Biofeedback is less a “treatment” than a training technique. It involves creating an information loop between a physiological variable and the person’s awareness. This facilitates learned control of some physiological function. 

Pain itself cannot be easily detected or fed back by instruments, but body conditions associated with the pain can be.  For instance, muscle tension can be monitored by surface EMG, with visual and/or auditory feedback displaying the tension in a particular muscle area. Bruxism, neck pain, and back pain are common applications. 

Pain reduction includes “suffering reduction” because emotional calm activates descending inhibitory tracts (anterior cingulate cortex, periaqueductal gray, ventromedial medulla, and dorsal horn of spinal cord). Suffering inhibits this pain suppression system. The suffering component is integral to pain intensity. 

NOTE:  if a patient has experience with meditation, breathing, or other relaxation techniques, they will often see the potential of biofeedback for measuring and sharpening their skills. However, if a patient is passively waiting for something to take the pain away, they may not value a “do-it-yourself” approach. 

Common Outcomes after some sessions of biofeedback focused on pain:

  • Better control over both pain intensity and response to pain (anxiety, depression, panic, anger)  
  • Reduced dependence on opioids and analgesics
  • Having something to practice and improve upon (body control of some type)
  • Improved quality of control over attention to pain, diminish anxiety and suffering
Clinical Use: 

Biofeedback is used for chronic pain conditions through teaching influence over physiological variables that either cause or respond to chronic pain. The learning process takes weeks to months, and includes home practice, sometimes using small home-practice units. 

Applications include muscle pain, including bruxism and TMJ, neck pain, low back pain; IBS; chronic headache; pelvic pain. Excessive sympathetic activity such as irregular breathing, tachycardia and low variability, anxiety, and G-I disruption are all addressable by biofeedback.

Biofeedback amplifies objective awareness of one’s body, including habitual factors that can increase pain: especially posture, bruxism, abdominal/pelvic tension, and neck/shoulder tension. Displaying body responses to intentional self-regulation increases confidence in potential self-control.

Most biofeedback practitioners are psychologists, nurses, counselors, or physical therapists. Main certification body (not mandatory) is the Biofeedback Certification International Alliance. Practitioners should be licensed in a health-care profession. More information is at AAPB.ORG, BCIA.ORG, and BFE.ORG.

It is wise to inquire about practitioner experience and outcomes in the disorder and in the modality being considered (muscle, breathing, circulation, HRV, etc.)  No practitioner is skilled in all modalities or all disorders.

Special Considerations: 

Biofeedback is best integrated with techniques such as cognitive change, emotional regulation, attention control, meditation and mindfulness, guided imagery, progressive muscle relaxation, regulated breathing, Autogenics, Open Focus, and yoga. The feedback shows tangible effects of these procedures.


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Nestoriuc Y, Martin A, Rief W, Andrasik F. Biofeedback treatment for headache disorders: a comprehensive efficacy review. Appl Psychophysiol Biofeedback. 2008 Sep;33(3):125-40.

Goldenberg JZ, Brignall M, Hamilton M, Beardsley J, Batson RD, Hawrelak J, Lichtenstein B, Johnston BC. Biofeedback for treatment of irritable bowel syndrome. Cochrane Database Syst Rev. 2019 Nov 12;2019(11):CD012530.