Suffering from tension headaches? Try biofeedback

What are Tension-Type Headaches?

Tension-type headaches (TTH) are the most common type of a non-traumatic headache. These headaches are often experienced on both sides of the head or in some cases as a sensation of the head being compressed or squeezed. These headaches are thought to be brought on by stress and are slightly more common in women.

TTH or Other Kind of Headache?

How can you tell if it is a TTH and not a migraine or other type of headache? In many cases, the individual will not notice any difference in the intensity of their symptoms with a change in the position of their head or in the posture of their neck. When tested, they do not necessarily have cervical spine impairments as one might find in more posture-related headaches (such as cervicogenic headaches). Individuals with TTH will not usually experience any change in their symptoms with exercise. Typically there is no vomiting with this type of headache, though some do experience nausea, photophobia, or phonophobia if they have had chronic TTH.

Why Do They Hurt?

Often with stress, we develop sensitization of our nervous system. If someone has experienced headaches episodically (less than 15 days out of a given month) they often have developed peripheral sensitization of the trigeminal nerve system. If that person experiences these headaches chronically (more than 15 days out of a given month) they often have developed central sensitization of the trigeminal nerve. In other words, the brain and/or spinal cord processing has actually changed on a fundamental level, contributing to the frequent recurrence of the headaches (4,6,8).

How Can EMG Biofeedback Help?

Biofeedback systems such as the Resility Bluetooth Muscle Activity Sensor can help in managing TTH. It is human nature to demonstrate muscle guarding around an area that is hurting. This is true whether the area is hurting for a short time (for example, you tense the muscles in your face and head when you get a brain freeze) or for a long time (a person trying to sleep off a migraine can be observed napping with their eyebrows furrowed).

The problem is, muscle tension – especially in tension-type headaches – exacerbates the problem. The tension causes pain, which causes more stress, more tension, more pain, etc. It’s a vicious cycle. If we can learn to keep the muscles of the head such as the frontalis and the temporalis relaxed, even during a headache. What’s more, we can shorten the lifespan of a headache and reduce the risk of peripheral and central nerve sensitization from occurring.

How Can Resility Help?

There are several ways to use the Resility system to help manage symptoms of TTH. There are two examples listed below.

Method 1 – Focus

Positioning: Find a relaxed position, reclined in a chair or resting on your back with your favorite pillow supporting your neck and head.

Electrode placement: Place the electrodes on your frontalis muscle (on your forehead), alternatively place them on your temporalis muscle (the side of your head). Make sure the electrode readings are syncing properly with your smartphone. Set the alarm threshold slightly above your resting tone.

Breath: Begin to focus on your breath. Without changing it, notice if you are breathing through your belly or your chest. Notice if you are breathing quickly or slowly. Notice if you are breathing deeply or shallowly. You may notice that deep belly breathing helps keep the muscles in your head relaxed. The biofeedback alarm will help you learn how to let these muscles “melt away”.

Duration: For some, 2-5 minutes of practice may be enough. For others, they may find they need more time to feel they have completely relaxed.

Frequency: Practice this 1-2x/day until you feel confident in your control of the muscles in your head and face.

Method 2 – Function

Positioning: Try using the Resility system while performing an activity that usually initiates a TTH. For example, try using it while at work or set it up before driving home in traffic.

Electrode placement: Place the electrodes on your frontalis muscle (on your forehead), alternatively place them on your temporalis muscle (the side of your head). Make sure the electrode readings are syncing properly with your smartphone. Set the alarm threshold slightly above your resting tone.

Action: Perform the usual activities that tend to stress you out, such as checking your work emails.

Duration: Some people choose to keep the electrodes on all day at first because they find it so helpful to learn which tasks throughout the day tend to cause them the most stress and tension. Other people find that just 5-10 minutes a day is enough to set them on the right track.

Frequency: 1x/day at first and then tapering off as a headache disappear to 1x/week, 1x/month, etc.

Sources:

1. Hall, T., K. Briffa, and D. Hopper, Clinical evaluation of a cervicogenic headache: a clinical perspective. Journal of Manual and Manipulative Therapy, 2008. 16(2):73–80.
2. Field, A. and E. Wang, Evaluation of the patient with a nontraumatic headache: an evidence-based approach. Emergency Medicine Clinics of North America, 1999. 17(1):127-152.
3. Smetana, G., The diagnostic value of historical features in primary headache syndromes: a comprehensive review. Archives of Internal Medicine, 2000. 160:2729-2737.
4. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia, 2013. 33(9):629- 808.
5. Benoliel, R. and E. Eliav, Primary headache disorders. Dental Clinics of North America, 2013. 57:513-539.
6. Bendtsen, L. and R. Jensen, Tension-type headache. Neurologic Clinics, 2009. 27:525-535.
7. Fuller, K., Headache, in Pathology: Implications for the Physical Therapy C. Goodman and W. Boissonnault, Editors. 1998, WB Saunders: Philadelphia.
8. Ashina, M., Neurobiology of chronic tension-type headache. Cephalalgia, 2004. 24:161-172.

About the Author:

Jennifer Dimon-Hardesty, PT, DPT lives in Washington where she practices mindful physical therapy. She enjoys specializing in orthopedics and pelvic health. Jennifer is always striving to think of ways to help people help themselves so that they can live the lives they want to live.

Note: All content found on the Resility Health Website, including text, images, audio, or other formats were created for informational purposes only. The content is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions you may have regarding a medical condition.