Biofeedback Therapy: What Is Biofeedback

What is biofeedback?

Biofeedback therapy 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. Electrodes attached to your skin -- or in some cases, sensors held in your hands -- measure these processes and display them on a monitor. With help from a biofeedback therapist, you can learn to change your heart rate or blood pressure, for example. At first you use the monitor to see your progress. But eventually you will be able to achieve success without a monitor or electrodes. Biofeedback is an effective therapy for many conditions, although it is primarily used to treat high blood pressure, tension headache, migraine headache, chronic pain, and urinary incontinence.

biofeedback-therapy

Are there different types of biofeedback?

The three most commonly used forms of biofeedback therapy are:

  • Electromyography (EMG), which measures muscle tension
  • Thermal biofeedback, which measures skin temperature
  • Neurofeedback or electroencephalography (EEG), which measures brain wave activity

We may also offer respiratory feedback, blood pressure,oxygenation, HEG, galvanic skin responsive and other types of feedback depending upon the patient’s presenting problem.

How does biofeedback work?

We aren't sure exactly how or why biofeedback works. However, there does seem to be a common thread as most people who benefit from biofeedback have conditions that are brought on or made worse by stress. For this reason, we believe that relaxation is the key to successful biofeedback therapy. When your body is under chronic stress your sympathetic nervous system becomes overactive. Guided by a biofeedback therapist, you can learn to lower your blood pressure through relaxation techniques and mental exercises. As you make progress, you can see and/or hear your progress which encourages you along the way.

What happens during a biofeedback session?

In a normal biofeedback session, electrodes are attached to your skin. They send information to a small monitor that translates the measurements into either a tone that varies in pitch, a visual meter that varies in brightness, or a computer screen that shows lines moving across a grid or a video or a game or a map of your brain. The biofeedback therapist may lead you in mental exercises or relaxation techniques or other relevant techniques (such as memory).

Several different relaxation exercises maybe 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 
  •  Visualization –- visualizing yourself in situations being calm and coping well.

As you slow your heart rate, lower your blood pressure, and ease muscle tension, you'll get instant feedback on the screen. Eventually, you'll learn how to control these functions on your own, without the biofeedback equipment. Through trial and error, with real time feedback you can soon learn to identify the mental activities that will encourage the physical changes you are striving for.

What is biofeedback used to treat?

Biofeedback seems to be effective for a range of health problems which is a problem for more than 15 million Americans. Some people choose biofeedback over drugs because of the lack of side effects. Others who do not feel they are receiving adequate benefit from medications chose biofeedback as an adjunctive intervention. Research also suggests that thermal biofeedback may ease symptoms of Raynaud's disease (a condition that causes reduced blood flow to fingers, toes, nose, or ears), while EMG biofeedback has been shown to reduce pain, morning stiffness, and the number of tender points in people with fibromyalgia. A review of scientific clinical studies found that biofeedback may help people with insomnia fall asleep. Other studies suggest it may even reduce the risk of cardiac events by lowering blood pressure levels and reducing the body's "sympathetic" response during times of stress. Biofeedback can also be used effectively in children. For example, EEG neurofeedback (especially when combined with cognitive therapy) has been reported to improve behavior and intelligence scores in children with attention deficit hyperactivity disorder (ADHD). Biofeedback, combined with a fiber-rich diet, may help relieve abdominal pain in children. Thermal biofeedback helps relieve migraine and chronic tension headaches among children and teens, as well.

Biofeedback has been found to be useful for the following health problems:

  • Anxiety 
  • Asthma 
  • Attention Deficit Disorder 
  • Autism 
  • Back pain 
  • Bed wetting 
  • Chronic pain 
  • Constipation 
  • Depression 
  • Diabetes 
  • Eating disorders, including anorexia nervosa, bulimia, and overeating 
  • Epilepsy and related seizure disorders 
  • Headaches and migraines 
  • Head injuries 
  • High blood pressure 
  • Irritable bowel syndrome (IBS) 
  • Learning disabilities 
  • Memory Problems 
  • Motion sickness 
  • Muscle spasms 
  • Reversible dementias 
  • Sexual disorders, including pain with intercourse 
  • Spinal cord injuries 

How many sessions will I need?

Each psychotherapy session with biofeedback last an hour. During this time, we will assess your current status, review your homework, set goals for this session, and discuss how to follow up at home. We generally see patients twice weekly for optimum benefit and you will want to plan on a minimum of 20 sessions thought some disorders may require longer.

Are there any risks associated with biofeedback?

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

Some References for Further Reading

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

Blackmore S, Williams D, Wolf S. Skirven: Rehabilitation of the Hand and Upper Extremity, 6th ed. Philadelphia, PA: Mosby, An Imprint of Elsevier; 2011.

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

Burgio KL, Goode PS, Urban DA, et al. Preoperative biofeedback assisted behavioral training to decrease post-prostatectomy incontinence: a randomized, controlled trial. J Urol. 2006;175(1):196-201; discussion 201.

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

Chiari L, Dozza M, Cappello A, et al. Audio-biofeedback for balance improvement: an accelerometry-based system.IEEE Trans Biomed Eng. 2005;52(12):2108-11.

Chiarioni G, Whitehead WE, Pezza V, et al. Biofeedback is superior to laxatives for normal transit constipation due to pelvic floor dyssynergia. Gastroenterology. 2006;130(3):657-64.

De Leon Rodriguez D, Allet L, Golay A, et al. Biofeedback can reduce foot pressure to a safe level and without causing new at-risk zones in patients with diabetes and peripheral neuropathy. Diabetes Metab Res Rev. 2013; 29(2):139-44.

Ernst E. Complementary/alternative medicine for hypertension: a mini-review. Wien Med Wochenschr. 2005;155(17-18):386-91.

George R, Chung TD, Vedam SS, et al. Audio-visual biofeedback for respiratory-gated radiotherapy: Impact of audio instruction and audio-visual biofeedback on respiratory-gated radiotherapy. Int J Radiat Oncol Biol Phys. 2006;65(3):924-33.

Glick RM, Greco CM. Biofeedback and primary care. Prim Care. 2010;37(1):91-103.

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Hosker G, Cody J, Norton C. Electrical stimulation for faecal incontinence in adults.Cochrane Database Syst Rev. 2007;(3):CD001310.

Husmann DA. Use of sympathetic alpha antagonists in the management of pediatric urologic disorders. Curr Opin Urol. 2006;16(4):277-82.

Jensen MP, Barber J, Romano JM, Hanley MA, Raichle KA, Molton IR, et al. Effects of self-hypnosis training and EMG biofeedback relaxation training on chronic pain in persons with spinal-cord injury. Int J Clin Exp Hypn. 2009 Jul;57(3):239-68.

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Patcharatrakul T, Gonlachanvit S. Outcome of biofeedback therapy in dyssynergic defecation patients with and without irritable bowel syndrome. J Clin Gastroenterol. 2011; 45(7):593-8.

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Terra MP, Dobben AC, Berghmans B, et al. Electrical Stimulation and Pelvic Floor Muscle Training With Biofeedback in Patients With Fecal Incontinence: A Cohort Study of 281 Patients. Dis Colon Rectum. 2006;49(8):1149-59.

Tsai PS, Chang NC, Chang WY, Lee PH, Wang MY. Blood pressure biofeedback exerts intermediate-term effects on blood pressure and pressure reactivity in individuals with mild hypertension: a randomized controlled study. J Altern Complement Med. 2007;13(5):547-54.

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