- Thomas Jefferson University – Headache Center (Philadelphia)
- The University of Mississippi Medical Center
- Diamond Headache Clinic (Chicago)
- Osher Center for Integrative Medicine (UCSF)
- Brain Wellness and Biofeedback Center of Washington
- Preference for a nondrug approach
- Intolerance of, or medical contraindication to, drug treatment
- Absent of minimal response to drug treatment
- Pregnancy, plan to become pregnant, or current nursing status
- History of long-term, frequent, or excessive use of analgesic or other acute medications that aggravate headache symptoms or are reducing medication effectiveness
- Presence of significant life stress or lack of adequate stress-coping skills”
- Biofeedback treatment yielded higher effects in patients with tension-type headaches as opposed to those suffering from migraines.
What is Biofeedback?
Biofeedback therapy utilizes electronic instruments which provide information about physiology and body functions that you unconsciously control. By getting immediate feedback, you can learn to control things such as heart rate by changing your mentality and thought processes. This process is helps improve awareness of key biological functions in order to consciously control them. By using the equipment, you can train your nervous system to react with relaxation instead of stress, helping you gain more control over many physical and mental health problems, such as anxiety, high blood pressure, and migraines. Biofeedback empowers the individual, making the patient more aware of his or her body to help remedy a health condition or simply aid with relaxation.
Devices that may be used in biofeedback therapy include an electromyograph (EMG), an electroencephalograph (EEG), a temperature trainer, and a heart rate monitor. The EMG measures electrical activity and tension in your muscles. The electrodes used with these devices measure only electrical activity; they don’t send any electrical current into your body. EEG biofeedback, also called neurotherapy or neurofeedback, measures brain waves in order for patients to learn to control and manage mental agitation and stressors. Additionally, a finger thermometer may be used to measure blood flow through your fingers. Because blood vessels in the fingers are very sensitive to stress, a finger thermometer is often used in the treatment of migraine headaches.
How is it used in the treatment of headaches?
There are generally three types of biofeedback used in headache control — muscular, thermal and brain wave. In each type, sensors are placed on your skin so that a biofeedback instrument can convert internal physiologic responses to a signal you can hear or see, and then learn to control.
How biofeedback helps control headache. Biofeedback can help you become aware of, and then modify, biological processes that are associated with migraine and tension type headaches. Both uneven blood flow and muscle contraction are processes that are usually involuntary and contribute to headache pain. Using biofeedback techniques, you can learn to put your nervous system into a state of deep relaxation. In this state, your muscles are loose and blood flows in a stable, even way to all parts of your body — the opposite of what happens during headaches.
One specific use of biofeedback is the measurement of muscle tension throughout the neck, shoulders, and facial areas. Tension headaches are usually a result of these muscles being kept tense for too long, and biofeedback can help identify which muscles are being overworked. Afterwards, biofeedback of muscle tension can be used to train people to realize actual levels of tension and to correct these levels via posture or habits, for example.
Is it effective? /What does research say?
Studies have shown that biofeedback, combined with medication, can be more effective than either treatment alone. Recently, it has been shown that migraine sufferers may be able to find long-term relief with biofeedback, with instances of lower recurrences of migraines and fewer hospitalizations. The evidence supporting the use of biofeedback for headaches has been classified as Grade A evidence by the US Headache Consortium.
Where is it currently being used?
Pros and Cons
Biofeedback is an appealing treatment approach due to the range of benefits it provides with limited side effects. It is noninvasive and can potentially reduce the need for medication. Not only does biofeedback provide a holistic approach to recovery, it engages the patient to actively participate in their healing process.
Biofeedback therapy has gained acceptance over the past 30 years as the mind-body connection has been increasingly studied and tested. It has been used for more than 150 illnesses and conditions — even NASA used biofeedback therapy to help astronauts deal with motion sickness in space. Its use for common types of chronic headache is supported by many research studies and the American Academy of Neurology recommends biofeedback and other mind-body therapies as effective headache treatments.
Biofeedback doesn’t work for everyone — it doesn’t cure headaches and it involves commitment by the patient. Biofeedback therapy works best when combined with other mind-body techniques and a healthy lifestyle. Like all mind-body medicine, biofeedback requires that patients educate and care more for themselves. Learning biofeedback may also be a lengthy process.
Who is Biofeedback best suited for?
From Andrasik, F. 2010. Biofeedback in headache: An overview of approaches and evidences. CCJM 77(3): S72-S78.
How much does it cost?
A biofeedback therapy session can run from $250 to $350.
How many sessions are required and how long are the sessions?
A typical biofeedback session lasts 30 to 60 minutes. The length and number of sessions are determined by your condition and how quickly you learn to control your physical responses. You may need a series of 10 sessions or as many as 50. Biofeedback is often not covered by insurance.