Researchers from the Department of Psychiatry at Brigham and Women's Hospital/Harvard Medical School reviewed the evidence on the efficacy of biofeedback for the two most prevalent headache conditions--migraine and tension-type headache.

Two recently published meta-analyses yielded data from 150 outcome studies - randomized controlled trials as well as uncontrolled quasi-experimental designs. Of these, 94 studies were selected for inclusion, going by predefined criteria. Meta-analytic integrations were carried out separately for the two conditions of interest.

The main results were medium-to-large mean effect sizes for biofeedback in both adult migraine and tension-type headache patients. Treatment effects remained stable over an average follow-up period of 14 months, both in completer and intention-to-treat analyses.

Headache frequency was the primary outcome variable and showed the largest improvements. Further significant effects were shown for perceived self-efficacy, symptoms of anxiety and depression, and medication consumption. In addition, reduced muscle tension in pain-related areas was observed in electromyographic feedback for tension-type headache.

Biofeedback was more effective than wait list and headache monitoring conditions in all cases, while electromyographic feedback for tension-type headache showed additional significant effects over placebo and relaxation therapies.

The study concludes that biofeedback is an effective intervention for both types of headache, and provides recommendations for future research. 

Citation:  Nestoriuc Y, Martin A, Rief W, Andrasik F.  Biofeedback treatment for headache disorders: a comprehensive efficacy review. Applied Psychophysiology and Biofeedback. 2008 Sep;33 (3): pages 125-40. Epub 2008 Aug 26. [email protected]