Ear Acupuncture – Turning Up the Volume on Treatment

Auricular or ear acupuncture has been around from the beginning of the written record of acupuncture. Acupuncture points on the ear are mentioned in the Yellow Emperor’s Classic of Internal Medicine, one of the oldest texts of Chinese Medicine dating from somewhere between 206 BCE and 220 CE. In ancient times, Mediterranean sailors pierced their ears for decorative purposes but also to improve their vision. The modern ear map puts the eye point right in the middle of the lobe of ear, a common point for piercings. In ancient Egypt, women seeking to avoid pregnancy would use needling or cauterization of the ear. Many modern practitioners will avoid certain points in the ear during pregnancy. Treatments for sciatic pain and arthritis which involved blood letting, needling or cauterization of the ear were carried to Europe by returning traders of the Dutch East India Company in the sixteen hundreds.

Although most of the meridian points that we use today are very much the same as the points originally recorded in the ancient classics; the ear map that we use has changed completely. Historically, only the six yang meridians, all of which begin or end on the head, were represented on the ear. In 1957 Dr. Paul Nogier, a French Physician, codified the ear points into a microsystem similar to the microsystem used in foot reflexology. Nogier’s system was based on correspondences that he observed between sensitivity and changes in the ear and specific areas of pain, sensation, and pathology in the body, thus allowing points to be identified for all limbs, organs and senses. The Nogier microsystem was tested extensively by Chinese clinicians who were able to confirm both Dr. Nogier’s mapping of ear points and the clinical validity of ear treatment for a multitude of disorders.

In 1970 Dr. H. L. Wen of Hong Kong conducted the first clinical studies of the efficacy of ear acupuncture for treatment of chemical dependency.  In 1973 Dr. Michael Smith of the Lincoln Hospital in New York started to use ear acupuncture to help reduce withdrawal symptoms for patients with opiate, nicotine or alcohol addictions. Dr. Smith’s work lead to the formation in 1990 of the National Acupuncture Detoxification Association and to the development of the standardized five point NADA ear protocol for treatment of chemical dependence. The NADA protocol has been adopted by other organizations and used extensively to treat stress and PTSD symptoms in veterans, first responders and disaster victims. In 2008 Colonel Richard Niemtzow, MD of the US Air Force introduced a generalized auricular protocol for pain reduction, which he called Battlefield Acupuncture. Dr. Neimtzow has been teaching and using his protocol in clinical settings; however, he believes that soldiers could be trained to use the protocol closer to the front line as an adjunctive treatment for pain and trauma and to reduce psychological distress and medication requirements.

Ear acupuncture is a useful tool for treating areas of the body that cannot be treated directly. When there is an open wound, lymphedema, or other contraindication for local needling, ear acupuncture allows effective treatment without increased risk.  For difficult to treat pain conditions like phantom limb pain, Reflex Sympathetic Dystrophy (RSD), or chest wall syndrome – as a side effect of radiation therapy – ear acupuncture can be one of the most effective therapies available.

Many people will have heard of ear acupuncture being used for anesthesia during certain types of surgery in China. Surgeries on the midline and above the diaphragm, like thyroid surgery, are candidates for acupuncture anesthesia.   Although acupuncture anesthesia is not generally available in the United States, we can use retained ear needles to help reduce the unwanted side effects of anesthesia like nausea. Retained ear needles inserted prior to surgery have also been shown in studies to reduce the amount of pain medication required immediately post surgery and to improve patient experience. For the past seven years I have been offering retained ear needles to my patients who are undergoing planned surgeries, although the occasional anesthesiologist has been reported to scoff at the idea, the patient feedback has been excellent.

Ear acupuncture is commonly used for detox, pain reduction, and reduction of symptoms of psychological stress. In my experience ear acupuncture also acts as a “treatment amplifier” if added to a meridian-based body treatment. Although the jury is still out on exactly how acupuncture works from the standpoint of Western biomedicine, current research indicates that needling acupuncture points has an effect on neurotransmitter activity both in the area of insertion and in corresponding areas of the brain.  It seems reasonable to hypothesize that stimulation of the ear points may further enhance or perhaps balance the neurotransmitter activity at both ends of the system.



1)   Acupuncturists Without Borders (2012) Healing Community Trauma – Class Notes

2)   Brumbaugh A (1994) Transformation & Recovery; Stillpoint Press

3)   Niemtzow R (2010?) Battlefield Acupuncture – Class Notes

4)   Oleson T (2003) Auriculotherapy Manual; Churchill Livingston