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How it can help you gain control over headaches

Biological feedback: a training course for your nervous system. Biofeedback is a technique for improving your awareness of key biological functions and bringing them under conscious control. By using various instruments to feed back information on how you're doing, you can actually retrain your nervous system to react with relaxation instead of stress. 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.

Your goal: change your body's habitual reaction to stress. Training your body to achieve an anti-headache state of deep relaxation will involve multiple sessions with a professional biofeedback therapist, usually a psychologist. During these sessions, relaxation may be measured one of three ways:

  • An electromyograph (EMG) measures the amount of electrical energy generated by muscles in your forehead, and will likely be used if you suffer from muscle contraction or tension headaches.
  • A finger thermometer measures blood flow through your fingers, and is often used for those with migraine headaches. Blood vessels in the fingers are very sensitive to stress (vessels constrict) and relaxation (vessels dilate; temperature rises).
  • An electroencephalograph (EEG) monitors the type of energy (brain waves) generated by your brain. Your biofeedback therapist will give you or tell you how to obtain a portable measuring device to use at home (usually an EMG or a finger thermometer). For best results, you will need to practice biofeedback/relaxation techniques often at home and may need some "booster" sessions with your biofeedback therapist as time goes on.

Many studies confirm the effectiveness of biofeedback in migraine and tension type headaches. Biofeedback has helped many headache sufferers to prevent headaches or to reduce their intensity and duration. When a large group of people with combined migraine and tension type headaches were trained to use biofeedback, more than half still reported at least 50% improvement in preventing and relieving their headaches up to four years after their initial training. While most did not achieve complete freedom from headache pain, the majority reported that the technique improved their headaches in a variety of ways (see table below).

To locate a biofeedback therapist, ask your doctor or another healthcare professional or consult the yellow pages of the telephone book under "Biofeedback" or "Psychologists." The Association for Applied Psychophysiology and Biofeedback at (800) 477-8892 can direct you to your state society for information on biofeedback therapists. The Biofeedback Certification Institute of America (BCIA) certifies biofeedback therapists through a national examination, and you may want to ask individual therapists about their certification status.

Biofeedback Benefit People Reporting Benefit
Migraine Sufferers Tension Type Headache Sufferers
Helped me stay calm during headaches 95% 95%
Helped reduce intensity of headaches 81% 92%
Helped me take less medication 80% 87%
Reduced time my headache lasted 73% 89%
Let me stop a headache completely on some occasions 49% 86%

The Biofeedback Loop
A biofeedback instrument acts as a kind of "sixth sense," allowing you to "see" or "hear" bodily changes that may contribute to headaches. In this example, sensors on the forehead (A) detect and amplify muscle tension, the (B) convert it to a light or an audible tone whose intensity is (C) fed back through your eyes and ears.

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