Biofeedback Therapy: How It Works and Benefits

Physical therapists work with thousands of individuals to help them with pain-free movement and function. The movement they most often work on is a voluntary movement. When you want to rise from a chair, your brain forms the impulse, and that impulse travels down a nerve to the muscles involved in rising from a chair. They contract, and your body voluntarily rises from the chair.

But there are many other functions that occur in your body that seemingly happen beyond conscious thought. Your nervous system is constantly controlling your heart rate, blood pressure, anxiety levels, and pain responses. Gaining voluntary control of some of these involuntary functions may help treat conditions like chronic pain, anxiety, or constipation. Biofeedback therapy can help you gain control of involuntary impulses in your body.

This article will describe what biofeedback therapy is, the different types of biofeedback therapy, how it's used, and how to get started.

Biofeedback Therapy Types - Illustration by Danie Drankwalter

Verywell / Danie Drankwalter

What Is Biofeedback Therapy?

Biofeedback therapy is a method that you can use to gain control over involuntary processes in your body. It is often used for pain control or relaxation, but you can use biofeedback to treat a host of conditions. Biofeedback often uses sensors to measure your body's function; during a biofeedback therapy session, you will use various techniques to improve your mind-body connection and gain control over those functions.

What Does Biofeedback Mean?

The term biofeedback means feedback from your body. By harnessing this feedback and getting information about how involuntary functions are behaving in certain situations, you may be able to control these functions.

Your body is naturally wired for survival. And in certain situations, your body goes through a stress response; it often has to engage in the fight or flight mode.

When something dangerous or anxiety-producing is happening, your autonomic nervous system kicks in, raising heart rate and blood pressure, initiating the sweat response, increasing breathing, and releasing stress-induced hormones. While these are important things that help keep us safe, sometimes these functions serve to derail us from the task at hand.

Getting control of these involuntary stress response reactions is one of the main goals of biofeedback therapy.

Types of Biofeedback

There are several different types of biofeedback. Some require special instruments that monitor your body's functions and tell you what is going on. Other types of biofeedback simply require mindfulness of your body's systems.

Electroencephalography (EEG)

During electroencephalography biofeedback (also called neurofeedback or brain wave biofeedback), special sensors measure brain activity and you attempt to control these mechanisms through therapy and altering the feedback coming from the brain sensors.

As your neurological system changes during therapy, the sensors detect this change, and you slowly gain control of your brain activity.

Respiratory Biofeedback

During respiratory biofeedback, your rate of breathing is monitored. After monitoring, you get feedback about how your breathing changes during certain situations.

This form of therapy helps you gain control of your breathing during situations that may cause increased tension or anxiety. This type of process may help with hypertension and certain respiratory issues as well.

Heart Rate Variability Biofeedback

Heart rate variability biofeedback uses special sensors to measure your heart rate. This feedback allows you to attempt to control your heart rate during specific situations. For example, if you get anxious during public speaking and your heart races, then you can practice public speaking with heart rate biofeedback in an attempt to keep your rate within normal limits during the activity.

Electromyography (EMG) or Muscle Contraction Biofeedback

Electromyography biofeedback (also called muscle contraction feedback) uses electrodes, or electrical conductors, to measure muscle activation. The electrodes are connected to a machine that gives feedback to the user via a visual or auditory signal, allowing the user to attempt to decrease or increase muscle activity. It is often used to control unwanted muscle spasms.

Galvanic Skin Response Training or Sweat Gland Activity Biofeedback

Galvanic skin response (GSR) training is done to control the amount of sweat gland activity that occurs in your body. Small sensors that measure your skin's electrical activity are used during GSR training. These sensors provide feedback to you so that you may gain control over the electrical activity in your skin, and thus decreasing excessive sweating (hyperhidrosis) or other neural activity.

Thermal or Temperature Biofeedback

Thermal biofeedback uses temperature sensors attached to your body. These provide you feedback about the temperature of your body, and you can work to gain control over your skin and body temperatures. This may be helpful in relieving stress and anxiety.

Biofeedback Devices

Various biofeedback devices are available to help you during biofeedback therapy. These may include interactive computer programs that give you feedback about your movements or mobile devices that measure gait speed and your body's movements or heart rate.

There are also several wearable biofeedback devices available. These devices may attach to your body and interact with your smartphone to give you feedback about your heart rate, respiration, or blood pressure.

One popular wearable is called Resperate. This device is worn on your chest and has a small wearable monitor that provides you feedback about the rate of your breathing. It then gives you an audible melody that helps you slow your breathing. Slower breathing rates—those less than six breaths per minute—may be beneficial in lowering blood pressure. By practicing with Resparate for 15 minutes, three to four days a week, you may be able to achieve some improvement in your high blood pressure.

Biofeedback Techniques

There are various techniques that you can use during biofeedback training—some you can do on your own. Be sure to check in with your healthcare provider before engaging in any biofeedback training to ensure you are doing it properly.

Deep Breathing

Deep breathing techniques can help a variety of conditions such as stress and anxiety, high blood pressure, or elevated heart rate. Breathing techniques can slow your respiration rate, leading to a sense of calm in the body.

To perform deep breathing, simply lie on your back with one hand on your chest and one hand on your belly. Take a deep breath in, and as you do, allow your belly to rise slightly. Hold a deep breath for a count of three, and then slowly breathe out, ensuring you exhale fully. Pause, and then repeat the deep breathing exercise. This type of breathing is also called diaphragmatic breathing.

Progressive Muscle Relaxation

Progressive muscle relaxation can help a variety of problems including muscle spasms, stress, and insomnia. You may use an electric myographical device attached to your muscles during this form of biofeedback.

To perform progressive muscle relaxation, simply lie on your back. Take a deep breath in, and then contract a muscle group, like your calves, in your legs. Hold this tight contraction for three seconds, and then release the contraction. Then, repeat the contraction on a different muscle group, like your thighs or buttocks.

Progressively work your way up your body, contracting and then relaxing your muscle groups. This can help you decrease stress and improve insomnia symptoms.

Guided Imagery

Guided imagery is often used during biofeedback to promote stress relief and to create a bridge between your mind and body. It is usually done with another person who acts as a "guide" while you are in a deep and enhanced state of imagining a situation. You can also perform guided imagery with a recorded voice acting as a guide.

During guided imagery, you should lie down in a relaxed position. Then, your guide can ask you to imagine a peaceful or pleasant situation. During the session, you may be asked to imagine your feelings and how your body feels while experiencing the emotions related to the imagery.

Mindfulness Meditation

Mindful mediation is a technique used to help you to slow down your thoughts, be present in your mind, and let go of negative thoughts. It is often used during biofeedback to help you relax and relieve stress or anxiety, decrease your heart rate, and improve sleep.

During mindfulness meditation, you should get in a comfortable position. Focus on your breathing, and then allow your mind to focus on your thoughts. The goal of mindfulness mediation isn't to stop your thoughts, but to encounter them and allow them to be. As you breathe through your thoughts, focus on the physical feelings in your body, and then allow them to be.

Keep in mind that mindfulness mediation is a practice, and therefore it is not meant to be perfect. Your meditation session should be relaxing and should allow you to clear your head and accept your thoughts and emotions as part of your life and being.

Uses for Biofeedback Therapy

There are several different uses for biofeedback therapy. Some of these are meant to help physical problems like pain or loss of movement. Others are meant to help sleep disorders or psychological and emotional problems.

If you have a problem that is persistent and limits your normal activity, then ask your healthcare provider if biofeedback therapy may be an option for you.

Emotional and Psychological Disorders

You may find relief from several emotional and psychological disorders with biofeedback therapy. These may include:

  • Post-traumatic stress disorder (PTSD): PTSD can cause emotional distress, changes in sleep patterns, and heart rate variability. Using biofeedback, you may be able to manage the physical and emotional impairments that come with PTSD.
  • Attention deficit hyperactivity disorder (ADHD): ADHD in children may cause impulsive and disruptive behavior. Using neurofeedback, your child may be able to better control their emotions and be less impulsive.
  • Eating disorders: If you experience an eating disorder like anorexia nervosa, biofeedback training may be a helpful intervention. A recent meta-analysis found that biofeedback may improve coping strategies for people with eating disorders and improve eating behaviors.
  • Anxiety and depression: If you suffer from anxiety or depression, biofeedback training may be done as part of your therapy to help you learn to better control your automatic responses and improve overall wellbeing.

Musculoskeletal Conditions

Some people with arthritis and other musculoskeletal conditions may use biofeedback therapy for relief. Conditions may include, but are not limited to:

  • Chronic pain: There are many different causes of chronic pain. Getting control of how your body reacts to painful stimuli may be done through the use of biofeedback.
  • Headaches: Chronic headaches and migraines may be decreased through the use of biofeedback. Other impairments related to headaches, like neck pain, changes in blood pressure, and heart rate elevation may also be altered.
  • Muscle spasms: Muscle spasms may be caused by neurological overstimulation and muscle fatigue. Working with a biofeedback therapist may promote relaxation, decreasing muscle spasms.
  • Nocturnal bruxism (teeth grinding): Grinding of the teeth at night may be a sign of stress or anxiety. Using biofeedback training to control stress may help decrease bruxism.

Chronic Health Conditions

Certain health conditions may be helped with the use of biofeedback, including:

  • Asthma: Research indicates that people with asthma may use less medication, have fewer symptoms, and decreased airway resistance through the use of biofeedback.
  • Chemotherapy side effects: Chemotherapy can sometimes cause nerve pain, decreased muscle endurance, and changes in heart rate and blood pressure. Patients on chemotherapy may be able to manage some of these symptoms with biofeedback.
  • Epilepsy: In epilepsy, some parts of your brain activity become abnormal, triggering a seizure. Using neurofeedback training may help in decreasing the frequency of seizures.
  • High blood pressure: Gaining control of respiration has been shown to decrease tension and lower blood pressure. Using biofeedback to control breathing may be an effective non-medicinal treatment for mild hypertension.
  • Motion sickness: Research indicates that using a virtual reality headset to control diaphragmatic breathing can decrease the symptoms of motion sickness.

Disorders of the Genitourinary System

If you have a problem with bladder or bowel control, then you may benefit from using biofeedback to help decrease symptoms related to these problems. Conditions that may be helped using biofeedback may include:

  • Urinary and fecal incontinence
  • Irritable bowel syndrome
  • Chronic constipation

Risks and Benefits

If you are considering using biofeedback therapy, you should understand the different risks and benefits associated with the therapy.

Benefits of Biofeedback Therapy

Often we use medication to control our body's systems and sometimes these medicines can cause unwanted side effects. Biofeedback may help you gain control of some of these systems, like heart rate or breathing, without the use of medicine and without having to deal with the side effects.

Biofeedback can also help put you in control of your body. If you are feeling anxious or depressed or if you are having trouble sleeping, you may start to feel helpless. Doing something that puts you in more control of your body can help you improve your overall wellbeing.

Risks of Biofeedback Therapy

Biofeedback therapy is considered a safe treatment approach for health conditions. No study has reported significant health risks with biofeedback.

Does It Work?

Biofeedback therapy has been around for years, and there are several well-constructed studies that indicate its helpfulness in various conditions. Biofeedback for some conditions, like high blood pressure and asthma, has been proven to be quite helpful. For other conditions, it may be anecdotally helpful, but its efficacy is not supported by peer-reviewed and well-designed research. More research is needed in these areas.

How to Get Started With Biofeedback Therapy

How to Prepare for Biofeedback Therapy

To find a healthcare professional who engages in biofeedback, it is a good idea to have a chat with your healthcare provider. People who engage in biofeedback are usually psychologists or social workers, although some other rehabilitation professionals, like physical therapists or recreational therapists, may be trained in biofeedback.

Prior to starting biofeedback, your therapist should perform a brief evaluation. A medical history should be taken, and goals for therapy should be discussed. Baseline measurements of the impairments will be recorded so that change over time can be monitored.

What to Expect During a Biofeedback Therapy Session

A typical biofeedback session will last between 30 and 60 minutes. When you arrive, your therapist will apply sensors to your body that can measure heart rate, brain activity, or breathing. Then your therapist will guide you in a specific mental activity involving meditation, imagery, or breathing exercises. You will be getting continuous feedback from the biofeedback device, and your therapist can help you make changes to your reactions and emotions during the session.

Keep in mind that biofeedback requires practice, and you should not expect significant changes in one session of training. But with time, you should be able to see positive changes in the impairments for which you are receiving biofeedback therapy.

How Many Sessions Will I Need?

When starting biofeedback training, it is a good idea to try three to five sessions and assess how things are going. You may require 10 to 20 sessions to improve your mind-body connection and get control of your body's systems.

Keep in mind that everyone is different and responds differently to certain therapies. Your experience with biofeedback may vary, so be sure to speak with your healthcare provider to understand exactly what you should expect.

Summary

Biofeedback therapy is a method that you can use to gain control over involuntary processes in your body. It can be used as a non-medication treatment for many different medical conditions. Biofeedback therapy can help you create a mind-body connection so you can control heart rate, breathing, perspiration, and other involuntary actions in your body.

Studies have shown that biofeedback therapy has many potential benefits and does not appear to be dangerous or risky. Working with a biofeedback specialist to supplement medical treatment for your condition can be helpful.

A Word From Verywell

Managing a chronic medical condition can be frustrating, and dealing with side effects of medicines and treatments can leave you feeling tired and fatigued. Biofeedback is one safe and effective option to help you create a mind-body connection to get control over your body's natural responses to stressors. That way, you can modify your behavior, improve your health, and return to your normal, everyday activities.

Frequently Asked Questions

  • Can I do biofeedback at home?

    Biofeedback therapy can be performed independently at home. You may need to purchase special equipment for the feedback, and a smartphone app may provide guidance during your therapy session.

  • What is the basic principle of biofeedback?

    By using feedback from your body, you can learn to improve your mind-body connection and get control of involuntary processes in your body.

  • What are the side effects of biofeedback?

    There are no risks associated with biofeedback, and benefits may include an increased awareness of your mind-body connection.

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