Intended for healthcare professionals

Rapid response to:

Primary Care

Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial

BMJ 2004; 328 doi: (Published 25 March 2004) Cite this as: BMJ 2004;328:744

Rapid Response:

Weekly Visits for 3 months help patients with chronic headache?

You claim in This week in the BMJ (27/03/04) that the paper by
Vickers et al shows that acupunture is beneficial for chronic headache
disorders. We would take issue with that claim because the design of the
study does not make it clear what was causing the modest effect which the
authors noted. The treated arm of the study received 3 treatments which
were not received by the control arm: these were, first, input from
another human being for a mean of 11 sessions, second, insertion of
needles, and third, insertion of needles in accordance with acupuncture
prescriptions. Both the BMJ and the authors may attribute the effect to
the third treatment and as pragmatic neurologists (who see large numbers
of these patients) we may attribute it to the first, but sadly both these
conclusions are equally speculative because the design of the trial does
not separate them.

Competing interests:
None declared

Competing interests: No competing interests

07 April 2004
Victor Patterson
Consultant Neurologist
Raeburn Forbes
Royal Victoria Hospital, Belfast, UK