Biofeedback

Biofeedback is a technique that trains people to improve their health by controlling certain bodily processes that normally happen involuntarily, such as heart rate, blood pressure, muscle tension, and skin temperature. Patches, called electrodes, are placed on different parts of your body to measure your heart rate, blood pressure, or other function. A monitor is used to display the results. With help from a biofeedback therapist, they will describe a situation and guide you through relaxation techniques. The monitor lets you see how your heart rate and blood pressure change in response to being stressed or remaining relaxed.  Initially, you will use the monitor to see your progress, but eventually you will be able to achieve success without the use of a monitor or electrodes. Biofeedback is an effective therapy for many conditions, but it is primarily used to treat high blood pressure, tension headache, migraine headache, chronic pain, and urinary incontinence.

Are there different types of biofeedback?

Several techniques may be used to gather information about an individual’s bodily responses. The one used may depend on individual health conditions and objectives, and is determined by a biofeedback practitioner. Machines and techniques may include:

Electroencephalogram (EEG): An EEG monitors the activity of brain waves linked to different mental states such as wakefulness, relaxation, calmness, light sleep and deep sleep. This process is also known as neurofeedback.

Electromyogram (EMG): An EMG uses electrodes or other types of sensors to measure muscle tension. The EMG makes a patient aware of muscle tension allowing him/her to recognize the feeling early on and try to control the tension right away. An EMG may be used to treat some illnesses in which the symptoms tend to worsen under stress.

Galvanic skin response training: Sensors measure the activity of a person’s sweat glands and the amount of perspiration on the skin, indicating the presence of anxiety. This information can be useful in treating emotional disorders such as phobias, anxiety and stuttering.

Temperature biofeedback: Sensors attached to fingers or feet measure skin temperature. Because body temperature often drops when under stress, a low reading can prompt a person to begin relaxation techniques. Temperature biofeedback may help treat certain circulatory disorders, such as Raynaud’s disease, or reduce the frequency of migraines.

Several different relaxation exercises are used in biofeedback therapy, including:

  • Deep breathing
  • Progressive muscle relaxation — alternately tightening and then relaxing different muscle groups
  • Guided imagery — concentrating on a specific image (such as the color and texture of an orange) to focus your mind and make you feel more relaxed
  • Mindfulness meditation — focusing your thoughts and letting go of negative emotions

Technique

Biofeedback training may be performed in physical therapy clinics, medical centers and hospitals. A typical biofeedback session lasts 30 to 60 minutes. Usually, you can start to see biofeedback benefits within 10 sessions or less. Some conditions, such as high blood pressure, can take 20 or more sessions to improve. The cost varies depending on whether a person’s insurance covers all or part of the procedure. Different doctors or health institutions may charge varying amounts.

During a biofeedback session, a therapist applies electrical sensors to different parts of a patient’s body. These sensors will monitor the physiological response to stress, for example, muscle contraction during a tension headache, and then feed the information back to a person via auditory (hearing) and visual (seeing) cues. These cues may be in the form of a beeping sound or a flashing light. With this feedback, a person may begin to associate the body’s response with certain physical functions, such as muscles tensing.

The next step is to learn how to invoke positive physical changes in the body, such as relaxing specific muscles when the body is physically or mentally stressed. The goal of biofeedback is to eventually be able to produce these responses alone, outside of the therapist’s office and without the help of technology.

What conditions can biofeedback help?

Biofeedback has been shown to be helpful in treating a variety of medical conditions. Some people choose biofeedback over drugs because of the lack of side effects.  Below are a few conditions that  may benefit  from biofeedback.

Chronic pain – By helping you identify tight muscles and then learn to relax those muscles, biofeedback may help relieve the discomfort of conditions like low back pain, abdominal pain, temporomandibular joint disorders (TMJ), and fibromyalgia. For pain relief, biofeedback can benefit people of all ages, from children to older adults.

Headaches – Headaches are one of the best-studied biofeedback uses. Muscle tension and stress can trigger migraines and other types of headaches, and can make headache symptoms worse. There is good evidence that biofeedback therapy can relax muscles and ease stress to reduce both the frequency and severity of headaches. Biofeedback seems to be especially beneficial for headaches when it’s combined with medications.

Anxiety – Anxiety relief is one of the most common uses of biofeedback. Biofeedback lets you become more aware of your body’s responses when you’re stressed and anxious. Then you can learn how to control those responses.

Urinary Incontinence – Biofeedback therapy can help people who have trouble controlling the urge to use the bathroom. Biofeedback can help women find and strengthen the pelvic floor muscles that control bladder emptying. After several sessions of biofeedback, women with incontinence may be able to reduce their urgent need to urinate and the number of accidents they have. Biofeedback can also help children who wet the bed, as well as people with fecal incontinence (the inability to control bowel movements). Unlike drugs used to treat incontinence, biofeedback doesn’t tend to cause side effects.

High Blood Pressure – Evidence on the use of biofeedback for high blood pressure has been mixed. Although the technique does seem to lower blood pressure slightly, biofeedback isn’t as effective as medication for blood pressure control.

Other biofeedback uses include:

  • Attention deficit hyperactivity disorder (ADHD)
  • Chronic obstructive pulmonary disease (COPD)
  • High blood pressure
  • Anxiety
  • Asthma
  • Autism
  • Back pain
  • Chronic pain
  • Constipation
  • Depression
  • Diabetes
  • Epilepsy and related seizure disorders
  • Headaches and migraines
  • Head injuries
  • High blood pressure
  • Insomnia
  • Learning disabilities
  • Motion sickness
  • Muscle spasms
  • Spinal cord injuries

Are there any risks associated with biofeedback?

Biofeedback is considered safe. No negative side effects have been reported.

How can I find a qualified practitioner?

The Association for Applied Psychology and Biofeedback (www.aapb.org) is a good resource for finding qualified biofeedback practitioners in your area.

 

References:

Abgrall-Barbry G, Consoli SM. Psychological approaches in hypertension management. Presse Med. 2006;35(6 Pt 2):1088-94.

Andrasik F. Biofeedback in headache: an overview of approaches and evidence. Cleve Clin J Med. 2010;77(3):S72-6.

Bruehl S, Chung OY. Psychological and behavioral aspects of complex regional pain syndrome management. Clin J Pain. 2006;22(5):430-7.

Buse DC, Andrasik F. Behavioral medicine for migraine. Neurol Clin. 2009 May;27(2):445-65. Review.

MedlinePlus- Internet Bethesda (MD): National Library of Medicine