Combined Pain Care Skills Training, SUD symposium puts focus on drug-free modalities

By Bernard S. Little Walter Reed National Military Medical Center, Hospital Communications

Completing deployments to Afghanistan and Kuwait more than six years ago, U.S. Army Reserve Lt. Col. Michelle Nordstrom shared that she started performing battlefield acupuncture to help service members better manage their pain after injury. She received training to deliver the protocol from retired U.S. Air Force Col. (Dr.) Richard C. Niemtzow, known as “the father of battlefield acupuncture,” who passed away last year.

An occupational therapist who does clinical research for the Uniformed Services University (USU) and clinical work at Walter Reed National Military Medical Center, Nordstrom now trains others in battlefield acupuncture, which she did during the recent 2026 Combined Pain Skills Training and Substance Use Disorder (SUD) Symposium. The hybrid event, hosted by the National Capital Region Pain Initiative (NCRPI) at Walter Reed, took place virtually Aug. 11-12, followed by in-person interactive workshops Aug. 18-19 at the National Union Building in Washington, D.C.

“It [battlefield acupuncture] seems to work, [because] if it didn’t, [healthcare providers] wouldn’t continue to do it,” Nordstrom said about the modality to those participating in the in-person workshop. Niemtzow developed battlefield acupuncture as a rapid-onset, ear-based pain management modality in 2001 to help service members and veterans reduce their reliance on opioids, alcohol and other drugs to alleviate their pain discomfort.

Battlefield acupuncture was one of several interactive workshops offered at pain care skills training and SUD symposium, and this was the second year that the NCRPI combined the training and the symposium, explained Amy J. Osik, NCRPI senior program manager.

“[Annually] the training, in its 16th year, brings colleagues and subject matter experts from across the country together to learn more about optimizing care and integrative approaches to pain management within the Department of War. The focus is on sharing best practices, conducting hands-on training and learning integrative approaches,” Osik explained.

Dr. Christopher J. Spevak, NCRPI program director, added that the program as well as annual symposium support readiness, restoration of function, and relief of pain while reducing the misuse of pain substances. "It’s designed to help clinicians and healthcare teams prevent, identify, and treat substance use disorders, which requires a multifaceted approach that includes education, research, intervention and clinical care,” he shared.

Other workshops at the event focused on art therapy for pain and SUD, massage therapy for pain, pain reprocessing therapy, dry needling, osteopathic manipulation for treating pain and dysfunction without drugs and surgery, anti-inflammatory nutrition for pain and SUD, and communications skills for difficult situations focused on pain and SUD cases.

U.S. Army Col. (Dr.) Jeremy Edwards, chief of pediatrics/pediatric palliative medicine at Walter Reed, discussed effective communications techniques that can be used across multiple scenarios in healthcare. He explained that effective communication is essential between providers and patients to help in pain management and SUD treatment. He focused on breaking bad news, difficult patient encounters, and complex care situations, stressing that it’s important for providers to suspend biases and practice active listening. “Know your audience and pay attention to nonverbal skills,” he added.

“Effective communication depends upon honest communication,” said Edwards. He added that effective communication should increase patients’ and families’ sense of control and self-worth while establishing a rapport. “The essence of true communication is the ability to enter a relationship based on respect, warmth, empathy and mutual regard.” He added this can also help patients with their pain management and enhance treatment for SUD.

U.S. Army Col. (Dr.) Chelsea Hamilton, a physiatrist who oversees the Augusta Ambulatory Care Centers at Dumfries and Fairfax, Virginia and also serves as director of the DiLorenzo Pentagon Health Clinic, discussed dry needling. She explained that dry needling is a protocol where no fluid or medication is injected. It is used to relieve pain, release tension, and improve mobility and generally for people with neck, back and shoulder pain, sports injuries, sprains and strains, and chronic muscle tightness and headaches. It helps muscles relax and reset.

Hamilton also focused on percutaneous electric nerve stimulation (PENS) in the treatment of acute and chronic pain. She explained that this involves fine needle electrodes that deliver low-frequency currents that bypass skin resistance to block pain signal transmission to the brain and stimulate the release of natural painkillers like endorphins.

Also during the in-person workshops, Dr. Jay Sandweiss, board certified in neuromusculoskeletal medicine and osteopathic manipulative medicine, discussed the basic principles and mechanisms used to evaluate movement and function of the neuromusculoskeletal system for pain and its relief.

“This offers health professionals a unique and effective system of diagnosis and treatment for musculoskeletal pain and dysfunction. In this current climate that seeks to find non-opioid and other non-invasive modalities, osteopathic manipulative medicine combined with manual muscle testing offers an ideal approach for treating many common musculoskeletal problems,” Sandweiss shared.

More than 30 workshops were part of the multi-day training and symposium with other topics focused on meditation practices, bioethics, gut dysfunction, and MSK [musculoskeletal] ultrasound. The primary focus was on military treatment efforts limiting prescriptions for pain management while offering alternative non-drug therapies and modalities and enabling service members to effectively return to duty.

For more information about the NCRPI program, call 301-319-2845.

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