Advanced Biofeedback Center

Muscle Tension and Migraine Headache

Assessment of condition

Overview

Your clinician will be interested in learning your history regarding your headaches. Do you think they are primarily tension headaches? Dull pain? Do you think they are migraine headaches? Pounding pain? Sensitivity to light? Sensitivity to loud sounds? Sensitivity to certain smells, like perfume, cologne, foods? Your clinician will also use a computerized biofeedback system to measure your muscle tension and skin surface temperature. This data is very helpful in more fully understanding the physical nature of your headaches. Because there is no "mind-body split" --- we believe in the biopsychosocial model of health and illness, and that your mind (really the action of your brain!) and your body work together --- we would be interested in knowing the nature of the daily stress that you endure, how you cope, and what we can do to help!

During the assessment phase, you may be asked to complete a "headache log" that documents the severity, frequency, and duration of your headaches. You may also be asked to complete some psychological and behavioral symptom checklists. Personality and intellectual testing may also be done, depending upon your presenting symptoms.

Sometimes patients are asked to undergo a psychophysiological stress profile which may be administered to determine just how you physically respond to while at "rest," during cognitively demanding tasks (like doing mental math problems), while thinking of stressful situations, and other conditions. We need to see just how extreme your reactions are during these situations.

Sensors

Harmless, non-invasive, skin surface EMG sensors measure the activity of the muscles over which they are placed. Chronic muscle tension --- often out of your awareness --- can lead to muscle tension headaches. If you suffer from migraine (vascular) headache, you can benefit from monitoring of skin surface temperature with a sensor called a thermistor.

Where sensors are placed

EMG sensors are placed over your frontalis (forehead), temporalis ("temples"), masseter (involved in chewing), occipitalis (back of the head), sternocleidomastoid (neck), or other muscles, depending upon your unique needs. Thermistors are typically affixed with velcro or paper tape to your index finger or great toe.

Behavioral intervention

Learning and behavioral change

The EMG (muscle) activity of a particular muscle is displayed on the LCD monitor. With coaching from the psychologist or biofeedback therapist, you begin to learn how to change the behaviors that produce muscle tension. Eventually, you gain great skill in voluntarily recruiting (tensing) or inhibiting (relaxing) the involved muscles. Although a bit more complex, you can also learn the process of elevating skin surface temperature. By increasing skin surface temperature of your index finger, for example, you are actually redistributing blood flow from your "core" to the "periphery" (from your heart, brain, lungs to your fingertips and toes). As you redistribute your bloodflow to your fingers and toes, your hands and feet begin to warm up. It's fairly difficult to have a migraine headache if you voluntarily warm your hands and feet to 96^o Fahrenheit!

Number of sessions

You may learn these skills in as few as 5 - 10 sessions! Your success begins with your belief that human beings can actually gain voluntary control over their physical/bodily processes. Maintaining awareness of these skills, positive expectations, and practice can lead to long-term behavioral change, decreasing the frequency, severity, and duration of muscle tension and migraine headaches.

Change in behavior

Goals

When your resting EMG (muscle) activity is less than 1.0 to 2.0 microvolts, then you can be assured that you have learned to decrease excessive muscle tension! When you are able to voluntarily elevate your skin surface temperature to 95^oF or 96^oF, you will be quite pleased to recognize that your have mastered a very important skill in relaxation training called "decreasing excessive autonomic arousal" or "decreasing sympathetic activation" or simply "becoming very relaxed!" The likelihood of experiencing a muscle tension or migraine headache would be greatly reduced when you are able to achieve those states.