Biofeedback

Biofeedback involves training individuals to gain control over brain states through electroencephalography (EEG) in order to help improve pain intensity. Biofeedback has been previously been shown to improve pain intensity in individuals with fibromyalgia and migraines (Jensen et al. 2013).

Discussion

A pre-post study (Jensen et al. 2013) found biofeedback improved worst pain intensity but not average pain intensity among individuals with SCI pain. Jensen et al. (2009) randomly allocated participants into hypnosis or the biofeedback treatment group. Participants in the hypnosis group reported a significant decrease in neuropathic pain intensity compared to those in the biofeedback group (p<0.01). However, no such effect was seen between the two groups in individuals without neuropathic pain. Middaugh et al. (2013) found that exercise and EMG biofeedback training resulted in significant reduction in WUSPI scores post intervention and at 6 month follow up.

Conclusion

There is level 4 evidence (from one pre-post study: Jensen et al. 2013) that biofeedback may reduce worst pain intensity post SCI but not average pain intensity.

There is level 1b evidence (from 1 RCT: Middaugh et al. 2013) that combined EMG biofeedback and exercise may reduce pain post SCI.

There is level 1b evidence (from 1 RCT: Jensen et al. 2009) that biofeedback is not as effective as hypnosis in reducing neuropathic pain post SCI.