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EMG Biofeedback for Tension Headaches
Using EMG Biofeedback for Tension
Headaches
Excess muscle tension can be the source of many headaches. Headache medication sometimes doesn’t work
and often comes along with unwanted side effects, in some cases even inducing
more headaches (rebound headaches) which create a vicious cycle requiring more
medication followed by more headaches.
Tension headache sufferers often don’t realize that they are
holding excess tension in their facial, neck, and upper back muscles. Muscles are intended to generate movement and
maintain posture. Muscles contract to
create movement. When the movement is
completed, the muscle should return to a relaxed state. When muscles remain contracted after movement
is completed the muscle becomes overworked and irritated. This can trigger pain. Tension headache pain usually is triggered by
excess tension in face muscles, including those around the eyes, in the
forehead, scalp, temples, and jaw. The
muscles in the scalp are also connected to the neck and upper back where the source
of the problem may also be found. When
we use EMG biofeedback for tension headaches, adhesive sensors are placed on
the site that we want to record from.
The sites normally used are forehead – frontalis. Sensors are placed across the forehead directly
above the eyebrows (active) and the ground directly above the bridge of the
nose in a straight line. We can
substitute a headband for the adhesive sensors when we are measuring EMG from
the forehead. The sensors are attached
to an EMG biofeedback instrument. Some
of the instruments are self-contained and the feedback information is given by
lights and sounds that indicate even small changes in the level of tension in
the muscles that we are recording from. Other
instruments are connected to a computer and give even more detailed feedback
including line graphs and bar graphs.
The computer systems can also store data and print reports. The person then uses the feedback information
to become more aware of the level of tension and how it changes based on what
they are doing. We can detect tension in
the forehead, around the eyes, in the jaw, tongue, lips, scalp, temples, and
even the throat. The person learns how
to relax all of these muscles through a combination of the direct feedback from
the instrument, relaxation exercises like progressive muscle relaxation, and
the coaching and encouragement provided by the biofeedback therapist. Sessions are provided at the biofeedback provider’s
office 1-3 times per week for 6-20 sessions.
It is strongly recommended that the person also practice muscle
relaxation and control at home. Home
biofeedback instruments may be rented or purchased for this purpose. As the person learns how to notice when they
are tensing their muscles and how to release the tension, the intensity and
frequency of their headaches tends to decrease.
Other biofeedback modalities like skin temperature may also be
used. That’s about it. Unlike medication there are no negative
side-effects. The possible positive
side-effects include less neck, upper back, and jaw pain, better ability to
relax, better muscle control for sports, and more energy. That’s not bad at all!
For more information on biofeedback providers, biofeedback
training, and biofeedback instruments check the following resources:
www.mindbodydevices.com
– A website with resources for personal biofeedback and stress management
products and services
www.biofeedbackinternational.com
– A website for professional biofeedback equipment and training
www.aapb.org – A website
with information on biofeedback for consumers and professionals
www.bcia.org – A website
with listings of certified biofeedback providers and information on
certification for professionals
www.nrbs.org – A website
with listings of biofeedback providers in the northeast USA as well as other
biofeedback related information
Article by Harry L. Campbell
President, Biofeedback Resources International Corp
914-762-4646
Email: [email protected]
Twitter: Biofeedbackman
Facebook: Biofeedback Resources International
Linked-In Harry L. Campbell
Please refer to the following for more information on
biofeedback for tension headaches:
Nestoriuc, Y., Martin, A., Rief, W. & Andrasik, F.
(2008). Biofeedback treatment for headache disorders: A comprehensive efficacy
review.Preview Applied Psychophysiology and Biofeedback, 33(3), 125-140.
Andrasik, F. (2007). What does the evidence show? Efficacy
of behavioural treatments for recurrent
headaches in adults. Neurological Sciences, 28, Suppl 2,
S70-7.
Arena, J.G., Bruno, G.M., Hannah, S.L., & Meader, K.J.
(1995). Comparison of frontal
electromyographic biofeedback training, trapezius
electromyographic biofeedback training, and
progressive muscle relaxation therapy in the treatment of
tension headache. Headache, 35(7), 411-419.
Arndorfer, R.E., & Allen, K.D. (2001). Extending the
efficacy of a thermal biofeedback treatment
package to the management of tension-type headaches in
children. Headache, 41(2), 183-92.
Blanchard, E.B., & Kim, M. (2005). The effect of the
definition of menstrually related headache on the
response to biofeedback treatment. Applied Psychophysiology
and Biofeedback, 30(1), 53-63.
Ciancarelli, I., Tozzi-Ciancarelli, M.G., Spacca, G., Di
Massimo, C., & Carolei, A. (2007). Relationship
between biofeedback and oxidative stress in patients with
chronic migraine. Cephalalgia, 27(10),
1136-1141.
Conner, S.J., & Rideout, S. (2005). What are the best
therapies for acute migraine in pregnancy? Journal
of Family Practice, 54(11), 992-5.
Damen, L., Bruijn, J., Koes, B.W., Berger, M.Y., Passchier,
J., & Verhagen, A.P. (2006). Prophylactic
treatment of migraine in children: Part 1. A systematic
review of nonpharmacological trials. Cephalalgia,
26(4), 373-383.
Devineni, T., & Blanchard, E.B. (2005). A randomized
controlled trial of an internet-based treatment for
chronic headache. Behaviour Research and Therapy, 43(3),
277-292.
Hermann, C., & Blanchard, E.B. (2002). Biofeedback in
the treatment of headache and other childhood
pain. Applied Psychophysiology & Biofeedback, 27(2),
143-162.
Kaushik, R., Kaushik, R.M., Mahajan, S.K., & Rajesh, V.
(2005). Biofeedback-assisted diaphragmatic
breathing and systematic relaxation versus propranolol in
long term prophylaxis of migraine.
Complementary Therapies in Medicine, 13(3), 165-174.
Labbe, E.E. (1995). Treatment of childhood migraine with
autogenic training and skin temperature
biofeedback: A component analysis. Headache, 35(1), 10-13.
Martin, P.R., Forsyth, M.R., & Reece, J. (2007).
Cognitive-behavioral therapy versus temporal pulse
amplitude biofeedback training for recurrent headache.
Behavior Therapy, 38(4), 350-363.
McGrady, A., Wauquier, A., McNeil, A., & Gerard, C.
(1994). Effect of biofeedback-assisted relaxation
on migraine headache and changes in cerebral blood flow
velocity in the middle cerebral artery.
Headache, 34(7), 424-428.
Nestoriuc, Y., & Martin, A. (2007). Efficacy of
biofeedback for migraine: A meta-analysis. Pain, 128(1-
2), 111-127.
Rokicki, L.A., Holroyd, K.A., France, C.R., Lipchik, G.L.,
France, J.L., & Kvaal, S.A. (1997). Change
mechanisms associated with combined relaxation/EMG
biofeedback training for chronic tension
headache. Applied Psychophysiology & Biofeedback, 22(1),
21-41.
Rokicki, L.A., Houle, T.T., Dhingra, L.K., Weinland, S.R.,
Urban, A.M., & Bhalla, R.K. (2003). A
preliminary analysis of EMG variance as an index of change
in EMG biofeedback treatment of tensiontype
headache. Applied Psychophysiology and Biofeedback, 28(3),
205-215.
Silberstein, S.D. (2000). Practice parameter: Evidence-based
guidelines for migraine headache (an
evidence-based review): Report of the quality standards
subcommittee of the American Academy of
Neurology. Neurology, 55, 754-762.
Trautmann, E., Lackschewitz, H., & Kroner-Herwig, B.
(2006). Psychological treatment of recurrent
headache in children and adolescents — a meta-analysis.
Cephalalgia, 26(12), 1411-1426.
Vasudeva, S., Claggett, A.L., Tietjen, G.E., & McGrady,
A.V. (2003). Biofeedback-assisted relaxation in
migraine headache: Relationship to cerebral blood flow
velocity in the middle cerebral artery. Headache,
43(3), 245-50.
Verhagen, A.P., Damen, L., Berger, M.Y., Passchier, J.,
Merlijn, V., & Koes, B.W. (2005). Conservative
treatments of children with episodic tension-type headache:
A systematic review. Journal of Neurology,
252(10), 1147-1154.
View all episodes
By Harry CampbellUsing EMG Biofeedback for Tension
Headaches
Excess muscle tension can be the source of many headaches. Headache medication sometimes doesn’t work
and often comes along with unwanted side effects, in some cases even inducing
more headaches (rebound headaches) which create a vicious cycle requiring more
medication followed by more headaches.
Tension headache sufferers often don’t realize that they are
holding excess tension in their facial, neck, and upper back muscles. Muscles are intended to generate movement and
maintain posture. Muscles contract to
create movement. When the movement is
completed, the muscle should return to a relaxed state. When muscles remain contracted after movement
is completed the muscle becomes overworked and irritated. This can trigger pain. Tension headache pain usually is triggered by
excess tension in face muscles, including those around the eyes, in the
forehead, scalp, temples, and jaw. The
muscles in the scalp are also connected to the neck and upper back where the source
of the problem may also be found. When
we use EMG biofeedback for tension headaches, adhesive sensors are placed on
the site that we want to record from.
The sites normally used are forehead – frontalis. Sensors are placed across the forehead directly
above the eyebrows (active) and the ground directly above the bridge of the
nose in a straight line. We can
substitute a headband for the adhesive sensors when we are measuring EMG from
the forehead. The sensors are attached
to an EMG biofeedback instrument. Some
of the instruments are self-contained and the feedback information is given by
lights and sounds that indicate even small changes in the level of tension in
the muscles that we are recording from. Other
instruments are connected to a computer and give even more detailed feedback
including line graphs and bar graphs.
The computer systems can also store data and print reports. The person then uses the feedback information
to become more aware of the level of tension and how it changes based on what
they are doing. We can detect tension in
the forehead, around the eyes, in the jaw, tongue, lips, scalp, temples, and
even the throat. The person learns how
to relax all of these muscles through a combination of the direct feedback from
the instrument, relaxation exercises like progressive muscle relaxation, and
the coaching and encouragement provided by the biofeedback therapist. Sessions are provided at the biofeedback provider’s
office 1-3 times per week for 6-20 sessions.
It is strongly recommended that the person also practice muscle
relaxation and control at home. Home
biofeedback instruments may be rented or purchased for this purpose. As the person learns how to notice when they
are tensing their muscles and how to release the tension, the intensity and
frequency of their headaches tends to decrease.
Other biofeedback modalities like skin temperature may also be
used. That’s about it. Unlike medication there are no negative
side-effects. The possible positive
side-effects include less neck, upper back, and jaw pain, better ability to
relax, better muscle control for sports, and more energy. That’s not bad at all!
For more information on biofeedback providers, biofeedback
training, and biofeedback instruments check the following resources:
www.mindbodydevices.com
– A website with resources for personal biofeedback and stress management
products and services
www.biofeedbackinternational.com
– A website for professional biofeedback equipment and training
www.aapb.org – A website
with information on biofeedback for consumers and professionals
www.bcia.org – A website
with listings of certified biofeedback providers and information on
certification for professionals
www.nrbs.org – A website
with listings of biofeedback providers in the northeast USA as well as other
biofeedback related information
Article by Harry L. Campbell
President, Biofeedback Resources International Corp
914-762-4646
Email: [email protected]
Twitter: Biofeedbackman
Facebook: Biofeedback Resources International
Linked-In Harry L. Campbell
Please refer to the following for more information on
biofeedback for tension headaches:
Nestoriuc, Y., Martin, A., Rief, W. & Andrasik, F.
(2008). Biofeedback treatment for headache disorders: A comprehensive efficacy
review.Preview Applied Psychophysiology and Biofeedback, 33(3), 125-140.
Andrasik, F. (2007). What does the evidence show? Efficacy
of behavioural treatments for recurrent
headaches in adults. Neurological Sciences, 28, Suppl 2,
S70-7.
Arena, J.G., Bruno, G.M., Hannah, S.L., & Meader, K.J.
(1995). Comparison of frontal
electromyographic biofeedback training, trapezius
electromyographic biofeedback training, and
progressive muscle relaxation therapy in the treatment of
tension headache. Headache, 35(7), 411-419.
Arndorfer, R.E., & Allen, K.D. (2001). Extending the
efficacy of a thermal biofeedback treatment
package to the management of tension-type headaches in
children. Headache, 41(2), 183-92.
Blanchard, E.B., & Kim, M. (2005). The effect of the
definition of menstrually related headache on the
response to biofeedback treatment. Applied Psychophysiology
and Biofeedback, 30(1), 53-63.
Ciancarelli, I., Tozzi-Ciancarelli, M.G., Spacca, G., Di
Massimo, C., & Carolei, A. (2007). Relationship
between biofeedback and oxidative stress in patients with
chronic migraine. Cephalalgia, 27(10),
1136-1141.
Conner, S.J., & Rideout, S. (2005). What are the best
therapies for acute migraine in pregnancy? Journal
of Family Practice, 54(11), 992-5.
Damen, L., Bruijn, J., Koes, B.W., Berger, M.Y., Passchier,
J., & Verhagen, A.P. (2006). Prophylactic
treatment of migraine in children: Part 1. A systematic
review of nonpharmacological trials. Cephalalgia,
26(4), 373-383.
Devineni, T., & Blanchard, E.B. (2005). A randomized
controlled trial of an internet-based treatment for
chronic headache. Behaviour Research and Therapy, 43(3),
277-292.
Hermann, C., & Blanchard, E.B. (2002). Biofeedback in
the treatment of headache and other childhood
pain. Applied Psychophysiology & Biofeedback, 27(2),
143-162.
Kaushik, R., Kaushik, R.M., Mahajan, S.K., & Rajesh, V.
(2005). Biofeedback-assisted diaphragmatic
breathing and systematic relaxation versus propranolol in
long term prophylaxis of migraine.
Complementary Therapies in Medicine, 13(3), 165-174.
Labbe, E.E. (1995). Treatment of childhood migraine with
autogenic training and skin temperature
biofeedback: A component analysis. Headache, 35(1), 10-13.
Martin, P.R., Forsyth, M.R., & Reece, J. (2007).
Cognitive-behavioral therapy versus temporal pulse
amplitude biofeedback training for recurrent headache.
Behavior Therapy, 38(4), 350-363.
McGrady, A., Wauquier, A., McNeil, A., & Gerard, C.
(1994). Effect of biofeedback-assisted relaxation
on migraine headache and changes in cerebral blood flow
velocity in the middle cerebral artery.
Headache, 34(7), 424-428.
Nestoriuc, Y., & Martin, A. (2007). Efficacy of
biofeedback for migraine: A meta-analysis. Pain, 128(1-
2), 111-127.
Rokicki, L.A., Holroyd, K.A., France, C.R., Lipchik, G.L.,
France, J.L., & Kvaal, S.A. (1997). Change
mechanisms associated with combined relaxation/EMG
biofeedback training for chronic tension
headache. Applied Psychophysiology & Biofeedback, 22(1),
21-41.
Rokicki, L.A., Houle, T.T., Dhingra, L.K., Weinland, S.R.,
Urban, A.M., & Bhalla, R.K. (2003). A
preliminary analysis of EMG variance as an index of change
in EMG biofeedback treatment of tensiontype
headache. Applied Psychophysiology and Biofeedback, 28(3),
205-215.
Silberstein, S.D. (2000). Practice parameter: Evidence-based
guidelines for migraine headache (an
evidence-based review): Report of the quality standards
subcommittee of the American Academy of
Neurology. Neurology, 55, 754-762.
Trautmann, E., Lackschewitz, H., & Kroner-Herwig, B.
(2006). Psychological treatment of recurrent
headache in children and adolescents — a meta-analysis.
Cephalalgia, 26(12), 1411-1426.
Vasudeva, S., Claggett, A.L., Tietjen, G.E., & McGrady,
A.V. (2003). Biofeedback-assisted relaxation in
migraine headache: Relationship to cerebral blood flow
velocity in the middle cerebral artery. Headache,
43(3), 245-50.
Verhagen, A.P., Damen, L., Berger, M.Y., Passchier, J.,
Merlijn, V., & Koes, B.W. (2005). Conservative
treatments of children with episodic tension-type headache:
A systematic review. Journal of Neurology,
252(10), 1147-1154.