Biofeedback is a type of therapy that is administered at various health facilities including medical centers, hospitals and physical therapy clinics. During biofeedback, patients are trained to use their mind to control body functions, such as muscle tension and heart rate. Health experts generally recommend that patients seek treatment with a licensed biofeedback therapist or healthcare professional with experience in using biofeedback.

Biofeedback may be used to reduce stress and alleviate anxiety, insomniainsomnia and depression. However, it appears to be most useful in treating physical health problems including hypertension (high blood pressure), headaches and arthritis (inflammation of the joints). Biofeedback was developed during the last half-century.

A number of techniques can be used to teach biofeedback, depending on the patient’s health and/or emotional problems and treatment goals. During biofeedback training, sensors are placed on the patient’s body. The patient is given auditory or visual cues to indicate body functions (e.g., tense muscles). The patient then learns to associate these functions with symptoms (e.g., anxiety, pain) and learns to control the functions (e.g., relax the muscles) to ease the symptoms. Eventually, the patient learns to do this without help from a therapist.

Biofeedback puts patients in control of their own treatment and may decrease medical costs by reducing their need for medication. For most patients, biofeedback therapy is safe. However, patients should consult their physician to determine if biofeedback is appropriate for them.

Biofeedback is a therapy in which the patient gains partial or complete control over various body functions through the use of relaxation techniques. It seeks to strengthen communication between the mind and body. Biofeedback is non-pharmacological, meaning that it does not involve the use of medications.

The goal of biofeedback is to use the mind to control the body. Therapists teach patients how to control certain involuntary body responses using feedback from a variety of monitoring procedures and equipment. This equipment usually displays biological data (e.g., heart rate, muscle tension) in a visual or auditory form, which allows a patient to become aware of body processes that are otherwise controlled unconsciously. By slowly learning to control these responses, patients can overcome various mental and physical health issues (e.g., panic attack, headache). Eventually, patients are able to control their body's response without the aid of the visual or audio cues.

Mastering relaxation techniques, whether in a specific body part or in the entire body, is often a large part of biofeedback. Controlling certain body functions, such as heart rate and muscle stress, can reduce tension, stress and pain.

Patients who participate in biofeedback may learn to control many responses, including:

• Muscle tension
• Brain wave activity
• Skin temperature
• Respiration
• Heart rate and circulation
• Blood pressure

Different methods of biofeedback training are used depending on the conditions and goals of the individual patient. Diaries or journals may be useful in determining the effectiveness of a patient’s use of biofeedback.

Biofeedback techniques were developed within the last half-century. After the techniques have been mastered in a clinical setting, the patient may be able to control body functions without the assistance of a therapist.

Biofeedback may be used in conjunction with other treatments or therapies or may be used alone depending upon the patient and the problem being treated.

Biofeedback certification is available from the Biofeedback Certification Institute of America. Although this certification is voluntary (it is not required), some biofeedback therapists in the United States choose to become certified. Many psychiatrists and psychologists learn biofeedback during their training and do not seek separate biofeedback certification.

The techniques used to teach biofeedback depend upon the individual's health and/or emotional problems and what they wish to accomplish. Methods and equipment that may be used include:

• Electromyography (EMG). Sensors (e.g., electrodes) are attached to the skin to measure the electrical activity of the muscles. This activity relates to muscle tension, which can influence or cause stress and pain. The patient learns to recognize tension early and control it right away.
  
  
• Galvanic skin response training. Sensors measure perspiration and sweat gland activity. This method is useful in the treatment of emotional disorders (e.g., anxiety disorders).
  
  
• Neurofeedback. An electroencephalogram (EEG) is used to monitor brain wave activity and teach patients to alter it. This activity may be linked to different mental states, such as wakefulness, relaxation, calmness and light or deep sleep. This may be helpful for children with some types of attention deficit hyperactivity disorder.
  
  
• Thermal biofeedback. Sensors are attached to the patient’s fingers and feet to measure skin temperatures. These temperatures often drop when the patient is under stress, so a low reading can prompt the beginning of relaxation techniques. Thermal biofeedback may be especially helpful in the treatment of migraine headaches and peripheral vascular disorders such as Raynaud’s disease.
  
  
• Heart rate and blood pressure monitors. Other devices, such as a pulse monitor, may be used during biofeeback to monitor a patient’s heart rate and blood pressure, both of which can change due to stress and hypertension (high blood pressure).

  
  
• Forced oscillation method. A rarely used method in which a patient breathes through a tube and pressure and flow of the breath are assessed using a device called a pneumotachometer. This method teaches control of respiration (breathing). Controlled breathing can help people with anxiety disorders and insomnia.

Biofeedback has shown evidence of assisting more than 100 conditions. It may be helpful for the following conditions related to mental health:

• Substance abuse and smoking addiction.
  
  
• Attention deficit hyperactivity disorder and learning disabilities.
  
  
• Depression.
  
  
• Anxiety disorders. Including panic attacks and panic disorder, generalized anxiety disorder, post-traumatic stress disorder, obsessive-compulsive disorder and phobias.
  
  
• Insomnia.
  
  
• Stuttering.
  
  
• Stress.

It may also be used to treat the following:

• Pain conditions, such as headaches, back pain and arthritis (inflammation of the joints).
  
  
• Gastrointestinal symptoms and conditions, such as:
  
  
• Nausea and vomiting.
• Urinary and fecal incontinence.
• Irritable bowel syndrome.
  
  
• Asthma.
  
  
• Hot flashes.
  
  
• Bruxism (grinding of teeth).
  
  
• Head injuries.
  
  
• Cardiac arrhythmia (irregular heart beat) and hypertension (high blood pressure).
  
  
• Epilepsy and seizures. Biofeedback may be helpful in preventing or reducing the severity of some types of epilepsy-related seizures.
  
  
• Stroke and related problems. When used for treating hypertension, biofeedback may help prevent stroke. Although it does not treat the condition itself, biofeedback can help treat the problems that result from stroke. 
  

Though biofeedback may be used for both mental and physical disorders, it appears to be most useful for the treatment of the latter.

Health experts generally recommend that patients seek treatment with a licensed biofeedback therapist or other healthcare professional with experience in using biofeedback. Biofeedback training can occur in a variety of facilities including medical centers, hospitals and physical therapy clinics.

For biofeedback, the therapist applies electrical sensors (electrodes) to different parts of the patient’s body. These electrodes are connected to monitors that give feedback in the form of auditory (e.g., beeping, clicking sounds) or visual (e.g., flashing light, changing color) cues. The patient begins to associate the body’s responses (symptoms) with certain physical functions (e.g., tense muscles, elevated heart rate). In this manner, the patient learns how to make positive physical changes (e.g., relax muscles, reduce heart rate) to alleviate the symptoms. Relaxation helps the patient to learn this control.

The eventual goal of biofeedback training is for the patient to exercise this control alone, without assistance from a therapist or technology. Therapy sessions typically last for 30 to 60 minutes. 

The results of biofeedback vary by individual, but it can provide significant benefits. When successful, biofeedback may allow patients to reduce or even eliminate their need for medication. The therapy also has the potential to increase the effectiveness of other treatments or help conditions when the patient fails to respond to other treatments. In some instances, it may decrease medical costs by removing the cost of other medications or therapies.

Biofeedback can also have psychological benefits. It may give patients control of their own healing and allow them to better monitor their own progress.

Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions about biofeedback:

1. Are you experienced in biofeedback?
   
   
2. Am I a good candidate for biofeedback?
   
   
3. Which body functions should I seek biofeedback control over to help my condition?
   
   
4. Which methods of biofeedback training should I use?
   
   
5. Should I use a journal to record my experiences with biofeedback?
   
   
6. Will biofeedback improve the effectiveness of any of the treatments I am currently undergoing?
   
   
7. Will biofeedback interfere with any of the medications I am currently taking?
   
   
8. Should I restrict my use of biofeedback in any way because of my condition?
   
   
9. If biofeedback does not work for me, what other treatment options do I have?
   
   
10. How long do I need to continue biofeedback?