When suffering from frequent tension headaches, patients may hear “You need to relax. Learn how to de-stress.” Physical and mental tension can certainly cause and make a tension headache worse, but this advice doesn’t tell a person how to relax while facing deadlines, stressful work environments, busy home-life and chaotic schedules. Just like playing guitar, learning to relax is a skill and one which can be mastered with time and practice. There are a lot of mind-body approaches to help ease tension headache which have been proven to prevent headaches or at lease reduce their severity. One of the tools we use in physical therapy to help treat frequent tension headaches are biofeedback devices.
Biofeedback and teaching relaxation techniques has been proven to reduce headache frequency and severity by 45-60%. This widely accepted non-drug technique is able to achieve the same results of common headache medications such as propranolol (Inderal®) and amitriptyline (Elavil®), but without the possibility of negative side effects. The only real drawback to biofeedback and relaxation techniques is it does require time and compliance on behalf of the patient. Biofeedback sessions can take one hour and the relaxation training may include several weekly visits over the course of several months. However, the ability to reduce the symptoms of a tension headache without the use of medication outweighs this drawback.
For many headache sufferers, combining both drug and non-drug treatments such as biofeedback yields the most significant improvement in headache activity. For example, the average improvement for migraine sufferers with either biofeedback alone or propranolol alone is a 55% reduction. However, when biofeedback is combined with propranolol, the average improvement is a 70% reduction in intensity and frequency in migraine sufferers.
How Biofeedback Devices Work
Biofeedback (or biological feedback) uses an instrument that monitors a bodily response, such as muscle tension or skin temperature, as the person tries to modify their response. For example, the monitor might give feedback with a tone that goes higher if the muscles in the forehead tighten and lower if the muscles relax. Another type of monitor uses a visual display such as a light that changes color as the patient increases or decreases temperature in their hands (or feet).
Increased muscle tension and changed body temperature are two of the body's main responses to stress and strain. By providing patients with instant and continuous information on these involuntary and unconscious processes in the body, they can observe and modify their body's reaction to stress. After a patient has used biofeedback to develop their ability to recognize and reduce tension in their body under clinical circumstances, the patient will be able to take these practical skills and apply them when they are under every day stress. These skills are useful tools in preventing, reducing, or stopping a tension headache.
Typically, electromyogram (EMG) biofeedback is used for prevention of tension headaches. With EMG biofeedback, an EMG machine monitors skeletal muscle tension. Just about any muscle can be monitored, but three muscles most commonly used are:
- Frontalis: the muscle in the forehead that is involved with frowning and tightens when contracted.
- Masseter: this muscle tightens your jaw and often stays clenched when a patient is stressed.
- Trapezius: this muscle hunches the shoulders and can tighten when alarmed or from too much time spent in front of the computer.
These muscles are used in EMG biofeedback because they typically respond to stress and can be easily measured. EMG training is done by placing two sensors (electrodes) at a specified distance from each other on the skin over the identified muscle. A third sensor is placed on a neutral spot to serve as an electrical reference point. These sensors then record the body’s responses to stimuli.
Currently 45 million Americans suffer from chronic headaches. It is one of the most treated diagnoses in physical therapy, second to low back pain. Biofeedback in conjunction with relaxation therapy offers real results to what can be a debilitating condition. Biofeedback also offers a real solution to the problem of not knowing how to “relax.”
For more information about popular Physical Therapy Modalities see our blog at ProHealthcareProducts.com.