Biofeedback / Neurofeedback Treatment for Fibromyalgia

There are a significant number of research and scientific studies that support Biofeedback as being effective in reducing various Fibromyalgia symptoms (minimizing pain, increasing physical function, decreasing tender points).  Biofeedback therapy teaches you to mentally and voluntarily relax your muscles and control your pain through concentration and applied mental techniques. Biofeedback can be helpful for a variety of chronic conditions that exhibit pain and muscle tension as common symptoms. A biofeedback practitioner guides/assist patients through mental exercises to help them relax and use their thoughts to alter how their body is behaving.

In a session, the therapist puts electrodes on your skin which track a variety of physiological measure (heart rate, blood pressure, etc) and a monitor shows you what is happening with these processes.  Through time and training in concentration and awareness, you can learn to control these processes.  This allows you to decrease your response to pain.

Biofeedback would not be a stand alone treatment for Fibromyalgia, but it can be effective as part of a collection of treatments.  In addition, it is risk free with great potential for benefits.  Do let your doctor know if you are thinking about trying a form of Biofeedback or Neurofeedback therapy.

What You Can Do Right Now

Frequently Asked Question about Biofeedback / Neurofeedback

How long is a session?

A typical biofeedback session takes about an hour.

What is a session like?

You will usually be invited to relax into a comfortable chair.  The therapist will then hook you up to the biofeedback machine, using sensor attached to your skin at various locations.  The electrical impulses are recorded by these sensors and reflected on a computer monitor or screen in front of you in the form of graphs or other visual displays.  Sometimes you will receive auditory feedback as well by way of musical tones.  The practitioner may instruct you and you will respond to the output you see on the screen

How often do I go for biofeedback?
Typically, once or twice a week.

How many sessions will I need?
This number will vary widely depending on what you are trying to address.  You may have as few as five sessions or as many as a hundred.  You do not have to commit to a certain number at any point in time.   You may also be taught home practice exercises to help you integrate your skills into your everyday life.

Does biofeedback work for children?

Biofeedback is very effective for children with a variety of conditions, including ADD and ADHD

How to Select a Good Biofeedback / Neurofeedback Practitioner

The lack of regulation can make finding a skilled neurofeedback practitioner difficult. In the United States the Biofeedback Certification Institute of America offers some degree of regulation and it certainly a good place to start when choosing a practitioner. Similar authorities exist in several other countries and in some cases medical insurers will require a practitioner to be certified by such a body.

Sometimes people who are trained in counselling or psychotherapy or even psychiatry will also offer biofeedback training.  Ask around; someone you know may have a strong recommendation.

Ultimately—and perhaps appropriately for a technology lauded for unlocking a patient’s own potential—prospective patients should do the research to make sure a therapist is right for them. If you do not have a personal recommendation researching the practitioner’s education, history, and whether or not they have published work on the subject is a good place to start.  You may also be able to find online reviews or articles that they have written about what they do.   A typical neurofeedback session will cost $50 to $120; a complete course of treatment often requires 30 or 40 sessions. Finally, after you’ve done all you can to make yourself comfortable with your neurotherapist, take comfort in the fact that the procedure itself is non-invasive and is itself a pleasant and relaxing experience.

History of Biofeedback / Neurofeedback

The term biofeedback was first introduced in 1969 but the principles of taking conscious control of autonomic body functions stretches back thousands of years. Yoga practitioners have been able to consciously control oxygen consumption, heart rate and body temperature by strict mental discipline, a practice that was believed impossible in the West until the 1950’s.

It wasn't until the 1960’s that Biofeedback became a true scientific discipline however. Three key researchers pioneered the field, discovering that, with training, people could learn to control autonomic body functions. Neal Miller, a graduate of the University of Washington, Stanford and Yale, conducted behavioral research with animals and he found that they could be trained to control their internal body systems, such as blood pressure and heart function.

John Basmajian served as a Captain in the medical corps during World War 2 before receiving a M.D. from the University of Toronto in 1945. He then began to study voluntary control over the skeletal muscles. He discovered that with feedback anyone could gain control over a single motor unit within a muscle. Other researchers found that with feedback animals can be trained to control internal body systems such as blood pressure.

Joe Kamiya began investigating internal world of perception while working at the University of Chicago in 1958. He discovered that individuals could learn (through EEG feedback) to discriminate between brain wave states. Then he discovered that with feedback, individuals could produce specific brain wave states on demand. In his study one subject was able to accurately guess whether a particular brainwave pattern was occurring around 65% of the time during the second day of testing, but was able to determine with accuracy of 100% by the fourth day.

Theory behind Fibromyalgia Treatment using Biofeedback / Neurofeedback

Biofeedback is about bringing some of the normally subconscious physical process (relaxation and tension, breathing, heart rate, blood pressure activity) at least partly under the control of your conscious awareness.  As you learn to recognize and control these in a neutral (non-stressed) situation, your brain is learning how to control these responses in a healthier way.  Over time, this becomes a new mental habit and your brain responds differently when those measures (which relate to the perception of pain) change.  Learning to do this helps you to reduce stress (on your mind and body and muscles) which then results in a reduced sensation of pain.  The brain has an important role to play in how the body perceives pain and transmits that pain, and learning to change that response can result in a perceived physical change in the degree of pain that is occurring.

Research of Fibromyalgia Treatment using Biofeedback / Neurofeedback

Numerous studies have been done looking at biofeedback and neurofeedback as a treatment for symptoms related to Fibromyalgia.  While some studies showed only minor effects, the majority show significant improvements for people with Fibromyalgia who learned biofeedback.  Results range from improvements in psychological symptoms, quality of life, visual attention, to decreased tenderness, pain and fatigue.  Here is a small sample of some of the clinical research trials.

Neurofeedback intervention in fibromyalgia syndrome; a randomized, controlled, rater blind clinical trial (2010)

Summary:  This was a randomized, rater blind study to assess the efficacy of EEG Biofeedback (Neurofeedback-NFB) in patients with fibromyalgia. Eighteen patients received twenty sessions of biofeedback treatments during four weeks while another 18 were given 10 mg escitalopram treatment each day for 8 weeks.  All post-treatment measurements showed significant improvements in both of the groups but the biofeedback group showed more benefits than the control group.  The study concludes that the "data support the efficacy of NFB [neurofeedback] as a treatment for pain, psychological symptoms and impaired quality of life associated with fibromyalgia."


EEG biofeedback treatment improves certain attention and somatic symptoms in fibromyalgia: a pilot study (2011)

Summary:  This study looked at 15 people with Fibromyalgia who completed 40 or more sessions of biofeedback training, while measuring pain, fatigue, psychological distress, morning stiffness and tenderness and compared the results with 63 people with Fibromyalgia who received standard medical care.  Visual attention improved signficantly for those with the biofeedback training, and they also showed improvments in tenderness, pain and fatigue.


Neurofeedback in fibromyalgia syndrome (2007)

Summary:  This study used EEG Biofeedback on three patients with fibromyalgia, looking at the before and after impact of a number of symptoms and clinical conditions (using the Visual Analog Scale for pain and fatigue, Hamilton Depression and Anxiety Inventory Scales, Beck Depression and Anxiety Inventory Scales, and SF-36 as measurement tools).  The results showed that "Most of the symptoms were decreased after ten sessions. There was also improvement in all of the scales after the treatment."


Relevance of muscular sensitivity, muscular activity, and cognitive variables for pain reduction associated with EMG biofeedback in fibromyalgia.

Summary: 18 patients with primary fibromyalgia received nine training sessions using EMG biofeedback over four weeks. Measurements were based on the baseline EMG activity of the trapezius, muscular sensitivity, and cognitive variables (helplessness and belief of control). The analysis showed a signficiant reduction in general intensity of pain and EMG activity as well as a significant increase in muscular senstivity. Self-reported pain reduction was predicted by a change in cognitive variables.


Stories of Fibromyalgia Treatment using Biofeedback / Neurofeedback

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