul 20. PubMed 27601311 ↗
  • Defense and Veterans Center for Integrative Pain Management.(2016). Retrieved from http://www. dvcipm.org/.
  • Spotswood, S. (2014). Auricular acupuncture: Convenient technique for battlefield pain. U.S. Medicine, Retrieved from http://www.usmedicine.com/agencies/department-ofdefense-dod/auricular-acupunctureconvenient- techniquefor-battlefield-pain/.
  • Koffman, R., & Helms, M. (2013). Acupuncture and PTSD: 'come for the needles, stay for the therapy'. Psychiatric Annals, 43(5),236e239.
  • Crawford P, Penzien DB, Coeytaux R. Reduction in Pain Medication Prescriptions and Self-Reported Outcomes Associated with Acupuncture in a Military Patient Population. Med Acupunct. 2017 Aug 1;29(4):229-231. doi: 10.1089/acu.2017.1234. PubMed 28874924 ↗
  • Niemtzow RC. Battlefield Acupuncture: My Story. Med Acupunct. 2018 Apr 1;30(2):57-58. doi: 10.1089/acu.2018.29077.rcn. No abstract available. PubMed 29937955 ↗
  • DHA-PI 6025.33, Acupuncture Practice in Military Medical Treatment Facilities February 20, 2020. Retrieved from pdf.
  • Bonakdar RA, Mills PJ. Auricular Acupuncture Therapy for Treatment of Musculoskeletal Pain in the Setting of Military Personnel: A Randomized Trial. United States Naval Medical Center San Diego in collaboration with Scripps Integrative Medical Center at La Jolla, CA. NIH Clinical Trail NCT02263001. Last Updated May 4, 2017.
  • Burton SJ, Moss DA, Crawford PF 3rd. Effect of needle selection on battlefield acupuncture tolerance and pain reduction: an exploratory randomized controlled trial. Acupunct Med. 2026 Feb;44(1):25-35. doi: 10.1177/09645284251400386. Epub 2025 Nov 29. PubMed 41317090 ↗

Study documents

  • Protocol and statistical analysis plan · Feb 16, 2021
  • Informed consent form · Nov 13, 2020

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No — We do not plan on sharing data.

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Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Nov 2020 to primary completion in Apr 2021, 5 months.

Results were first posted in Apr 2024, 2 years 11 months after primary completion.

Of 213 non-industry interventional studies with no phase under Musculoskeletal Pain, half reached primary completion within 13 months of starting (the median), counting those still running; a quarter within 5 and three quarters within 34. This study's 5 months is below that.

Counting every sponsor, half of 226 studies reached it within 12 months; a quarter within 5 and three quarters within 33.

How these figures are worked out, and which studies are left out of them.

Registered
Jun 29, 2020
First posted
Jul 9, 2020
StartActual
Nov 1, 2020
Primary completionActual
Apr 20, 2021
CompletionActual
Apr 20, 2021
Results first posted
Apr 4, 2024
Last update
Apr 4, 2024
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Apr 4, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT04464954
Lead sponsor
Paul Crawford
Responsible party
Paul Crawford (Principal Investigator, Mike O'Callaghan Military Hospital) — Sponsor-investigator
First posted
Jul 9, 2020
Start date
Nov 1, 2020
Primary completion
Apr 20, 2021
Completion
Apr 20, 2021
Results posted
Apr 4, 2024
Last update
Apr 4, 2024

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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