[Show abstract][Hide abstract] ABSTRACT: Sixty-two female patients with chronic tension headache were randomized into two treatment groups--acupuncture and physiotherapy. The intensity of headache, muscle tenderness and neck mobility was assessed before and after treatment. Thirty healthy women were used for comparison. Before treatment it was found that muscle tenderness was increased and neck rotation was reduced in the patient group compared with controls. There was a significant correlation between the intensity of headache and muscle tenderness. After treatment, the intensity of headache and muscle tenderness were reduced in both treatment groups. The headache was more improved in the physiotherapy group, and there was a marked reduction in the intake of analgesics. The tenderness was reduced in all muscles tested in the physiotherapy group but only in some of the muscles after acupuncture. The limitation of neck rotation was not influenced by either treatment.