Resources

What are Biofeedback and Neurofeedback?

Biofeedback provides information about the body for improved regulation. Information about muscles, skin temperature, perspiration, respirations, heart rate, blood pressure or brainwaves is displayed by a computer in the form of graphs and sound. This information is then used by the person to gain insight into the nature of the problem and to learn self regulation. Biofeedback training is the interaction between the person, his/her symptom, the computer and the therapist.

There are many kinds of biofeedback. Some are classified as Peripheral Biofeedback. EMG(electromyograph) is information about muscles and can be used to learn to reduce tension or for neuromuscular re-education. Thermal training(skin temperature) and GSR(galvanic skin response) are used to monitor sympathetic and parasympathetic nervous system activity while reducing stress. RSA (respiratory sinus arrhythmia) is used to teach slow diaphragmatic breathing for enhancing mental quieting.

Neurofeedback (brainwave or EEG biofeedback) is a computerized technique for exercising the brain. It is especially useful with chronic pain syndromes such as neuropathic pain or CRPS(Complex Regional Pain Syndromes) which appear to originate in the brain or central nervous system. Neuofeedback must be done at the biofeedback office at all times. It is a form of operant condtioning which trains the brain to make voluntary changes for cortical control and exercises and strengthens central nervous system responses. The number of sessions necessary depends on the severity of the symptom but the minimum number is around twenty. Each session is about 45 minutes long. It appears that within model of comprehensive pain management, those patients who do neurotherapy adapt better to their pain and do better in psychotherapy and physical therapy. They get better results with their medications and should they need spinal cord stimulators or pumps for pain control, they may have better success.

Every biofeedback session includes neurofeedback and the early sessions all include teaching peripheral biofeedback techniques to be practiced out of the office, several times daily. As well, the pain patient is given materials with which to practice and therefore enhance the mind/body connection. Relaxation and thermal imagery tapes teach relaxation in a very pleasant way. By pairing the relaxation to a “signal-breath”, the body learns to relax in a very short time under any stressful circumstance. With the help of the RSA biofeedback, the patient breathes more effectively. He/she practises improved breathing after each tape exercise at home. Relaxation with diaphragmatic breathing is one way to manage severe pain with more control. Monitoring fingertip temperature and hand perspiration measures the effectiveness of the relaxation. Warm dry hands are a sign of a relaxed body. Disposable thermometers and graphs are given to keep track of the changes. Frequently, fear contributes to pain, so simple information about anatomy and physiology helps the patient support his own body in healing. Special imagery techniques built on the newer awareness of the body’s functions are used in conjunction with the relaxation tapes to relieve the fear and enhance mental relief from the stressors caused by pain.

INFORMATION ABOUT NEUROFEEDBACK for clients:
Books
“A Symphony in the Brain” Jim Robbins Atlantic Monthly Press 2000
“ADHD – A 20 hour Solution” Othmer and Steinberg

An online Brochure
“What is Neurofeedback”

Websites
EEGInfo
EEG Spectrum International
The Enhancement Institute

Finding neurofeedback providers in your area
EEGInfo
EEG Spectrum International

INFORMATION ABOUT BIOFEEDBACK for clients

Article about Biofeedback
“Biofeedback – The Ultimate Self Help Discipline” Siegfried Othmer, Ph.D. and Caroline Grierson, RN, BCIAC

Biofeedback Tools
HeartMath
EMwave
Alpha-Stim
Wild Divine
Resperate

Websites and Finding biofeedback providers in your area
bsc@biofeedbackcalifornia.org
Biofeedback Certification Institute
Applied Psychophysiology and Biofeedback

INFORMATION ABOUT CHRONIC PAIN – for patients

DVD Brochures
“What is Neurofeedback” ( link to embedded)
Includes information about Migraines
“Neurofeedback and Chronic Pain” ( Link to embedded)

Link to come

How can Neurofeedback help pain?
Pain is actually sensed in the brain. It is not “out there” in the body where it is felt. The brain is ultimately in charge of how severely the pain is perceived and where it is localized in the body. The brain also registers pain emotionally, and feeling of fear, trauma, or helplessness may increase pain sensitivity.
One way to deal with the self-reinforcing cycle of chronic pain is to redefine the way the brain interprets nerve impulses and allow its sensitivity to return to normal levels. Clinical outcome studies indicate that Neurofeedback or EEG (brain wave) biofeedback can be used to break the cycle and lead to a decrease or in, some cases, total elimination of chronic pain.
EEG biofeedback uses sophisticated computer technology to allow the therapist to monitor the brain waves. Visual and auditory cues are given to the patient to coach him/her to alter the brain waves toward more normal patterns of activity.
In the case of chronic pain, the brain is paying too much attention and has become over-sensitized. By learning to control the brain waves with the aid of EEG biofeedback, one can affect the underlying structure of one’s attention and return the brain’s pain sensitivity to normal levels.
Neuofeedback is a non-invasive process which uses state of the art digital technology to monitor and train the brain in ways which were previously not thought possible. Yet the key to its remarkable effectiveness in dealing with chronic pain is not the hardware or software, but rather the brain’s ability to learn to reorganize and maintain its own functional state. Brain plasticity allows us to alter how we function in life.

Comprehensive Pain Management Programs
Los Angeles area:
Joshua Prager MD
California Pain Medicine Centers

A few suggested readings about pain
Free Yourself From Pain David E Bresler Awareness Press, 1979
Managing PAIN before It Manages You Margaret A Caudill, M.D., PhD The Guilford Press, New York, 2000 - Revised edition
Living with RSDS, Linda Lang and Peter Moskovitz, M.D. New Harbinger Publications, Inc. 2003 (Very specific reading about Reflex Sympathetic Dystrophy)

Newsletters
The Newsletter of the American Pain Foundation
Fibromayalgia AWARE
Reflex Sympathetic Dystrophy Syndrome Association

Websites
Chronic Pain Resource Center
National Fibromyalgia Research Association
Interstitial Cystitis Association
The Vulvar Pain Foundation