Chronic Pain

Can Neurofeedback Help with Chronic Pain?

How does neurofeedback work with pain?

Biofeedback techniques (using monitoring instruments) provide patients with physiological information that allows them to reliably influence psychophysiological responses. The evidence is strong for the effectiveness of this class of techniques (relaxation and biofeedback) in reducing chronic pain in a variety of medical conditions.


“All pain occurs in the brain”
There are many forms of chronic pain: chronic low back pain, chronic headaches (such as a migraine headache and chronic daily headache), fibromyalgia, myofascial pain disorders and other disorders of muscles and joints. One of the best well–known applications of biofeedback has been to the area of chronic pain. Most recently, it has been found that neurofeedback can be particularly helpful. Chronic pain patients experience a variety of dysregulations. Pain is not the only complaint, but when pain is present, there is no more quality of life. Chronic-pain-NeurofeedbackPain 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. Feelings of fear, anxiety, depression or helplessness may increase pain sensitivity.

Symptoms of Chronic Pain

In a traumatic tissue injury, or in the case of an inflammation, the human body itself releases pain-inducing substances (acetylcholine, serotonin, and histamine) and at the same time leads to the formation of prostaglandin E2.

Prostaglandin E2 and bradykinin sensitize the pain receptors and increase their sensitivity to the body’s own pain-compounds, the prostaglandins.

If this cycle is not interrupted, it may result in a pain pathway, which leads from the periphery via the spinal cord to the thalamus. The greater the pain, the higher the discharge frequency of the pain receptors and the stronger the synaptic connections, that pass on the pain.

At The Think Hub Center, our objective is to train you to balance your brain and body to achieve optimal functioning and health.

We begin with an extensive assessment which includes a clinical interview, plus psychological and physical symptom questionnaires, Quantitative Electroencephalogram (QEEG), Psycho-Physiological Stress Profile and neuropsychological testing.

One way to deal with the self-reinforcing cycle of chronic pain is to redefine the way the brain interprets nerve impulses and allows 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.

During the Physiological Stress Profile (PSP) at The Think Hub Center, your heart rate, respiration, muscle contractions, finger temperature and skin conductance are measured during rest, stress, recovery and during paced breathing periods. This test shows us how your body is functioning and what types of interventions will be helpful to decrease symptoms and increase health and well-being.

QEEG is a non-invasive test that measures electrical impulses from your brain. We use this information to understand your brain functioning and symptomatology. We diagnose and create individualized treatment plans. The procedure is done without any medication and is completely painless.

With the information from the QEEG, we know exactly which position on your scalp needs to be increased or decreased for improved functioning.

By training you to regulate your brainwaves, your brain is rewarded and learns to direct itself towards a more desirable level of functioning. Through neurofeedback training, you can learn to increase brain functioning, such as memory, emotion regulation, and learning. Conversely, you can also decrease unwanted side effects of imbalances in the brain, such as depression, anxiety, sleep disturbances, and addictive behaviors.

At The Think Hub Center, we use respiratory feedback, Heart Rate Variability (HRV) training, Skin Conductance (SC), finger temperature and surface Electromyography (EMG) protocols. These protocols help to train your body to return to a balanced state, increase positive coping and increase your ability to handle the demands of your everyday life, while at the same time decrease your pain and suffering.

Migraines and Neurofeedback: A Drug-free Non-Invasive Solution
Stress is often a big trigger for migraine sufferers. Neurofeedback (also known as Neurotherapy, EEG biofeedback or Neurobiofeedback) is showing promise as a non-invasive and painless method of relieving stress reactivity and the resulting rebound into migraine pain.

QEEG abnormalities have been reported in a number of studies. Dr. Jonathan Walker (Walker, 2011) has reported finding significantly increased high-frequency Beta (21-30 Hz) activity in 1-4 cortical areas; most commonly in central, centroparietal, and parietal regions.

An earlier clinical study by Stokes and Lappin in 2008 examined the effectiveness of two types of neurofeedback, i.e., EEG and HEG neurofeedback, combined with a more conventional peripheral biofeedback therapy, i.e., temperature biofeedback from the fingers, in the treatment of a migraine headache.

They reported that 62% of their patients obtained major improvement or total remission of their migraines, 18% obtained a moderate improvement, and only 21% obtained slight improvement. Fully 70% of the patients obtained a greater than 50% reduction in the frequency of their headaches and no patient experienced a worsening of their headaches. As well, most patients also experienced significant improvements in their sleep, mood, and mental focus.

EEG Neurofeedback for a Migraine
While neuroimaging studies using MRI are usually normal in a common migraine, QEEG assessment will usually show abnormalities in persons with a recurrent migraine (Bjork, et al., 2009; Sprenger, 2010; Sprenger & Goadsby, 2009). An increased high-frequency Beta (21-30 Hz) activity in 1-4 cortical areas, most commonly in central, centroparietal, and parietal regions is usually observed. Neurofeedback protocols consisted of reducing 21-30 Hz activity and increasing 10 Hz activity (5 sessions for each affected site).

EEG neurofeedback sessions can normalize the QEEG in the majority of migraineurs and can make them become drug-free.

Prevalence Rate:
2 – 4 % (Some studies show 10%) of the population

Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, neurocognitive symptoms, sleep disturbance and multiple tender points. “Tender points” refers to tenderness that occurs in precise, localized areas, particularly in the neck, spine, shoulders, and hips.

People with this syndrome may also experience morning stiffness, irritable bowel or bladder anxiety, cognitive problems (“foggy mind”) such as memory impairments, muscle spasms, headaches, nerve irritation, reduced coordination, multiple chemical sensitivity (odors, noise, bright lights, medications, foods) and decreased physical endurance.

We offer a wide spectrum of treatment methods for patients suffering from Fibromyalgia. We aim to deliver evidence-based therapies individualized to every patient.



Prevalence Rate:
11 – 20 % of the U.S. population

Irritable Bowel Syndrome (IBS) is a symptom-based diagnosis characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits. As a Functional Gastro-Intestinal Disorder  IBS has no known organic cause.

Functional Abdominal Pain is the ongoing presence of abdominal pain  for which there is no known medical explanation. It is quite similar to but less common than, Irritable Bowel Syndrome (IBS), and many of the same treatments for IBS can also be of benefit to those with FAP. The fundamental difference between IBS and FAP is that in FAP, unlike in IBS, there is no change in bowel habits.

Non-Cardiac Chest Pain. Sometimes patients have pain in their chest that is not like heartburn (no burning quality) and that may be confused with pain from the heart. Particularly if you are over 50 years of age, your doctor will always want to first find out if there is anything wrong with your heart, but in many cases, the heart turns out to be healthy. In many patients with this kind of pain and no heart disease, the pain comes from spastic contractions of the esophagus, or increased sensitivity of the nerves, or a combination of muscle spasm and increased sensitivity.

Recently, researchers found that there is a relationship between symptoms of IBS or Functional Abdominal Pain and an impairment of the Autonomic Nervous System. Biofeedback, especially Heart Rate Variability Biofeedback, has been shown to be able to restore Autonomic Nervous System function and dramatically reduce or eliminate symptoms (Sowder E, Gevirtz R, Shapiro W, Ebert C., 2010; Humphreys PA, Gevirtz RN., 2000).

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