Biofeedback: Controlling Pain with Less Need for Medication
When pain kicks in, so does stress and tension. As the pain builds, we unconsciously clench our muscles, respiration and heart rate accelerates, and skin temperature drops. As the pain builds, our bodily tension response only serves to worsen our experience of that pain.
Fortunately, although pain causes unconscious bodily reactions, we can learn to regulate our body and perform relaxation exercises that can counter this tension response and reduce feelings of pain.
Biofeedback is a technique that helps people recognize how pain causes changes in their body. It teaches people exactly how, when and where to relax. Once people can recognize what pain does, they can learn to control this reaction and reduce the experience of pain.
How Does Biofeedback Work?
A biofeedback therapist uses instruments that measure bodily responses such as muscle tension or breathing rate. A patient who experiences pain while hooked into biofeedback instrumentation can see when, where and how their body reacts to pain. The patient receives immediate feedback about biological responses to pain. Once patients see what pain does, they can learn to control it.
During a session of biofeedback, for example:
1. A person suffering from headaches caused (or in part caused) by tension might benefit from muscle tension biofeedback.
2. The therapist would affix electrodes that measure muscle tension during a headache, and the patient would be able to see, in real time, changes in muscle tension in different parts of the body.
3. Once a patient can see how and where pain causes increased muscle tension, they can learn how to relax those muscles and see through the instruments how relaxation results in reduced muscle tension. They can also feel how reduced muscle tensions results in reduced pain.
4. Eventually, the patient learns how to recognize and relax muscle tension caused by pain without the need for instruments.
What Does Biofeedback Measure?
Pain can trigger the sympathetic nervous system, which can in turn result in the following:
• Shallow and rapid breathing
• Increased muscle tension
• Increased heart rate
• Feelings of stress and anxiety
• Increased blood pressure
A sympathetic nervous system response is also known as a “fight or flight” response. Although it is a survival mechanism for moments of real danger, when pain stimulates this sympathetic reaction, it only serves to worsen the feelings of pain. Biofeedback is a technique that teaches patients to retain conscious control over the unconscious reactions of the sympathetic nervous system.
A biofeedback therapist may choose to use different instrumentation, depending on the source of pain and the needs of the patient. Bodily responses measured can include:
• Muscle tension. Using an electromyography machine during biofeedback sessions, a patient learns to reduce muscle tension in different areas that can cause increased pain. The electromyography machine measures electrical activity in the muscles, which in turn reveals the degree of muscle tension. The instrument reveals any small increases in muscle tension, helping the patient learn to immediately and fully relax.
• Skin temperature. Pain and stress can lead to falling skin temperature, and when alerted to this through the use of thermal temperature sensors, biofeedback patients can actually learn how to increase skin temperature.
• Brain waves. An electroencephalogram (EEG) machine reveals brain wave activity. Patients can learn to reduce brain waves associated with pain responses. This is also known as neurofeedback.
• Breathing. A respiration measuring instrument denotes breath rate and intensity.
• Sweat. Galvanic measurement instruments on the skin reveal any increase in perspiration. This type of biofeedback is used particularly for anxiety-related disorders.
What Conditions Respond Well to Biofeedback
Pain disorders that may respond well to biofeedback therapy include the following:
• Carpal tunnel syndrome
• Headaches (biofeedback can help patients with a variety of headache subtypes reduce the intensity of their pain and avoid worsening the experience of pain through increased tension; biofeedback of temperature and muscle tension types are often used)
• Lower back pain
• Joint pain
• Temporomandibular disorders
• Prostate infections
• Myofascial pain
Biofeedback also works well for conditions beyond chronic pain, such as addiction, anxiety, insomnia and depression.
What Is a Biofeedback Session Like?
A biofeedback session can take place in a variety of health clinics. A session typically lasts for an hour or less, and it is not an uncomfortable experience.
Patients are connected to the measuring instrumentation and see or hear visual or auditory cues that indicate change in whatever is being measured (tension or breathing, for example). Patients then try through learned techniques to control their bodily reaction, and can see how well they control it through the instrument’s display response.
Ultimately, after repeated biofeedback sessions, patients learn to recognize these physical changes without the need for instrumentation.
Biofeedback Works Best as an Adjunct Therapy
Studies have shown that biofeedback is most effective when applied as a complementary or adjunct therapy to other forms of pain management, particularly when used as an adjunct to cognitive behavioral therapy (CBT). Biofeedback increases personal feelings of control over pain, which ties in well with the message of control delivered through the application of CBT.
Does Biofeedback Work?,
Biofeedback is an accepted complementary pain management therapy that has been clinically studied and proven to work better than placebo.
Some people find biofeedback difficult to master. People who do gain mastery over the technique do not find any appreciable pain relief from it. Others find it quite helpful.
Biofeedback is a low-risk, worthwhile complementary pain management therapy that does not conflict with other forms of pain control. Most practitioners recommend biofeedback therapy as part of a comprehensive biopsychosocial approach to the management of pain.