#biofeedback and #migraines

 So I have done my first session of biofeedback. I would like to be able to do more of them closer together but I am out of coverage for this and so... expensive to say the least. So every three weeks it is. Nevertheless it is something I have wanted to try but it isn't something i had access to. Maybe when I get to the pain clinic there will be more of this sort of thing and that will be great but until then this is how I will plod along.

“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. Head Wise

I did the biofeedback with thermal sensors. My hands were about 71 degrees. I was like 'cold hands warm heart' hehe. I always have cold hands. Guess this is why. But I also have FM and that skews things a bit. Nevertheless. So we start and I imagine this red and green line on the screen going Up and Up. Well the red line said screw you and was flatlined... this is the hand with nerve damage. The left hand slowly but surely began to creep up. I kept my breathing relaxed. Imagined heat. Imagined the lines going up. And the green line slowly but steady made its way up into the 80's. Then... all of a sudden the red line did a massive catch up game, exponentially raising in temperature degree by degree over the five minute intervals until it had caught up with greens slow and steady. But with a constant 4 degree difference between the two. We suspect its slow response was due to the nerve damage but once I was relaxed it caught up. Don't know. Got the left to 91 anyway and the right 4 degrees below. There was a spot when my heart rate jacked up (I had taken a triptan earlier in the day so it was very low when I got there but started to do its random hammering up) and when it did this my breathing got faster and when that happened... temperature in both began to tank. I had to concentrate, slow my breathing and they slowly went back up. So not sure how well I would do with a hammering heart rate and higher level of pain, but really for a first go... not bad at all. But it was pretty easy to relax at a lower pain level and having the triptan completely zombify my brain... you know when you literally could watch paint dry and not realize you were doing it for half an hour. I could zone out on anything... and did on the screen which was trippy if you have eyes like mine... red and green are not good colors for my eyes... the screen got so wonky unless I blinked a lot. But anyway, triptan zen mode aside I liked this effect of relaxation on raising the external peripheral temperature of my hands. And I look forward to the next session.

So what do I think about it? I think it is a tool to teach me to learn to relax properly and to see the effects of that visually. To focus and concentrate on that relaxation and know that it has a physiological effect... even though I know logically that it does... to visually see that it does and then to replicate the experience of that at home. Sort of teaching yourself the skills of relaxation, because no one does that. Could you use other methods? Of course. And we do. Just that some people might find this method more appealing to them. Some people are more visual so seeing this and then feeling their body at the same time might be a better learning tool on how to develop the skill. And to be honest might be for me. I can sit there and breath and visualize... and get bored and drift off in my head... and go... this is interesting and maybe helps with stress but don't see how it helps any other way. I mean I spend hours in that relaxed state when I have insomnia at night... and don't see how that helps any. So I like the idea of learning to focus more on relaxation techniques and what I am doing and how it is effecting my body. And maybe it will help with pain management.

"Usually patients can expect a 50% reduction in the frequency and severity of attacks," said Dr. Joshua Cohen with the Headache Institute at Roosevelt Hospital.
Dr Cohen is a neurologist and says there are no side effects, but you have to believe in it and take the time to learn it.
"There's probably no patient that wouldn't benefit in some way from biofeedback," adds Dr. Cohen. New technology to control migraine headaches

I believe every neuro says this about every single treatment. But there is potential in every treatment. And non-drug treatments? They work awesome with drug treatments. And my migraines cannot get worse so I would like them to get better. I will not discard anything that has the potential to improve the situation. I know meditation has effects on the body... short term and long term so learning how to effectively do relaxation that effects me physically isn't going to be a bad thing. And might improve my meditation skills, which such, and improving that isn't going to be a bad thing. Any improvement is an improvement when it comes to chronic migraines.

A 2009 study involved 64 patients with migraine (with or without aura and/or tension type headaches) who had the headache condition for more than a year. "Biofeedback is an established non-pharmacologic technique commonly used in the treatment of migraine and tension type headaches. Multiple published studies have suggested that biofeedback is effective in reducing the frequency and severity of headaches, often allowing patients to decrease their dependence on medication. Studies have also suggested that biofeedback may effect a decrease in medical utilization." Patients either received  biofeedback in addition to basic relaxation instruction or relaxation alone. "Biofeedback training consisted of 10 50-minute sessions utilizing standard EMG feedback from the frontalis and trapezius muscles and temperature from the third finger of the dominant hand. Visual and auditory feedback was provided." 33 patients received biofeedback and relaxation techniques and 31 just the relaxation techniques. All patients were asked to respond to questionnaires for 36 months.

Results indicated "Patients who completed the program with education in pain theory and relaxation techniques showed a statistically significant decrease in the frequency and severity of the headaches in the first 12 months that continued to 36 months. Biofeedback provided no additional benefit, specifically no change in the frequency or severity of the headaches. After 3 months 48% of those in the relaxation group reported fewer severe headaches, while 35% of those in the biofeedback group reported fewer severe headaches; after 6 months, 52% of those in the relaxation group reported fewer severe headaches as compared with 57% reporting fewer severe headaches in the biofeedback group. The number of medications used by the patients and the utilization of medical care decreased in both groups over 36 months suggesting a regression to the mean."

The study suggested that "Biofeedback is an extremely costly and time-consuming treatment modality that, in our study, provided no additional benefit when compared to simple relaxation techniques alone, in the treatment of migraine and tension type headaches in adults."

So here we find simply put you don't need biofeedback to get the benefits of relaxation. But we need the education on relaxation techniques and the skills to do it properly. And these things can help us. And I was told biofeedback simply works better on some people who are visually inclined... who like to see the visual representation of what is occurring as they relax.
Video on Neurofeedback... which I have not tried but similar idea. Now understand that this isn't absurd. A study found 'throbbing pain' is actually not throbbing with our heart beat like we sometimes feel it is... it is throbbing with our alpha brain waves. If you could train yourself to relax and realize your could relax to a state that was controlling this... see the effect on your brain it could help you learn to relax properly or in fact... meditate. It is not to say that this method is better than any other... you just see it and so you are learning that you have an effect, and so you are just getting a crash course on how to effectively relax and know that doing so has an effect on the brain and body.
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