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
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),
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,
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-
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,
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,
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