In conclusion, the hypothesis that acupuncture is efficacious in the treatment of neck pain is not based on the available evidence from sound clinical trials. Further studies are justified.

Over two-thirds of the GPs in Devon and Cornwall who responded to the survey had been involved with complementary medicine in some way during the previous week. This figure is higher than the national average. The majority of respondents believed that acupuncture, chiropractic and osteopathy were effective and should be funded by the NHS.

A multicentre, randomized clinical trial was undertaken to test the hypothesis that acupuncture is more efficacious than sham control procedure in the prevention of episodic tension-type headache. Fifty subjects were randomized to receive a course of treatment with either brief acupuncture or a sham procedure. Subjects were followed up for 3 months. Changes in headache were assessed by daily diary, the primary outcome measure being the number of days with headache. No significant differences were found between the changes in the two groups for any measure at any time point. Results also show that patient blinding was successful. In conclusion, this study does not provide evidence that this form of acupuncture is effective in the prevention of episodic tension-type headache.

Summary T,.nsion heaclache is canman, and treatment with ,i(.LtpLIlcture is frequently recommended,,tlthouglt the evidence of its cffcctivcncss is contradiclory. This small, randontised, controlled trial was desiEned as a pilot to tcst procedLlrcs in preparajan fot a multi centre trial invcstiEating the efiect al acupuncturc as a treatmcnt far tension headache. l, t) \oluFlpct\ -ttfler;Fp uottt, pi,odi,. ', n-',,n '1p-headache wcrc rccruited by local n-.\a,spaper articlcs. Patients were randontised lo receive either bricf nccdlinB la lender areas ar selected traditional points (Croup A), ot pressure lrcnt ;t cocktail stick supportcd withitl a guide tulrc to c|-.lin-^t1, nontcDder and non-aa:LtpLtncture areas (Group B). The palients' vi-.\t, ol the treatnent sites \,\,as obstructed so that no indicatian could be gained as to which [a]ftt of eattneDt was being given.Thrau?hout the period of the ttial, duration, frequency and intensity of headachcs wcrc rccorded, from which the mean weekly headachc lndex was calculated-There was no diflerence betv,ecn thc changes in weekly headache ind-.r iD the t\\,o Eroups, camparing scates beforc and after treatment, Howcvcr, Craup A experienced a caDsiderably highcr nuntber ol headach-.-lree weeks than Croup B.'fhe credibility ol the t\\,o procedures was tested usinB a slandatd ctedibility questionn;;ire aDd a "final verdicl". One sul)ject it1 Orctup B cctncluded that she had not rcceiveal Benuine acupun.ture, but overall there ! as ro -slatistic?/ difterence between the credibility of treatment in the two gr.,ups.

No abstract