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Tension Headache and the use of Biofeedback to control them

 

Tension Headaches and Stress Headaches

Tension headache is very common and is typically experienced as a dull, non-throbbing pain in the back of the neck or in a "headband" distribution.

Several controlled trials utilizing electromyogram (EMG)-biofeedback (which teaches people how to mentally relax their neck or head muscles) have shown this treatment to be helpful in about 50% of tension headache sufferers, both in adults 1, 2, 3, 4, 5 and in children and adolescents. 6, 7 Progressive muscle relaxation is another muscle relaxation technique that has significantly reduced tension-type headache in controlled studies of adults, 8, 9 and children and adolescents. 10,

Relaxation with techniques for stress management was found to be significantly better than drug therapy in a controlled trial of chronic tension-type headache sufferers, 11 although about half of all subjects continued to have headaches three to four days per week after the end of treatment.

A large controlled study of tension headache patients compared relaxation therapies (including progressive muscle relaxation, hypnosis, and cognitive psychotherapy) with EMG-biofeedback, and found biofeedback to be significantly more effective than relaxation in decreasing headache pain and frequency.

 

References

  1. Rokicki LA, Holroyd KA, France CR, et al. Change mechanisms associated with combined relaxation/EMG biofeedback training for chronic tension headache. Appl Pschophysiol Biofeedback 1997;22:21-41.
  2. Bruhn P, Olesen J, Melgaard B. Controlled trial of EMG biofeedback in muscle contraction headache. Ann Neurol 1979;6:34-6.
  3. Holroyd KA, Andrasik F, Noble J. A comparison of EMG biofeedback and a credible pseudotherapy in treating tension headache. J Behav Med 1980;3:29-39.
  4. Carrobles JA, Cardona A, Santacreu J. Shaping and generalization procedures in the EMG-biofeedback treatment of tension headaches. Br J Clin Psychol 1981;20:49-56.
  5. Janssen K. Differential effectiveness of EMG-feedback versus combined EMG-feedback and relaxation instructions in the treatment of tension headache. J Psychosom Res 1983;27:243-53.
  6. Bussone G, Grazzi L, D'Amico D, et al. Biofeedback-assisted relaxation training for young adolescents with tension-type headache: a controlled study. Cephalalgia 1998;18:463-7.
  7. Kroner-Herwig B, Mohn U, Pothmann R. Comparison of biofeedback and relaxation in the treatment of pediatric headache and the influence of parent involvement on outcome. Appl Psychophysiol Biofeedback 1998;23:143-57.
  8. Blanchard EB, Applebaum KA, Radnitz CL, et al. Placebo-controlled evaluation of abbreviated progressive muscle relaxation and of relaxation combined with cognitive therapy in the treatment of tension headache. J. Consult Clin Psychol 1990;58:210-5.
  9. Blanchard EB, Nicholson NL, Taylor AE, et al. The role of regular home practice in the relaxation treatment of tension headache. J Consult Clin Psychol 1991;59:467-70.
  10. Kroner-Herwig B, Mohn U, Pothmann R. Comparison of biofeedback and relaxation in the treatment of pediatric headache and the influence of parent involvement on outcome. Appl Psychophysiol Biofeedback 1998;23:143-57.
  11. Larsson B, Melin L, Doberl A. Recurrent tension headache in adolescents treated with self-help relaxation training and a muscle relaxant drug. Headache 1990;30:665-71.
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