What types of headache and other illnesses respond to biofeedback training?
Migraine affects about 12% of the US and most Western populations, and is 3 times more common in women than men. Migraine can be treated with a variety of strategies that include medications and nonpharmacologic therapies such as biofeedback, as well as other behavioral therapies and devices. Biofeedback refers to the use of instrumentation to monitor and display physiologic responses that the patient may not be aware of so that they can be “modified” in a more adaptive direction. Feedback gives immediate objective information and is usually combined with a relaxation-based therapy. The most common biofeedback treatments for migraine include feeding back muscle activity in the face and neck to help people relax contracted muscles and teach them a “low-arousal” response; they learn to increase finger temperature, which coincides with modifying the “stress” nervous system. Biofeedback has been shown to be helpful for migraine and tension-type headache. It is also helpful to decrease anxiety and stress levels and lower blood pressure.
Can patients use biofeedback treatments in conjunction with migraine medication?
Research has shown that migraine, in particular higher-frequency migraine, is best treated by a combination of medications and behavioral strategies. Biofeedback is a good option for use in conjunction with medication for migraine.
Who is trained to provide biofeedback treatments?
Biofeedback for migraine is something usually performed by psychologists and other professionals with specialized training. Many practitioners are certified by the Biofeedback Certification Institute of America ( BCIA). It is important to find an experienced biofeedback practitioner who also has some expertise in treating headache disorders.
How are biofeedback treatments performed?
Biofeedback is a therapy that follows a learning model whereby the patient gradually learns a self-regulation skill that impacts their headaches.
Patients come to an office, typically once per week, where they are attached to instruments that measure physical responses associated with migraine. The patient typically sits in a comfortable chair or recliner, and numerous physiologic responses are monitored with surface electrodes.
When treating headache, sensors are typically placed on the head and neck to monitor muscle responses and a thermistor is placed on a finger to measure temperature. Feedback is given via visual cues (computer graphics) or a change in auditory tone as the patient is taught various relaxation techniques.
Patients use the feedback to learn a physiologic relaxation response that may be beneficial for their headache management. Most of the research on biofeedback is related to treatment to prevent migraine; however, these techniques can be helpful to use during an acute attack, ideally paired with an acute care migraine medication.
Can children with migraine have biofeedback treatments as well?
Most children typically have a lower frequency of migraine than adults, although some have frequent migraines with associated disability and are candidates for preventive medication (although no medications are yet approved for children by the US Food and Drug Association). Most children are good candidates for behavioral therapies such as biofeedback. There are many computer games utilized in biofeedback training that children easily learn to modify physical responses. There are some fairly recent data suggesting that behavioral treatments, some of which include biofeedback, are effective strategies for children and may be more effective than preventive medication.