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  » Alternative Medicine  »  Biofeedback

What is biofeedback?

Biofeedback is a technique in which people are trained to improve their health by learning to control certain internal bodily processes that normally occur involuntarily, such as heart rate or blood pressure. These activities can be measured with electrodes and displayed on a monitor that both the participant and his or her practitioner can see. The monitor thereby provides feedback to the participant about the internal workings of his or her body. This person can then be taught to use this information to gain control over these "involuntary" activities. Biofeedback is an effective therapy for many conditions, but it is primarily used to treat tension headache, migraine headache, and chronic pain.

The three most commonly used forms of biofeedback therapy are electromyography (EMG), which measures muscle tension; thermal biofeedback, which measures skin temperature; and electroencephalography (EEG), which measures brain wave activity.

How does biofeedback work?

Scientists are not able to explain how or why biofeedback works. However, there does seem to be at least one common thread: most people who benefit from biofeedback have conditions that are brought on or made worse by stress. Therefore, many scientists believe that relaxation is the key to successful biofeedback therapy. When a body is repeatedly stressed, internal processes like blood pressure become overactive. Guided by a biofeedback therapist, a person can learn to lower his or her blood pressure through relaxation techniques and mental exercises. When a person successfully relaxes and lowers his or her blood pressure, the feedback signals reflect this accomplishment. This acts as affirmation and encouragement for the person's continued efforts.

What happens during a biofeedback session?

In a normal biofeedback session, electrodes are attached to the skin near the area being monitored. The electrodes then feed information to a small monitoring box that translates the results into a tone that varies in pitch, a visual meter that varies in brightness, or a computer screen that varies the lines moving across a grid. The biofeedback therapist then leads the person in mental exercises. Through trial and error, people can soon learn to identify and control the mental activities that will bring about the desired physical changes.

How many sessions will I need?

Each session lasts less than an hour. The number of sessions required depends on the condition being treated. Generally, most people begin to see results within 8 to 10 sessions. Treatment of headache, incontinence, and Raynaud's disease (a condition that causes a loss of blood flow to the fingers, toes, nose, or ears) requires at least 10 weekly sessions and then less frequent sessions as health improves. Conditions like high blood pressure, however, usually require 20 weekly biofeedback sessions before improvement can be seen. In addition to these sessions, you will also be taught mental exercises and relaxation techniques that can be done at home and must be practiced at least 5 to 10 minutes every day.

What illnesses and conditions respond well?

Conditions and diseases that respond well to biofeedback include Raynaud's disease, disorders of the digestive system, epilepsy, anxiety, high blood pressure, phantom limb pain, every kind of headache, and nighttime bedwetting in children.

How can I find a qualified practitioner?

Specialists who provide biofeedback training range from psychiatrists and psychologists to nurses, dentists, and physicians. The Association for Applied Psychology and Biofeedback (www.aapb.org) is the national membership association for professionals using biofeedback and is a good resource for finding qualified biofeedback practitioners in your area. To receive a directory of trained biofeedback specialists in your area, write to the AAPB at 10200 W. 44th Avenue, Suite 304, Wheat Ridge, CO 80033-2840 or call them at 800-477-8892.

How much does a session cost?

In most areas, a standard visit as part of a course of treatment will generally cost between $40 and $150.

Will insurance usually cover biofeedback?

Insurance providers generally reimburse people who receive care from licensed medical practitioners. Check with your insurance company to see what your policy offers.

Supporting Research

AHCPR. Clinical Practice Guideline Number 2: Urinary incontinence in adults: acute and chronic management. Rockville, MD: Agency for Health Care Policy and Research, US Dept of Health and Human Services; 1996. AHCPR publication 96-0682.

Annequin D, Tourniaire B, Massiou H. Migraine and headache in childhood and adolescence. Pediatr Clin North Am. 2000;47(3):617-631.

Burgio KL, Whitehead WE, Engel BT. Urinary incontinence in the elderly. Bladder-sphincter biofeedback and toileting skills training. Ann Intern Med. 1985;103(4):507-515.

Chesson AL, Anderson WM, Littner M, et al. Practice parameters for the nonpharmacological treatment of chronic insomnia. Sleep. 1999;22(8):1128-1133.

Freedman RR. Physiological mechanisms of temperature biofeedback. Biofeedback Self Regul. 1991;16(2):95-115.

Leventhal LJ. Management of fibromyalgia. Ann Intern Med. 1999;131:850-858.

Lubar JF, Swartwood MO, Swartwood JN, O'Donnell PH. Evaluation of the effectiveness of EEG neurofeedback training for ADHD in a clinical setting as measured by changes in T.O.V.A. scores, behavioral ratings, and WISC-R performance. Biofeedback Self Regul. 1995;20(1):83-99.

Norton C, Kamm MA. Outcome of biofeedback for faecal incontinence. Br J Surg. 1999;86(9):1159-1163.

Rao SS. The technical aspects of biofeedback therapy for defecation disorders. Gastroenterologist. 1998;6(2):96-103.

Resnick NM. Improving treatment of urinary incontinence. JAMA. 1998;280(23):2034-2035.

Sabo MJ, Giorgi J. Biofeedback. In: Novey DW, ed. Clinician's Complete Reference to Complementary and Alternative Medicine. ¤/i>St. Louis, Mo: Mosby; 2000:32-40.

Saxby E, Peniston EG. Alpha-theta brainwave neurofeedback training: an effective treatment for male and female alcoholics with depressive symptoms. J Clin Psychol. 1995;51(5):685-693.