It seems like a simple concept: When you’re in pain, it’s important to pay attention to what your body is telling you so you can help it fix the problem.
But as any migraineur knows, that’s easier said than done.
When all you can focus on is the throbbing, aching and everything else that comes with a migraine attack, you’re probably not thinking about how the rest of your body is working. You might not notice that your fingertips are cold or that your breathing has gone shallow. And even if you do notice these phenomena, you might not think they have anything to do with the awful feeling going on in your head.
But, as it turns out, it’s all connected—and focusing on relieving some of the physiological symptoms of migraine can go a long way toward easing your pain. A system called biofeedback, which involves tracking the body’s functions and using visualization and stress-relief techniques to manage them, is gaining fans in the migraine community.
Biofeedback may not consistently halt a migraine, but it can be useful in helping reduce headache intensity and duration, says Morris Levin, MD, professor of neurology and psychiatry at Dartmouth Medical School and the co-director of Dartmouth’s Headache Center. The idea has been percolating for decades, as physicians and specialists in emotional and behavioral health have worked together to learn about the connections between thoughts and feelings and the tangible issues they create in our bodies.
The bottom line, he says, is that the way the body handles stress—whether it’s just the daily grind or a particularly difficult event—can spark a harmful chain reaction.
“I think there’s something about the way humans respond to stress,” Dr. Levin says. “The fast heart rate, higher blood pressure, tighter muscles, cold hands and feet—the whole situation we get into in the fight-or-flight response causes all sorts of physical problems, like headaches.”
Learning and listening
Biofeedback is actually more of a learning process than a treatment. It’s taught by a variety of professionals, including psychologists, physicians and physical therapists, and can be a good fit for many people, according to Dr. Levin. Experts say even children and teens can benefit from learning about the connection between their body and their pain.
“[Good candidates are] patients who have not done well with other treatments; patients who don’t like taking medications or don’t want to try more invasive surgical options; or patients who say to their physician, ‘I feel like this is all stress, and if I could just relax, I’d feel better,’” he says.
The experience usually begins in the same way—with an appointment at a clinic where patients get an up-close look at how their body is working. Thermometers, monitors and other sensors provide relevant physiological information, such as skin temperature, heart rate and muscle tension.
Derek Schwartz, PhD, a California-based psychologist and biofeedback expert, says this is a valuable experience for patients, who are often out of touch with their body’s responses and the internal factors that may contribute to their migraines.
“With biofeedback, patients can see this information displayed on a computer screen, which can potentially help them control certain physiological functions and responses that may affect their headaches,” he says. “They can look at it and say, ‘Oh, that’s why I’m feeling better.’”
This information often holds some pretty surprising information. For example, cold hands can be a clear signal that something isn’t right, says Kathleen Farmer, PsyD, co-founder of the Headache Care Center in Springfield, Mo.
“Your finger temperature is a predictor of how much stress your body is carrying,” she says. “The average finger temperature in an average person is 85 degrees. Migraineurs often have finger temperatures in the 70s. The goal of biofeedback is to warm the finger temperature to 96 degrees.”
Warmer fingers, Farmer says, help put the brain in a state that promotes relaxation and concentration. In other words, when you’re stressed out and in pain, your fingers are probably cold. Feeling good? You’ve likely got warm hands.
Putting knowledge into action
Of course, knowing the temperature of your fingers or the efficiency of your breathing isn’t much good to you if you can’t do anything about it. Once the numbers are in, the next step in biofeedback is empowerment. The patient must recognize that he or she can do something to change those numbers—and in doing so, help manage a migraine.
A practitioner typically guides the patient through a series of visualization exercises aimed at reducing stress levels. As the migraineur imagines him or herself in a quiet, peaceful place, for example, the monitors track various indicators.
A beep or flashing light often helps alert patients to changes in their body. After a few sessions, which usually last around one hour, patients should begin to see the connection between how they think and how they feel.
Armed with that information, many migraine sufferers can start using biofeedback on their own, without any help or fancy equipment. Farmer says she’s had patients get so comfortable with recognizing and controlling their physiological processes that they’ve been able to go from having a migraine every day to only getting them occasionally. Others have been able to ease the severity of their attacks.
Some at-home practitioners use CDs or DVDs to provide the same type of step-by-step guidance they would get at a clinic. Music or recordings of soothing nature sounds can also be helpful. Eventually, many people figure out what their body needs and how to accomplish it without using a finger thermometer or heart rate monitor.
But no matter how skilled biofeedback practitioners become, they can still get rusty if they don’t put in some effort.
“It’s up to the person to do it,” Farmer says. “I can demonstrate how to do it, and they can actually experience it. But they have to practice. It’s not like taking a pill.”
One drawback of biofeedback is that in-office sessions can be fairly expensive. A typical clinic session generally runs between $75 and $150. For hypertension patients, insurance will cover a portion of the treatment—Farmer says it’s usually about 50 percent—but that can vary quite a bit from provider to provider. For at-home practitioners, the additional cost can be minimal or significant depending on which tools they use. High-tech biofeedback machines sell for hundreds, and sometimes thousands, of dollars.
Schwartz says some of those tools can be valuable on a basic level, but the most important thing is to fully understand the mind-body connection—the interaction between a person’s thoughts, behaviors, emotions and physiology.
“From a holistic perspective, biofeedback is about creating physiological, cognitive and emotional awareness,” he says. “It’s being more aware in the middle of craziness to take some deep breaths, drop the shoulders—do those kinds of things. Smell the roses.”
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Biofeedback Tool Kit
Type “biofeedback equipment” into any search engine, and it’s easy to get overwhelmed. You can spend anywhere from thousands of dollars on machines that measure your brain waves to just $14.95 on a relaxation CD.
Although most of this equipment can be purchased online, some of the most expensive biofeedback tools are found in a clinical setting. Here is a quick look at the tools of the trade:
Finger thermometers: These are used in a technique called finger warming. Higher temperatures generally mean more migraine relief.
Electrodes: Sensors, which are stuck to the skin with an adhesive and attached to a machine with cables, are used to measure brain or heart activity.
Portable sensors and monitoring devices: There are sensors for just about every function of the body, from a wristband that measures joint motion to a machine that measures changes in the activity of your sweat glands and the size of your pores.
Light and sound machines: These are aimed at reducing stress and helping patients feel calm.
CDs, DVDs and software: These can be handy for at-home guided visualization exercises.
