Neurofeedback techniques are heaving with contention, myth, and misunderstandings, so it’s no surprise they find themselves in evidence-based medicine blogs so often. The therapy works on the basis of abnormal brain patterns. Patients are hooked up to an EEG and trained to relax or focus. Neurologist Steve Novella calls biofeedback a cognitive behavioral therapy that teaches patients to “adapt and adjust”.
What Biofeedback Can and Cannot Do
It’s not possible to train the brain to have “normal” EEG patterns, but it is possible to learn how to relax. Your emotional state has a powerful effect on how well you cope with pain. It can even push your symptoms to new heights, throwing down the first domino in a complex anxiety/pain cycle. Neuropathic pain’s expression responds directly to stress, possibly because the chronic pain pathways intersect with the brain’s emotional center.
Neurofeedback is sometimes done with EMGs, which measure muscle tension. This may help patients to become more aware of their bodies’ response to pain. Relaxation techniques and mindfulness have a varied effect on different kinds of pain. Small trials suggest that lower back and neck pain may respond well to progressive muscle relaxation, which can be learned through EMG biofeedback.
Biofeedback’s reliance on brain wave patterns can distract from its role as a CBT technique. Any form of relaxation can benefit symptoms that are exacerbated by anxiety, including chronic pain. Since pain itself often causes depression and anxiety, cognitive behavioral therapy is a much needed and too often ignored treatment.
Magical Cures and Snake Oil
Alternative medicine practitioners have embraced biofeedback as a therapy for everything from ADHD to high blood pressure. Clinical trials have yet to show any results, but neurofeedback is as adequate as any other cognitive therapy for pain patients needing to reign in their anxiety.