Using biofeedback to manage migraines

Feeling helpless and out of control is one of the side effects of migraine. You do not know when the next headache will strike or how severe it will be. Biofeedback is a treatment process that can give you back some control over both your body and your migraines. Biofeedback sessions teach you to relax your muscles and brain waves, lower your pulse rate, slow down your breathing, and increase blood flow to your hands and feet. All have been shown to reduce migraine frequency and pain.

What is biofeedback?

“Biofeedback is a way to gain awareness about your body and learn to control some functions that are usually considered involuntary,” says psychologist Robert N. Jamison, PhD, Associate Professor of Anesthesiology and Psychiatry of Harvard Medical School. Biofeedback is useful in migraine management because it is a form of relaxation training, says Dr. Jamison. What makes biofeedback different is the use of equipment. “You cannot know exactly what you weigh until you step on a scale,” says Dr. Jamison. “In the same way, biofeedback machines give you precise information about your body’s functioning. We have found that this kind of information helps people control the way their bodies react and can reduce their level of migraine pain.”

If you are interested in biofeedback treatment, you can discuss this option with your primary care doctor, who can refer you to a psychologist trained to perform biofeedback. During a biofeedback session, the therapist attaches sensors to various parts of your body, depending on what is being measured. Measurements from the sensors appear on a computer monitor along with tones of differing frequency or pitch. Most people, including children, can use this information to make changes within their bodies, creating a state of relaxation from the feedback of the equipment. “The biofeedback monitor gives you precise information on how you are doing,” says Dr. Jamison. “While we don’t yet understand the exact mechanisms of how small bodily changes associated with relaxation help to improve migraines, we do know that relaxation is useful in migraine management and that it can be learned, the same way you learn to play an instrument.”

How biofeedback training helps manage migraines

“Anxiety and stress contribute to migraine headaches and often make the pain worse,” says Dr. Jamison. “When you are stressed and have a migraine, you might notice that your body feels a certain way, for example: your hands might feel cold and clammy and you might feel tightness in your neck and shoulders.” In humans and other mammals, explains Dr. Jamison, anxiety usually causes blood to flow away from the hands and feet and towards the heart and head. When you are relaxed, blood is more evenly distributed throughout the body and muscles are less tense. “So if we recreate the physical feelings of relaxation, this helps in two ways,” says Dr. Jamison. “We can often prevent an early migraine before it develops, and we can reduce the pain of an existing migraine. Biofeedback is a learning tool that helps us do both.”

Types of biofeedback

There are different types of biofeedback used for migraine treatment, all of which use awareness as a tool to help you make changes within your body.

  • Electromyographic (EMG) biofeedback. Electrodes attached to the shoulder, neck, upper back, jaw, or forehead detect electrical activity under the skin to measure muscle tension in these areas. Beeps that get higher in pitch and occur more rapidly, or a visual display of a line going up a graph on a computer, tell you that muscles are tightening. As you relax the muscle groups, you can hear the tone and see the line on the graph go down.

  • Thermal (temperature) biofeedback. Sensors attached to a finger measure and show the temperature of your hand. With this awareness, you can use your mind to relax the smooth muscles around your blood vessels to normalize your blood flow throughout the body. Redirecting blood flow may reduce the blood vessel expansion in the head that may reduce the migraine pain.

  • Galvanic Skin Response (GSR) Biofeedback. Sensors attached to two fingers measure the amount of perspiration (sweating) in the fingers, which is what causes clamminess. With this information, you can learn to reduce this moisture and increase relaxation.

  • Electroencephaelographic (EEG) Biofeedback. Electrodes attached to the head allow you to change your brain waves to a more relaxed state as you watch them on a monitor.

  • Respiration and Heart Rate. This equipment can track the pattern of your breathing and the rate of your heart beat.

Biofeedback is not a migraine cure, stresses Dr. Jamison, but research has shown that if you have regular biofeedback therapy sessions, and practice relaxation strategies at home without equipment, it may lead to fewer, less intense headaches and may cut down on your need for migraine medication.

References

Nestoriuc, Y., Martin, A. (2007). Efficacy of biofeedback for migraine: A meta-analysis. Pain, 128, 111-127.

Yucha, C., & Gilbert. C. Evidence Based Practice in Biofeedback & Neurofeedback, American Association for Applied Psychophysiology and Biofeedback. Retrieved December21, 2007 from www.AAPB.org