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Introduction to Biofeedback

When a person experiences acute pain where actual tissue damage is occurring the body’s automatic and protective reaction is to tense up and restrict movement of the painful area. This is a helpful reaction that serves to promote survival. However, in chronic pain there is often no ongoing tissue damage, so the body's natural reaction to tense up leads to chronically tense muscles that can actually become a major reason for the pain to continue! In addition, most people with a chronic pain problem experience Increased stress and anxiety. This adds to tension level affecting muscles, joints, and connective tissues. Our nervous system also is more active under stress and can have increased sensitivity to pain. Because these physical signs of tension can greatly increase pain, tension reduction methods such as biofeedback are common treatments in pain centers.


Biofeedback helps people learn to recognize and control physical tension that aggravates their pain,

Biofeedback has also been found helpful in treating anxiety, high blood pressure, Raynaud’s disease insomnia, teeth grinding, and irritable bowel syndrome.


Biofeedback is a way of providing auditory and visual feedback on certain biological functions (hence the name biofeedback). By providing people with feedback on what is going on in their bodies, they can learn how to better control their physiology. For chronic pain patients, biofeedback is most commonly directed at general tension levels and at specific muscles that are problematically tense and overreactive. The biofeedback instruments provide immediate auditory or visual information on whether specific muscles are becoming more or less tense to help people learn how to relax their muscles more deeply. Biofeedback is also directed at temperature and perspiration changes that reflect general tension levels.

With biofeedback treatments, electrical leads are attached to the surface of skin. No needles are involved, and the procedure does not cause discomfort. In fact, most people find biofeedback treatments a relaxing and enjoyable experience.

Most people stay relatively unaware of the many biological changes occurring in their bodies, increases in muscle tension level can easily go unnoticed until we suddenly realize our pain problem is acting up. Many people stay chronically tense, so that their pain seems unrelated to fluctuations in stress levels, With the aid of the biofeedback instruments, patients learn how to recognize problematic physiological changes and how to reverse them before they set off an episode of increased pain. Thus, biofeedback helps patients feel and be in greater control of their physiology instead of feeling helpless to decrease chronic pain and pain flare-ups, This Increased sense of control is a key factor underlying all behavioral strategies for pain management



The first biofeedback appointment is for evaluation. This consists of measuring level of physiology, such as muscle tension, during various tasks. If abnormalities are detected, then it is more likely that a patient wilt benefit from biofeedback treatment.


There are three stages of biofeedback treatment

  1. The patient learns to adjust his or her physiology (i.e.. muscle tension) to a normal range while receiving auditory or visual feedback.

  2. The patient learns to maintain this more normal physiology without receiving biofeedback from the instruments. This is verified in the office, and then the patient learns to maintain this control while practicing at home.

  3. The patient learns to maintain this control and to function In a range nearer to normal while undergoing common daily activities,


Patients usually do not begin to benefit from biofeedback therapy until they are well into the first stage, which usually requires several appointments. Treatments are typically provided once per week until the first two stages of treatment are completed. After that, patients receive treatment once or twice per month.

Research has shown that most individuals derive maximum benefit from about ten treatments, Further treatments produce diminishing returns, However, for some individuals and some disorders the maximum benefit is achieved only after dozens of treatments, This is particularly true with seizure disorders and neuromuscular rehabilitations

Patients may also report additional improvements in the months following completion of treatment as they continue to practice the skills. For patients with chronic disorders, home practice at least three times per week is needed to maintain the benefits. Studies have shown that benefits persist for at least ten years following treatment bf the patient continues to practice at home.


Biofeedback is neither magic nor a cure-all for pain disorders. For biofeedback to be successful the patient must practice the exercises regularly. As with any single approach for chronic pain, it does not work for everyone. It does, however, provide one step, or piece of the puzzle, towards managing pain for many patients. Biofeedback fs most beneficial for chronic pain when it is combined with other treatment approaches, such as physical therapy, self-hypnosis, counseling, TENSI medication, patient education, and pain management groups.

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