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, or in some cases, sensors held in your hands, 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 a monitor or electrodes. Biofeedback is an effective therapy for many conditions, although it is primarily used to treat high blood pressure, tension headache, migraine headache, chronic pain, and urinary incontinence.

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?

Researchers are not sure exactly 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. For this reason, many scientists believe that relaxation is the key to successful biofeedback therapy. When your body is under chronic stress, internal processes like blood pressure become overactive. Guided by a biofeedback therapist, you can learn to lower your blood pressure through relaxation techniques and mental exercises. When you are successful, you see the results on the monitor, which encourages your efforts.

What happens during a biofeedback session?

In a normal biofeedback session, electrodes are attached to your skin. They send information to a small monitor that translates the measurements into either 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, such as urinary incontinence, which is a problem 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 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. Other studies suggest it may even reduce the risk of cardiac events by lowering blood pressure levels and reducing the body's "sympathetic" response during times of stress.

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) and autism. Biofeedback, combined with a fiber-rich diet, may help relieve abdominal pain in children. Thermal biofeedback helps relieve migraine and chronic tension headaches among children and teens, as well.

Biofeedback may also be useful for the following health problems:

• ADHD
• Age-related macular degeneration
• Anxiety
• Asthma
• Autism
• Back pain
• Bed wetting
• Chronic pain
• Constipation
• Depression
• Diabetes
• Eating disorders, including anorexia nervosa, bulimia, and overeating
• Epilepsy and related seizure disorders
• Headaches and migraines
• Head injuries
• High blood pressure
• Irritable bowel syndrome (IBS)
• Learning disabilities
• Motion sickness
• Muscle spasms
• Sexual disorders, including pain with intercourse
• Spinal cord injuries
• Muscle pain and immobility

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 see results within 8 to 10 sessions. Treatment of headache, incontinence, and Raynaud disease requires at least 10 weekly sessions and some follow up sessions as health improves. However, conditions like high blood pressure 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 to 10 minutes every day.

Are there any risks associated with biofeedback?

Biofeedback is considered safe. No negative side effects have been reported. If you have serious mental health issues, check with your psychiatrist to make sure you are an appropriate candidate for biofeedback.

How can I find a qualified specialist?

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 a good resource for finding qualified biofeedback practitioners in your area.

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