What is biofeedback?

Biofeedback 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 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 the monitor or electrodes. Biofeedback is an effective therapy for many conditions, but it is primarily used to treat the following health problems:

• Anxiety
• Back pain
• Chronic pain
• Constipation
• Depression
• Diabetes
• Epilepsy and related seizure disorders
• General injuries
• High blood pressure
• Motion sickness
• Muscle spasms
• Sexual disorders, including pain with intercourse
• Spinal cord injuries

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

How does biofeedback work?

The aim of biofeedback training for most people is to reduce the activity of the sympathetic nervous system by learning relaxation. For those who respond to stress with a parasympathetic response, the explanation must be couched in these terms, again, with the aim of training being the balancing of the two systems. In this case, the client needs to activate the sympathetic nervous system when stressed, and learn to differentiate the us of the parasympathetic nervous system as a stress response and as a part of the relaxation response.

The purpose of biofeedback therapy is to gain voluntary control of the body. As opposed to treatment by drugs, surgery, chiropractic, massage, psychotherapy and other forms of interventions, clinical biofeedback trains the client to control maladaptive body processes.

Control is achieved through learning-awareness process. Body response patterns are learned. They have become habits, conditioned responses. For example, our muscles soon learn to respond automatically as we learn to swim or type. They may also learn to respond automatically to stress by contracting, for example, in the area of the neck and shoulders. Just as we can change habitual typing errors, or learn to swim more efficiently, so can we eliminate maladaptive psychophsyiological patterns and learn more adaptive patterns. We can learn the skills needed to control any body function of which we are aware. Clinical biofeedback also involves learning relaxation techniques, using the instruments to the practitioner and client toward processes that are most effective for the client. Instrument readings are further used to reinforce physical and mental/emotional behavior that are related to relaxation and automatic nervous system balance. Reinforcement is an important aspect of learning.

The client is an active participant in the process of healing and health maintenance. The client and practitioner are partners in setting and meeting treatment goals. The client is responsible for between-session practice of relaxation or other homework techniques and for maintaining awareness of symptom patterns as the relate to life-style factors. The client is expected to gain awareness of stressors in order to prevents symptoms from occurring by practicing relaxation or coping techniques when stressors are expected or present.

If you have ever taken your temperature or stepped on a scale to see how much you weigh, you have used biofeedback. The temperature and weight readings from these devices give “feedback” about your body to tell you whether you have a fever or have gained weight. This information will help you make decisions about what to do next. In a similar way, biofeedback therapists use specialized equipment to train patients how to improve their health by using signals from their own bodies. Biofeedback is a non-invasive form of treatment. The therapist attaches sensors or electrodes to the body and these sensors provide a variety of readings–feedback–which is displayed on the equipment for the patient to see. The signals typically measure skin temperature, muscle tension and/or brainwave function. With this information, patients can learn to make changes so subtle that at first they cannot be consciously perceived. With practice, however, the new responses and behaviors can help to bring relief and improvement to a variety of disorders.

Through biofeedback a person experiencing migraines can learn to ward off headaches. A person who experienced a stroke may regain muscle use. Children and adults diagnosed with ADD or ADHD may see improved concentration and control. People with urinary or fecal incontinence or other pelvic floor disorders can achieve improved bladder control. Individuals with stress-related disorders learn to relax and improve their overall health. What happens during a biofeedback session?

In a normal biofeedback session, electrodes are attached to your skin. They send information to a small monitoring box that translates the measurements into a tone that varies in pitch, a visual meter that varies in brightness, or a computer screen that shows lines moving across a grid. The biofeedback therapist then leads you in mental exercises. Through trial and error, you can soon learn to identify the mental activities that will bring about the physical changes you want.

What is biofeedback good for?

Biofeedback seems to be effective for a range of health problems. For example, it shows promise for treating urinary incontinence, which is a problems for more than 15 million Americans. Some people choose biofeedback over drugs because of the lack of side effects. Based on findings in clinical studies, the Agency for Health Care Policy and Research has recommended biofeedback therapy as a treatment for urinary incontinence. It may also help people with fecal incontinence.

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.

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 fiber in the diet, may help relieve abdominal pain in children. Thermal biofeedback helps relieve migraine and chronic tension headaches among children and teens as well.

How many sessions will I need?

Each session generally lasts less than 1 hour. The number of sessions required depends on the condition being treated. Many people start to see results within 8 - 10 sessions. Treatment of headache, incontinence, and Raynaud's disease requires at least 10 weekly sessions and some follow-up sessions as health improves. Conditions like high blood pressure, however, usually require 20 weekly biofeedback sessions before you see improvement. You will also be taught mental exercises and relaxation techniques that you can do at home for at least 5 - 10 minutes every day.

Are there any risks associated with biofeedback?

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