Migraine and Tension Headaches Can be Treated with Biofeedback Based Behavioral Interventions
About 4 of 5 of people who have tension and migraine headaches which did not start with trauma can reduce their headache frequency, intensity, and duration by an average of about 80% (with many having no remaining headache activity for at least 10 years) by using biofeedback based behavioral interventions.
Tension Headaches
“Tension” headaches originate from muscles kept too tense for too long anywhere in the head and neck -especially including the jaws. People who have muscle related pain usually cannot tell how tense their painful muscles are as well as people without muscle related pain. The inability to accurately relate actual levels of muscle tension to sensations from the muscles leads to muscles being kept tenser than necessary for longer than necessary given the task at hand. Muscles kept only five percent tenser than necessary for less than a half hour longer than necessary leads to pain which can be sustained for an entire day.
Biofeedback for Tension Headaches
Biofeedback devices record tension in the muscles generating the pain and show those levels to the patient. The patient learns to associate actual levels of tension with sensations from the muscles so muscles are kept appropriately relaxed. Most people learn to recognize their levels of tension and to automatically keep them at appropriate levels. This eliminates or vastly reduces head area pain from this source. People who successfully learn this skill and apply it eliminate or vastly reduce the intensity, duration, and frequency of their tension headaches.
Migraine Headaches
“Migraine” headaches usually begin during adolescence or young adulthood with no obvious initiating incident. They may begin abruptly or gradually and may or may not be related to sexual maturity. These are the type of migraine headaches which can be effectively prevented through behavioral techniques such as biofeedback. Migraine-like headaches which begin with trauma such as an auto accident or which come in clusters usually cannot be effectively treated through behavioral interventions.
Migraines and Blood Flow
Nearly all people with migraine headaches have less near-surface blood flow to the fingers and toes (and sometimes noses) than those who do not have migraine headaches. As all of the heat emanating from the fingers and toes is generated by near surface blood flow, these people tend to have relatively cool extremities. Biofeedback devices can accurately record the temperature of the fingers (or any other body part) and show the temperature to patients so they can learn to recognize and then control finger temperature sufficiently to maintain normal levels of finger temperature. People who can learn this skill and maintain normal levels of fingertip temperature do not get migraine headaches as often or as severely as previously. Many entirely eliminate their headaches. Most also significantly decrease or eliminate their need for migraine medications.
People who do not learn to control their muscle tension or finger blood flow do not change their headache activity.
Evidence Supporting The Effectiveness of Biofeedback
The evidence supporting the effectiveness of biofeedback (frequently used in conjunction with related techniques such as progressive muscle relaxation training) for the treatment of tension and non-traumatic origin migraine headaches is very strong. Numerous controlled studies with reasonably large numbers of patients and long follow-ups (of up to ten years) show that biofeedback is highly efficacious for these types of headaches with about 4 of 5 people showing an average of an 80% reduction in headache activity. The evidence supporting this assertion and the reviews of the peer reviewed literature are summarized below.
Other types of headaches, such as those caused by trigger points and nerve over-reactivity cannot be treated effectively with behavioral interventions.
For information about biofeedback:
To watch a slide show on biofeedback, go to www.biofeedbacktraining.org. On the home page’s left column, scroll down to “biofeedback info and equipment” then click on “what is biofeedback”. This will lead you to the slide show.
THERAPISTS:
If you are a therapist and would like to find out more about how to treat headaches using behavioral interventions such as biofeedback, please contact us at contact@behavmedfoundation.org or look at the courses on the web site www.biofeedbacktraining.org.
PATIENTS:
If you have migraine or tension headaches and would like to look into biofeedback based interventions, go to the web site www.bcia.org to locate a certified biofeedback practitioner near you.
