A clinical trial evaluating the efficacy of biofeedback in reducing the frequency and severity of migraines and tension headaches in adults.
A US randomized controlled trial of Mullally and colleagues, published in Pain Physician in 2009, evaluated during 3 years the efficacy of non-invasive and non-pharmacological biofeedback to reduce the frequency and severity of migraines and headaches voltage. The results show that biofeedback is not more effective than relaxation to reduce headaches.
The Study Rationale
Migraine affects 12% of adults. It affects the quality of life of those who suffer. It impacts their family, social and professional. It generates significant direct and indirect medical costs.
Tension headaches affect about 40% of the population. They are the source of greater use of care and lower productivity. The drugs remain the primary treatment for all types of headaches. However, side effects occur frequently some of which can cause death.
Studies suggest that biofeedback electro-myographic named more frequently EMG biofeedback, administered alone or combined with relaxation techniques, reduce tension headaches of 40% to 60%. EMG biofeedback is a technique that would allow patients to improve their physical health by taming the signals from their bodies. It was still necessary to ensure a randomized controlled trial.
The technique of EMG biofeedback could reduce tension headaches by about 40%.
Is biofeedback effective in reducing the frequency and severity of migraines and tension headaches?
The randomized controlled Mullally and colleagues evaluated for 36 months the efficacy of biofeedback to reduce the frequency and severity of migraines and tension headaches. The study examined 64 adults aged between 18 and 55 years. All participants suffered from migraine with or without tension headaches. Headaches appeared to be more than a year before the start of the intervention. The frequency should be between 2 and 5 times per month.
Patients were randomly assigned either to the biofeedback program combined with relaxation techniques, either single relaxation program. All patients were followed by a neurologist.
Patients completed a questionnaire at the start of surgery and at 3, 6, 9, 12, 24 and 36 months. The questionnaire raised the total number of headache, the number of severe headache and mild headaches. Patients who followed the biofeedback technique were asked about the effectiveness of this technique to prevent or reduce moderate and severe headaches.
The Non-Pharmacological Intervention (NPI) assessed
Biofeedback was supervised by a licensed psychologist with extensive experience in the use of techniques for managing headaches. The method of biofeedback consists of 10 sessions of 50 minutes. First, a sensor fetches the frontal muscles signals. Then the information is transmitted to the patient in auditory and visual form that he becomes aware of his state of contraction or relaxation. Finally, through relaxation, it acquires a degree of control over the physiological functions that contribute to headaches.
The patients in the relaxation group significantly decrease the frequency and severity of headaches in the first 12 months. These results are maintained after three years. The group benefiting from the biofeedback and relaxation benefits from the same improvements. After three months, 48% of patients in group benefiting from the biofeedback and relaxation reported less severe headaches compared to only 35% in the relaxation group. The number of drugs used by the patients and the medical care utilization decreased in both groups after three years.
Biofeedback provides no additional benefit compared to only relaxation sessions to reduce the frequency and severity of migraines and tension headaches.
What it means for Patients
People suffering regularly from migraines and tension headaches can use relaxation methods. They are effective in reducing the frequency and severity of migraines and headaches in the long run. The biofeedback technique brings no additional benefits.
What it means for Healthcare Professionals
Relaxation should remain the main non-pharmacological intervention to prevent migraines and tension headaches.
What it means for Researchers
This study did not provide scientific evidence for the effectiveness of biofeedback to reduce migraines and tension headaches. However, lack of adherence during the study could bias the results.
What it means for Policymakers
Headaches are a major public health problem. They are very expensive. They increase dependence on care and loss of productivity. Biofeedback is used for decades pout attempt to treat headaches. This trial showed no additional benefit of biofeedback over conventional relaxation techniques to treat migraines and tension headaches in adults.
Mullally WJ, Hall K, Goldstein R (2009). Efficacy of biofeedback in the treatment of migraine and tension type headaches. Pain Physician, 12, 1005-1011.
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To reference this Blog en Sante © article
Ninot G (2015). Efficacy of biofeedback against headaches. Blog en Sante, A69.
© Copyright 2015 Gregory Ninot. All rights reserved.