The effects of different parameters of acupuncture on syndromes of pain in the head and neck regions were assessed in 177 patients. Long-term treatment was offered and further evaluations of up to 2 years were done on those who responded to acupuncture. Ages of the 78 males and 99 females treated varied from 18 to 79 years (mean 42). Pain was chronic and had lasted for 3 months to 6 years. All patients had had some form of treatment previously, with little benefit. The following were the diagnoses dealt with: secondary trigeminal neuralgia following tooth extraction or facial trauma; chronic sinus pain; temporomandibular pain, scalp muscle contraction headache; central pain; suboccipital and cervical musculoskeletal pain; head and neck pain associated with psychological distress. The following parameters of acupuncture were studied at 10 trial sessions for each patient and were randomized: (1) regional location of the needles, (2) intensity of stimulation, (3) duration of stimulation, (4) mode of stimulation. Intratrial design was crossover and controls were placebo acupuncture in two trials. If more than 20% reduction in pain intensity had been achieved at the end of 10 treatment sessions patients continued long-term treatment with acupuncture. The number of treatments varied according to individual requirements and on the outcome of treatment. Patients were followed up for 2 years. The results of the trial sessions showed that acupuncture reduced pain in 100 out of 177 patients (56%). The effective regional locations of needles were local and intrasegmental to pain, and deep protopathic stimulation with needles was more effective than intradermal insertion of needles. The optimal duration of treatment was 30 min or more and the most effective frequency for stimulation was with low-frequency (2 Hz) electrical stimulation. Eighty-four of the 177 patients (47%) started long-term treatment, experiencing relief for periods up to 2 years in a few. Thirty-eight patients (21%) discontinued treatment on the basis of complete and prolonged relief of pain. Sixteen did so after the trial sessions and 22 in the course of continuing treatment. Our results further indicate that acupuncture was more effective in dealing with pain in which muscle spasm predominated as opposed to neurogenic and inflammatory pain in head and neck.

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