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Neurofeedback for Headaches



The Human and Economic Costs of Headache

Headaches take a tremendous toll in human suffering, and cost employers millions of dollars each year in absenteeism, disability, and lost productivity. Headaches affect 91 % of males and 96 % of females in the course of their lifetimes. Chronic headaches are challenging to treat, accounting for about 18 million medical visits per year, and many patients continue to suffer in spite of extensive and expensive treatment (McGrady, Andrasik, Davies, et al, 1999).

The Efficacy of Biofeedback for Headache

The National Headache Foundation has published Standards of Care for Headache Diagnosis and Treatment, which state that "biofeedback has been shown to be an excellent treatment in the long term management of migraine and tension-type headache disorders (NHF, 1999, p. 17)." The Agency for Health Care Policy and Research commissioned a meta-analysis of the available reports on behavioral interventions for migraine. Thermal biofeedback, relaxation therapy, and cognitive-behavioral therapies were found to be at least moderately effective for migraine, by comparison to waiting-list controls (Goslin, Gray, McCrory, et al, 1999). Another meta-analysis showed moderate effectiveness for EMG biofeedback, relaxation therapy, and cognitive-behavioral therapy in alleviating tension-type headache (McCrory, Penzien, Rains, et al, 1996). The meta-analysis by Holroyd and Penzien (1990) showed biofeedback/relaxation to be identical in effectiveness to propranolol, to date the most researched prophylaxis for migraine. Both of these treatments in turn significantly surpassed placebo and no treatment.

Qualitative Advantages of Biofeedback Treatment

Biofeedback also has particular advantages over most medical treatments for headaches. Not only can it produce long-term remission of symptoms, but it does so without side effects. On the contrary, common side effects of medical treatments of headache include weight gain, sedation, and impaired concentration, and headache medications frequently lose their effectiveness over time. There is even preliminary evidence to suggest that successful treatment with biofeedback and relaxation can result in substantial cost savings (Blanchard, Jaccard, Andrasik, Guarnieri, & Jurish, 1985).

Conclusion: Biofeedback Can Help Headache Sufferers

Clinical experience and research show that headaches remain a challenge for the physician and the patient. Many patients continue to suffer daily severe pain, in spite of heroic treatment regimens. Health care cannot afford to dismiss any intervention that benefits large groups of patients with "modest" improvement, and occasional patients with dramatic improvements. For many patients, with mild to severe tension or migraine headache, biofeedback remains a valuable and risk-free approach to treatment.


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