New Approaches to Treating Battlefield Injuries

ByABC News

May 11, 2005 — -- More than 12,000 soldiers have been injured in Iraq, with better body armor protecting the head and vital organs and improved transport allowing more of the wounded to survive.

But those who do often are in horrendous pain. Doctors who treat the wounded in Iraq call this a war on human limbs, with injuries to skin and muscle that are among the most painful known to medicine.

"I think it's kind of like a living hell," said Staff Sgt. Chris Cook. "I mean, you're constantly … your pain takes up all of your thoughts."

To relieve that hell, Dr. Trip Buckenmaier's team at Walter Reed Army Medical Center in Washington, D.C., is pioneering a technique that is changing battlefield medicine.

"We're thinking about pain in the military like I don't believe military officials have ever thought about pain," Buckenmaier said.

Sgt. Tanner Hoag nearly lost his arm to a roadside bomb. In previous wars, his pain would probably have been numbed by morphine, an addictive narcotic. But Buckenmaier used an electric probe to pinpoint the exact nerve that transmits pain from the wound.

He then injected the nerve with a constant flow of non-addictive medicine called regional anesthesia.

"Right now I feel it kicking in," Hoag said after the injection. "My fingers are going numb and eventually, and in the past … it would just fall and I would have to pick it up and put it on my lap."

Buckenmaier and his colleagues have been training other doctors in the technique. He spent three months in Iraq treating soldiers hours after they were injured -- reducing their pain to almost zero.

"From the compassionate standpoint, we need to be doing this," he said. "Our soldiers deserve the best possible pain control we can give them."

What Buckenmaier has learned in the war zone could help anyone with pain. It has to do with how the brain interprets an injury.

If someone injures their leg, impulses from the damaged nerves are transmitted into the brain. Researchers theorize that if that process is not interrupted, the brain will essentially memorize the pain, leading to chronic pain long after the wound heals. Traditional narcotics like morphine do not stop the signals -- they just prevent the patient from feeling them as pain.

"Now, with regional anesthesia, we can attenuate or stop most of those pain signals from reaching the brain so that the stress response, the stress hormone release and the depressions to the immune system -- a whole host of things we know are detrimental -- are turned down," Buckenmaier explained.

Cook has had 17 surgeries since a truck bomb in Iraq nearly severed his leg eight months ago. His pain is all but gone.

"You know, I think that it's a miracle of science," he said, "but I do believe that, you know, to begin the healing process, not feeling pain helps to aid in the healing process."

Buckenmaier believes this is the future for pain control, and he's trying to prove it -- one injured soldier at a time.

ABC News' Bob Woodruff reported this story for "World News Tonight."