Read why one migraine specialist believes that biofeedback should be the first line of treatment in patients with migraine.
While migraine can vary in intensity, duration, and cause, many of the headaches can be triggered by stress and other lifestyle factors, says Susan Masterson, PhD, a licensed clinical health psychologist who has studied migraine.
“Migraines are experienced as a result of vasculature constriction followed by dilation. Usually patients will relate the symptoms [of migraine] occur after times of increased stress, or regularly with a lifestyle and surroundings that are chronically stressful,” she says.
One form of treatment that has been shown to be effective at treating stress, chronic pain, and migraine is biofeedback (also called neurofeedback). Biofeedback is a technique that helps a person use information from their body to manage symptoms.
Masterson describes the process: a user sits at a computer or holds a small device at home with sensors connected to their fingers and to a display of some kind. A temperature reading shows on the screen, often accompanied by a tone that varies with the amount of warmth detected.
“Patients begin to associate mental states with the feedback received and through operant conditioning begin to learn how to bring about the state that produced the warmth,” Masterson says.
This is often done in combination with cognitive behavioral therapy or some other kind of talk therapy where the therapist helps the person become aware of what they are thinking and feeling.
“It’s really quite enlightening. You might find things stress you out more than you thought by watching your temperature drop and go back up,” she says.
On a physical level, what is happening is that relaxation allows blood vessels to relax, allowing blood to run away from the face and head and back into the extremities, Masterson says. “The relaxation response tells you what your body is doing before you are even aware of it.”
It is very similar to mindfulness practice, Masterson says, in which a person focuses their mind solely on the present moment and whatever task is before them.
“Through the learning process, they figure out whether it’s conscious or not, how to get their mind into the state that’s going to send the blood back to the extremities or relax the muscles or change the frequency of the brain waves.”
With repetition, this relaxation response comes more and more easily and can reduce the frequency and intensity of migraine, she explains.
“Migraine is typically a vascular type of headache,” Masterson says. “Not all vascular headaches are migraines, but it’s about that constriction. So if you can keep that pendulum from swinging wildly as far as the blood vessels opening and closing, you’re going to get a whole lot better control over the migraines and the ones you get may be less intense.”
Masterson believes so highly in biofeedback she is surprised it is not a first line of treatment in migraine. Instead, she finds physicians often suggest it to people who have suffered chronically and tried everything else.
“It’s not typically the thing the doctor sends you to start with, which is a shame. There should definitely first be attempts to self regulate.”
Other barriers to biofeedback may include cost, as insurance plans may not pay for it, and access, as not every city has a certified biofeedback organization. Masterson recommends connecting with the Biofeedback Certification International Alliance to find a practitioner.
Masterson hopes that more people who suffer with migraine will consider biofeedback as an option. “A lot of times people don’t understand that the connection is so real between what we think and what our body is doing.”