What is biofeedback?
Biofeedback is a tool that helps sufferers alleviate their own pain. By means of devices sensitive to very small changes in bodily conditions, it allows the user to monitor and fine-tune the connections between emotions and health.
The mind can play an important role in treating headaches and other types of chronic pain. Biofeedback helps people recognize and control the tension and stress that can fuel pain. Specifically, it can teach you to release the tension in your muscles and improve your circulation, two steps that can significantly ease many types of pain.
How does it work?
Biofeedback works by translating subtle physical changes into easy-to-read signals. A session starts when a therapist attaches sensors to your skin, usually a thermistor that measures the temperature of a finger and/or an electrode that registers the tension in sore muscles. These sensors don't just spit out numbers. The electrodes, for instance, may be hooked up to a pair of headphones that translate tension into sound; the thermistor can be attached to a flashy computer-generated graph.
The therapist will then help you relax, perhaps by asking you to imagine a quiet, peaceful place or by teaching you a breathing technique. As your mind becomes calm, the temperature in your finger may rise from, say, 88 degrees to 94 degrees, a sign that your circulation is improving. The readings from the electrodes may drop from perhaps 7 microvolts to 3 microvolts, indicating that your muscles are becoming relaxed. You would normally overlook such changes, but the biofeedback system makes them impossible to ignore.
Thanks to biofeedback, the connection between your brain and your body becomes a two-way street. You suddenly become aware of your ability to enhance your blood flow and release tension, actions that once seemed beyond your control. And after 10 or 12 sessions, this ability becomes so ingrained that you can call on it whenever you need pain relief. You won't have headphones or blinking lights to guide you when you relax at home, but the subsiding pain will give you all the feedback you need.
How effective is biofeedback?
Pain centers around the country incorporate biofeedback into their treatments, often in concert with other relaxation therapies such as hypnosis. In the hands of a competent technician, these techniques can be a valuable addition to the standard treatments of exercise and medication.
Biofeedback is most useful for stress-related pain, especially migraines and tension headaches. As reported by the American Pain Society in 2004, migraines generally respond best to temperature feedback while tension headaches are best treated with electrical feedback. A 1990 study published in the journal Pain found that a combination of biofeedback and relaxation cut migraine pain by 43 percent. A 2008 meta-analysis of 53 studies concluded that biofeedback can be an effective treatment for tension-type headaches, and a 2007 review of 55 studies found it to be effective for migraines as well.
There is ample evidence that biofeedback can also ease the pain of chronically sore backs, necks, and shoulders. It may even help relieve some of the most serious and vexing forms of pain. A small 2005 study published in Applied Psychophysiology and Biofeedback found that biofeedback can reduce phantom limb pain, the difficult-to-treat pain that lingers after an amputation. A 2005 report from the American Cancer Society notes that biofeedback may be able to ease pain and improve the quality of life for some cancer patients.
Not every type of pain responds to biofeedback. The therapy is not recommended for sudden, severe lower-back pain and other aches caused by temporary injuries.
How can I find a biofeedback therapist?
You can search for qualified therapists in your area by visiting the Web site of the Biofeedback Certification Institute of America (http://www.bcia.org). Click on "How can I find a practitioner near me" and enter your city, state, and zip code.
Astin JA. Mind-body therapies for the management of pain. Clinical Journal of Pain. January/February 2004. 20(1): 27-32.
American Pain Society. Biofeedback as an adjunctive treatment modality in pain management. 2004. http://www.ampainsoc.org/pub/bulletin/jul04/clin1.htm
Holroyd KA and DB Penzien. Pharmacological versus non-pharmacological prophylaxis of recurrent migraine headache: a meta-analytic review of clinical trials. Pain. 1990. 42: 1-13.
Holroyd KA and DB Penzien. Psychosocial interventions in the management of recurrent headache disorders. Behavioral Medicine. 1994. 20: 53-63.
Harden et al. Biofeedback in the treatment of phantom limb pain: a time-series analysis. Applied Psychophysiology and Biofeedback. March 2005. 30(1): 83-93.
American Cancer Society. Biofeedback. June 2005. http://www.cancer.org/docroot/ETO/content/ETO_5_3x_Biofeedback.asp?sitearea=ETO
Practical guidelines for cancer pain management. Journal of Anesthesiology 1996 May;84(5):1243-57
Acute low back problems in adults. Rockville (MD): U.S. Department of Health and Human Services, Public Health Service, AHCPR; 1994. Dec. 160 (Clinical practice guideline; no. 14)
Nestoriuc, Y, Rief, W, Martin, A. Meta-analysis of biofeedback for tension-type headache: Efficacy, specificity, and treatment moderators. Journal of Consulting and Clinical Psychology. 2008 June; 76(3): 379-96.
Nestoriuc, Y, and Martin, A. Efficacy of biofeedback for migraine: A meta-analysis. Pain. 2007 March; 128(1-2): 111-127.