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. Patches, called electrodes, are placed on different parts of your body to measure your heart rate, blood pressure, or other function. A computer monitor is used to display the results. The biofeedback technician will describe a situation and guide you through techniques to help you gain control over some of your involuntary bodily processes.

Biofeedback is not the same as relaxation training. While you may learn to become more relaxed, the purpose of biofeedback is for you to develop techniques to increase control over involuntary bodily processes, and to re-establish balance between the sympathetic and parasympathetic branches of your autonomic nervous system to increase your body's natural ability to calm, heal, and regenerate.

Duiring biofeedback treatment, you will view on the computer monitor how your heart rate, breathing, skin temperature, and muscle tension change in response to techniques you develop using paced breathing, mindful self-awareness, guided imagery, and even computer videogames. Initially, you will use the monitor to see your progress, but eventually you will be able to achieve success without the use of a monitor or electrodes.

Biofeedback is an effective therapy for many conditions. These are listed below.

What are the types or modalities of biofeedback?

There are several types of biofeedback:

Respiration (breathing)
Heart Rate
Heart Rate Variability (HRV), important for nervous system balance
Skin Temperature, Peripheral Temperature: Sensors attached to fingers or feet measure skin temperature. Because body temperature often drops when under stress, a low reading can prompt a person to begin relaxation techniques. Temperature biofeedback may help treat certain circulatory disorders, such as Raynaud’s disease, or reduce the frequency of migraines.
Skin Conductivity (moisture) via Galvanic Skin Response (GSR): Sensors measure the activity of a person’s sweat glands and the amount of perspiration on the skin, indicating the presence of anxiety. This information can be useful in treating emotional disorders such as phobias, anxiety and stuttering.
Muscle Tension (EMG), and Surface Electromyography (sEMG): EMG makes a patient aware of muscle tension allowing him/her to recognize the feeling early on and try to control the tension right away. EMG may be used to treat some conditions in which the symptoms tend to worsen under stress, such as muscle tension headaches and myofascial pain.
Blood Pressure
Brain Waves via Neurofeedback (EEG): EEG monitors the activity of brain waves linked to different mental states such as wakefulness, relaxation, calmness, light sleep and deep sleep.

Treatment usually uses a combination of modalities in the clinic, along with short daily practice sessions at home with one modality.

What happens in biofeedback therapy?

A typical biofeedback session lasts 30 to 60 minutes. Usually, you can start to see biofeedback benefits within 10 sessions or less. Some conditions, such as high blood pressure, can take 20 or more sessions to improve.

The biofeedback technician attaches sensors on the skin in certain locations in order to measure physiological signals. For example, heart rate may be measured with electrodes placed on the arms, or with a blood volume pulse sensor on the fingertip or earlobe. These sensors are non-invasive, and easy to remove. Information from these sensors is relayed to a recording device and displayed to the patient on a computer screen so the patient is able to see how his/her body is functioning in real time. Then, using various techniques taught by the technician, the patient can be trained to influence these bodily processes.

The goal of treatment may be to change the resting state of the body or to increase the patient’s ability to influence bodily functions in specific situations. The ultimate goal is for the patient to learn how to invoke positive physical changes in the body, such as relaxing specific muscles when the body is physically or mentally stressed, and to be able to produce these responses outside of the clinic and without the help of technology.

What conditions can biofeedback help to relieve?

Biofeedback has been shown to be helpful in treating a variety of behavioral and medical conditions listed below. Some people choose biofeedback over drugs because of the lack of side effects. The effectiveness of treatment varies by the condition treated. Current rates of effectiveness can be found at www.aapb.org.

Conditions marked with an asterisk * are among those treated in our clinic by biofeedback or a combination of biofeedback and CBT (Cognitive Behavioral Therapy):

*Anxiety:
Anxiety relief is one of the most common uses of biofeedback. Biofeedback lets you become more aware of your body’s responses when you’re stressed and anxious. Then you can learn how to control those responses.
*High Blood Pressure:
Evidence on the use of biofeedback for high blood pressure has been mixed. Although the technique does seem to lower blood pressure slightly, biofeedback isn’t as effective as medication for blood pressure control.
*Migraines and *Muscle Tension Headaches:
Headaches are one of the most studied conditions treated by biofeedback. Muscle tension and stress can trigger migraines and other types of headaches, and can make headache symptoms worse. There is good evidence that biofeedback therapy can relax muscles and ease stress to reduce both the frequency and severity of headaches. Biofeedback seems to be especially beneficial for headaches when it’s combined with medications.
*Chronic Pain / *Low Back Pain / *Neck Pain:
By helping you identify tight muscles and then learn to relax those muscles, biofeedback may help relieve the discomfort of conditions like low back pain, abdominal pain, temporomandibular joint disorders (TMJ), and fibromyalgia. For pain relief, biofeedback can benefit people of all ages, from children to older adults.
*PTSD / *Trauma Recovery (treatment might include EMDR with biofeedback)
*Depression
*ADD and *ADHD
*Asthma
*Insomnia (Sleep Disorders)
*Fibromyalgia
*Raynaud’s Syndrome
Major and Minor Joint Pain
Phantom Limb Pain
Non-cardiac Chest Pain
TMJ Disorders / TMD
Recurrent Abdominal Pain
Digestive Disorders / Irritable Bowel Syndrome (IBS)
Elimination Disorders / Constipation
Urinary Incontinence / Fecal Incontinence
Diabetic Peripheral Neuropathy
Epilepsy
Hyperhidrosis
Substance Abuse / Alcoholism / Addiction
Facial Muscle Pain / Bell’s Palsy
Congestive Heart Failure
Muscular Problems After Stroke

Does biofeedback take the place of standard medical treatment?

No. Biofeedback complements medical care, and does not replace standard medical care. Our standard approach is to coordinate care with your physician and specialists. Biofeedback is often used along with other innovative medical approaches.

Do I need a referral from my physician or specialist?

When we use biofeedback to address a medical condition, we will ask you to help us request a referral from your Primary Care Physician or specialist. As part of the referral, we will ask your physician for the medical condition and diagnosis code that will be the target of the biofeedback treatment. As your treatment progresses, we will provide status reports to your physician.

Does insurance cover biofeedback?

At this time, biofeedback treatments are covered by some insurance payers for some conditions. You can check with your insurance payer about whether or not your plan covers biofeedback, or we can do this for you.

Are there any risks associated with biofeedback?

Biofeedback is considered safe. No negative side effects have been reported. Although biofeedback is considered safe, please check with your doctor to see whether this is an appropriate treatment for you.