Migraines are a type of serious headache disorder that affects women twice as often as men. Migraine headaches are characterized by pain that is typically on one side of the head and accompanied by nausea and/or vomiting, as well as sensitivity to light and sound. In about a third of people, migraines are preceded by an “aura.” An aura is an abnormal sensory experience that can present as flashing lights, numbness or tingling in the face or extremities, a disturbed sense of smell, or having difficulty speaking. Some people with migraines describe having a “funny feeling” that signals their impending onset.

The Circular Relationship Between Migraines and Stress
Although the cause of migraines is not precisely known at present, this medical condition is believed to stem from inflammation or pressure on blood vessels and nerves innervating the face. Migraines can also be triggered by a variety of factors, including changes in the weather, diet, hormonal fluctuations, insufficient sleep, and stress or anxiety. Of course, as with any chronic pain condition, people who suffer from migraines often report increased stress and anxiety, as well as corresponding difficulty in sleeping, as a result of the condition.

Biofeedback as a Complementary/Alternative Medicine Tool
Biofeedback is a complementary/alternative medicine treatment that has been used successfully with a variety of conditions. These include but are not limited to headaches and other types of chronic pain conditions, as well as anxiety, Raynaud’s disease, and high blood pressure, to name a few. Biofeedback is considered very safe and involves having painless sensors attached to the face or body in order for a computer to provide information about bodily states, such as peripheral skin temperature, the degree of tension in the muscles, and heart rate/relative blood flow. The computer then gives feedback about whether or not the person is in a desirable range. This approach has a solid body of research behind it for the treatment of migraines and the stress that often accompanies them.

Because the goal of biofeedback typically involves decreasing tension and increasing feelings of calm, the technique is often combined with relaxation training including slow, deep breathing, guided imagery or hypnosis, or elements of cognitive behavioral therapy. When a person is able to use these approaches to reduce stress or pain, the feedback from the computer, which is fairly immediate, signals “success” to the person. Feedback is typically visual, such as seeing a change in on-screen animation or other graphics, and/or auditory, as indicated by hearing a reward tone, soothing music, or nature sounds. This type of response helps the person to recognize when they have entered a more desirable state and trains them to do so more easily and rapidly over time.

For example, when a person is in pain or under stress, their temperature decreases due to constriction of blood vessels. Therefore, a temperature sensor placed on the finger of a person who is stressed may read in the 70-something or 80-something degree range (which is low), but will increase accordingly as they relax, ideally into the 90+ degree range. Sensors evaluating muscle tension (known as electromyography [EMG]) can reveal clenching or contractions that one may not be conscious of. Practice increases awareness of the above and conditions the muscles to remain more relaxed. Similarly, a heart rate elevated by stress can be lowered to a healthy range with the aid of feedback from a sensor (blood volume pulse [BVP]) that provides information about relative cardiovascular fitness.

Biofeedback is typically done in the office of a provider who is either certified in biofeedback or a licensed mental health professional trained in this modality. Clients are instructed to engage in at-home relaxation practice between sessions in order to enhance and maintain treatment gains. Although these are not required for home practice, there are a variety of portable biofeedback devices on the market for those who find these helpful.

In summary, biofeedback can be a useful tool for those suffering from migraines and stress, as well as other issues not addressed here. For more information about migraines or biofeedback, please consult the links below.

Resources

• Carolyn J. Hildreth, MD. (2009). Patient information page: Migraine headache. JAMA, 301 (24), 2608. Available from: http://jama.ama-assn.org/content/301/24/2608.full.pdf
• Mayo Clinic. (2010). Biofeedback. Available from: http://www.mayoclinic.com/health/biofeedback/MY01072
• Nestoric, Y., Martin, A., Rief, W., & Andrasik, F. (2008). Biofeedback treatment for headache disorders: a comprehensive efficacy review. Applied Psychophysiology and Biofeedback, 33(3), 125-140.

To find a biofeedback provider near you:
Biofeedback Certification International Alliance, http://www.bcia.org/i4a/pages/index.cfm?pageid=1

To view a YouTube video showing an at-home temperature biofeedback device: http://www.youtube.com/watch?v=B-84kQXfs3c

Related articles:
Complementary & Alternative Medicine and Psychotherapy: Hypnosis in the Management of Chronic Pain
Women and Chronic Pain: Getting the Help You Need
Yoga for Balancing Mind and Body

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