What other types of illnesses could benefit from biofeedback training?
There are data showing that biofeedback therapy can be helpful for anxiety disorders, insomnia, and functional bowel disorders and may help in modifying high blood pressure . It can also be a very effective stress-management strategy.
Do you refer some of your patients with migraine to a psychologist for biofeedback treatments?
Yes, but it is always good for the referring physician to check on the credentials of the person performing the biofeedback treatment. Some headache specialists might do it themselves, but we do not. It takes a while—at least several sessions—and psychologists are better at it. Patients’ perspectives are also important. We communicate with the referred biofeedback treatment specialist to get more insight on the patient. For example, some patients are anxious and depressed, and they are not sleeping at night. The doctor we referred the patient to may recommend an antidepressant for the patient to help address those issues. It is a team effort.
What is the average cost per treatment?
The costs vary throughout the country and range from $75 to $400 per session. Insurance coverage varies.
How many times should a patient go in for treatment?
Most protocols are about 10 to 12 sessions, depending on patient response.
Have there been clinical trials on biofeedback treatments/devices?
There have been many clinical trials that have been positive, so there is good evidence that biofeedback can be an effective treatment for migraine and tension-type headache. There are many types of biofeedback devices that measure different modalities. The most common one used in migraine is measuring scalp muscle contraction with surface electromyography or measuring peripheral blood flow with a temperature gauge. The goals are to relax muscles and learn to increase finger temperature, which is related to decreased arousal of the sympathetic nervous system or stress system. Other modalities include learning to modulate brain waves (electroencephalography or neurofeedback) and certain cardiovascular measures that reduce the stress response by a different mechanism. The goal is for patients to learn a low arousal response that they can utilize in their natural environment. Certain breathing techniques and visualization exercises are also helpful, but biofeedback refers to using physiologic recording equipment to help learn to change physical responses related to headache disorder.
Over our years of experience, we have found that biofeedback can help a large percentage of our patients with migraine and tension-type headache, and it is associated with almost no adverse events.