The latest population statistics for the U.S. estimate that 100 million Americans suffer with chronic pain. The medical profession is on a continual quest for ways to alleviate pain with the least risk to the patient as possible.
Biofeedback is defined as willful modulation of an automatic biologic process. As Biofeedback (BF) has no appreciable side effects, it would be a reasonable choice for chronic pain treatment. The question is, when it comes to Biofeedback, does it work?
The application of this mode of therapy does not require a medical degree, is safe, is simple, and can be administrated at home.
A Brief Physiology Of Biofeedback
Pain is mediated by all 3 segments of the nervous system: the peripheral, central, and autonomic nervous systems. Proportionate participation of each system is dependent on whether the pain is acute or chronic.
Acute pain is defined as pain that lasts for less than 3 months. Acute pain is adaptive and gives evidence of a disturbance existing in a complex biologic organism. Indeed, the absence of the ability to feel pain (there are acquired and inherited diseases that can do this) shortens life expectancy in the individuals that suffer from such maladies.
Chronic pain is defined as continuous or daily pain that lasts for more than 3 months. Chronic pain is maladaptive and increases mortality as a separate risk factor. The presence of chronic pain shortens human life expectancy and requires effective treatment.
Biofeedback is particularly useful in chronic pain syndromes. In chronic pain, central mediating mechanisms are the predominate modulator of the pain. This is not true for most acute pain. Biofeedback is not as useful for acute pain therefore.
Through BF, central sensitization (where the nervous system amplifies pain), autonomic pain mediation, hormonal up regulation, and neurotransmitter up regulation are all affected. By influencing automatic biologic processes with BF, all the aforementioned processes can be “turned down.” The resultant effect is a reduction in chronic pain.
The pain source itself may not be directly affected by the BF technique. BF modulates the transmission, perception, and generation of pain.
BF techniques simply make that which is automatic in human physiology noticeable to the individual and, therefore, subject to willful modulation. This is called “operationalizing” an automatic process. BF requires a device to externalize the automatic process to accomplish this.
By measuring heart rate, muscle tension, temperature, and skin perspiration (all physiologic functions that are usually automatic), an individual can be taught how to affect a change in these processes. The effect is to reduce pain as the automatic process is down regulated.
After several BF sessions (usually 10) an individual can often forego the use of the BF machine and employ the relaxation or mental imagery that is necessary to effect the targeted automatic response.
What Are The Devices Used In Biofeedback?
There are 4 basic BF machine training tools:
1) Galvanic Skin Response Training:
By measuring the conductivity of the skin to a gentle electrical current, an indirect measure of the skin sweating can be assessed. This would help treat anxiety.
2) Electromyographic Response Training:
By measuring the muscle reactivity to a gentle electrical current, an indirect measure of muscle reactivity can be assessed. This would help treat muscle spasm and muscle pain.
3) Heart Rate Response Training:
By measuring heart rate an effect of stress can be measured.
4) Skin Temperature Response Training:
By measuring finger temperature an effect of stress can be measured.
Note that each of the above measuring tools are measuring body metrics that are usually automatic. Through relaxation techniques and mental imagery the effect on the metric can have a physiologic effect on the chronic pain that is being treated.
What Disorders Are Treatable With Biofeedback?
The following disorders have been shown to benefit from BF:
- Chronic Low Back Pain
- Chronic Temporomandibular Joint Dysfunction
- Chronic Abdominal Pain
- Chronic Headaches
- Chronic Urinary Incontinence
- Chronic Fecal Incontinence
- Chronic Anxiety
- Phantom Limb Pain
The following conditions may be helped with BF:
- ADHD (Attention Deficit Hyperactivity Disorder)
- COPD (Chronic Obstructive Pulmonary Disease)
- Raynaud’s Disease
- Chronic Constipation
- Rheumatoid Arthritis
Demonstration Video On Biofeedback
Does The Treatment Vary From Person To Person ?
Because of the complexity of the nervous system and its uniqueness in each individual, a universal prescription of BF for everyone is not possible. Each individual will need to utilize the BF technique as recommended by their biofeedback technician and adjust their training in accordance with their own unique response.
It may take up to 10 sessions before a reduction in pain is observed. Some conditions require much more (Hypertension may require 20 or more sessions) before a benefit is observed. Each session usually lasts 30 minutes.
In conclusion, the answer to the question, “Biofeedback: does it work?” is a resounding yes. It will take some patience on the part of the person seeking relief. Best results are seen when the treatments are guided by a trained technician in BF.
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I wish you good health and much joy.