By: Lance Leone and Anthony Bailes of South Texas Veterans Health Care System (STVHCS)  John S Finnell of STVHCS and Bastyr University, and Elizabeth ‘Jayne’ Halmai of (STVHCS and University of Texas Health Science Center. 


Chronic pain and opioid use are significant problems among veterans, especially those with chronic pain and psychiatric trauma. There is a need for evidence-based, cost-effective, interdisciplinary approaches to chronic pain. As many as 44% of patients seek out complementary and integrative health (CIH) approaches for the management of pain, and approximately 60% of patients seeking CIH services for low back pain reported: “great benefit.” Nonpharmacologic pain management interventions that have shown promise for the management of acute and chronic pain and are deliverable in group settings are the auricular protocols: Battlefield acupuncture (BFA) and Battlefield Acupressure (BAA).

The purpose of this project is to assess the effect of BFA and BAA, as nonpharmacologic approaches to pain management, delivered in group-based virtual health promotion programs in a VA population.


The South Texas Veterans Health Care System (STVHCS) is one of 18 flagship sites offering the VA Whole Health System of Care, which will provide patient-centered complementary in integrative health (CIH) care to Veterans and act as an incubator for future CIH research within the VA.


BFA and BAA, respective group-based acupuncture and acupressure interventions, were delivered in a 30-minute group-based intervention to Veterans experiencing chronic pain. Devices used for the BFA/BAA intervention included a choice of ASP tacks, freehand DETOX5 needles, and ear tacks for BFA or Vaccaria ear seeds for BAA. Devices were applied by an acupuncturist or a trained clinician.

The study population included Veterans enrolled in the Whole Health Program at the South Texas Veteran Health Care System from 2019 to 2020. The pain was assessed using the pain visual numeric scale (PVNS) before and after either BFA or BAA intervention.

Differences in pre-post PVNS scores were assessed using the student’s t-test for mild (1-3), moderate (4-7), and severe (8-10) pain, respectively, and for pain level overall.

On average, Veterans attended the BFA/BAA group medical visits once per week for less that three weeks total for pain management.


A cohort of N=937 Veterans participated in the BFA and BAA group medical visits in 2019 to 2020. Participants reported experiencing mild (n=57), moderate (n=306), and severe (n=574) pain.