Biofeedback

Biofeedback for Chronic Pain

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It depends on the kind of pain. For chronic back pain, a 2017 meta-analysis of 21 studies found that biofeedback reduced pain intensity, with the effect holding over an average of eight months. For fibromyalgia, a 2019 evidence map found a short-term benefit for pain from muscle biofeedback, but not from brainwave training, and at low confidence. For several other painful conditions, the evidence is unclear.

How is biofeedback supposed to help with pain?

By making a pain-related body signal visible so you can learn to change it, such as muscle tension measured with surface sensors (EMG). A VA Whole Health guide to biofeedback describes it as one element of a multifaceted intervention that a practitioner may combine with cognitive behavioral therapy, relaxation techniques or physical therapy.

What does the research say about back pain?

For back pain, the key source is a 2017 meta-analysis in the International Journal of Behavioral Medicine by Sielski and colleagues, covering 21 studies and 1,062 patients with chronic back pain. According to its abstract:

  • Pain intensity fell, with a small-to-medium effect that remained stable over an average follow-up of eight months.
  • Depression, disability and muscle tension also decreased, and cognitive coping improved.
  • Longer courses of biofeedback were more effective for reducing disability.
  • The authors conclude that biofeedback can lead to improvements both as a standalone treatment and as an add-on to other treatment.

What about fibromyalgia?

The picture is weaker. The 2019 evidence map in the Journal of General Internal Medicine summarizes a review of seven trials in fibromyalgia:

  • Pain intensity improved in the short term, but only with muscle (EMG) biofeedback, not with brainwave (EEG) biofeedback, and the map rates this as low confidence.
  • Longer-term pain, sleep problems, depression, fatigue and quality of life showed no difference.
  • Harms: some studies reported none; others linked EMG biofeedback with stress, and EEG biofeedback with fatigue, headache and sleep problems.

And other kinds of pain?

For knee osteoarthritis, the map found the evidence unclear, based on a single trial. Migraine and tension-type headaches are the exception at the other end: the map found high-confidence evidence that biofeedback reduces how often they occur, how long they last and how intense they are.

Fitting it into your pain treatment

Raise it with the clinician who manages your pain, and ask whether biofeedback would sit alongside your current treatment, which type they would use and how many sessions they suggest. Then keep a simple pain diary, noting intensity, sleep and what you could do each day, so you can judge after a few weeks whether the sessions are making a difference you can feel.

This article is general information, not medical or psychological advice; talk with a licensed clinician about your own situation.

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