Both physical and emotional pain are subjective experiences that can be affected by sensory and cognitive factors. Pain can have an extended impact on the general function of the brain, and both psychological and cognitive factors play major roles in pain development and management. Some people believe using biofeedback and neurofeedback training the brain can be taught how to respond to these ‘pain signals’.

In this article, we will be covering everything you need to know about these technologies, including the differences between the biofeedback and neurofeedback. Most importantly, how do Biofeedback and Neurofeedback help in pain management?

However, before jumping into advance questions about neurofeedback and biofeedback, let’s define the terms first.

What is Biofeedback?

Biofeedback is a body-mind technique involving the use of hearing (auditory) and usual feedback to be able to control involuntary bodily functions. This also includes having free will control over muscle tension, heart rate, blood flow, blood pressure, and pain perception.

The process includes connecting to a sensor device that supplies feedback about that particular aspect of the body.

The purpose of biofeedback is always to make a crafty change that brings a desired effect in the body. This may include;

  • slowing respiration or heart rate,
  • reducing pain feelings, or
  • relaxing that particular muscle.

With the help of biofeedback people can improve on their emotional, mental, and physical health.

Biofeedback can help people to manage symptoms or any kind of disease too.

Uses of Biofeedback

Biofeedback can assist in several conditions.

  • Chronic pain

Biofeedback assists users to identify tight muscles and learn on how to relax them, it can also relieve back pain, temporomandibular joint disorders, fibromyalgia, and abdominal pain.

Biofeedback can treat pain in people of all ages, both older adults and children.

  • Headache

Stress and muscle tension can spark headaches and migraines and can make the symptoms worse. Biofeedback therapy can ease stress and relax muscles to reduce both the severity and frequency of headaches.

Biofeedback looks to be particularly effective in treating headaches when it is used together with medications.

  • Anxiety

Biofeedback is generally used to treat anxiety. It allows the user to become more aware of his body responses, especially when he is stressed or anxious. Users learn how to control their responses.

  • Urinary incontinence

Biofeedback helps people who find it difficult to control their urge to go to the bathroom. It helps women to strengthen the floor of their pelvic muscle which regulates bladder emptying. After some Biofeedback sessions, women with urinary incontinence can minimize their urgency and frequent need to urinate.

Also, Biofeedback can assist children who bed wet and individuals who are not able to control the movement of their bowels. Unlike incontinence drugs, biofeedback does not have side effects.

  • High blood pressure

There are still mixed shreds of evidence on the effect of Biofeedback on high blood pressure. Although it seems to slightly lower blood pressure, Biofeedback is not as effective as blood pressure controlling drugs.

  • Other users

Other uses of Biofeedback include; Reynaud’s disease, injury, asthma, Epilepsy, constipation, rheumatoid arthritis, chronic obstructive pulmonary diseases (COPD), and attention deficit hyperactivity disorder (ADHD).

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How Biofeedback Works?

Biofeedback uses medical instruments to deliver feedback. It allows a person to take control of his physical activities in order to improve health and performance.

As noted earlier, it also treats several health conditions which include chronic pains, stress, hypertension, anxiety, and many other physiological conditions.

The purpose of biofeedback is to deliver a long-lasting control and results over a particular symptom or condition.

Now, let’s turn on to neurofeedback.

What is Neurofeedback?

Neurofeedback is a method of training the activity of the brain, and it is also a kind of Biofeedback form for the brain. The brain requires healthy slow and fast-moving brainwave activity in order to function properly.

Neurofeedback also works at changing brain electrical activity. It works to improve the source of unwanted symptoms and it is non-invasive.

Uses of Neurofeedback

Neurofeedback is designed to help in conditions such as auditory processing disorders (ADP) and ADHD, stress disorders, panic attacks, anxiety, Asperger’s, headaches, depression, some types of memory issues, migraines, and sleep issues.

Some professional Olympians, athletes, and business professionals make use of Neurofeedback to enhance their performance through stress management and improved focus.

Many people commend supplemental advantages to Neurofeedback training such as less anxiety, improved sleep quality ability to adjust and tackle everyday challenges.

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How Does Neurofeedback Work?

Neurofeedback methods involve EEG sensors that monitor the brainwaves and a computer that sends the feedback. There are diverse ways to get this feedback, which may include playing a game, watching a video, or listening to music.

The stimuli (video, game, or music) operate smoothly only when the brainwaves are optimally functioning. This serves as a reward for the brain. When the brain functions fewer effective, it sends negative feedback (the music stops, the video pause, and the game stops as well). This tells the brain that all is not well and prompt it to discover how to go back to a piece of seamless music, game, or movie.

During a neurofeedback training programs, the feedback teaches the brain and it can advance lasting changes of the structure within the brain, causing the brain to operate consistently in a greater optimal range after the training session, relieving symptoms.

The Differences of Biofeedback and Neurofeedback

People may often mistake Biofeedback and Neurofeedback for the same work but they both have their different forms and treatment processes.

Let’s explore the differences now.

  • Biofeedback monitors multiple processes, while Neurofeedback has no sensors to measure those vital processes

During the biofeedback training session, the sensor to watch physiological processes like breathing, muscle contractions, heart rate, sweat perspiration, and temperature. Biofeedback sends the body the feedback on how the body functions and allows users to make some changes to better health, chronic pain, hypertension, physical performance, stress, or anxiety.

Biofeedback is mostly limited to physiological sensations, while Neurofeedback has no sensor to measure the heart rate, breathing, and others.

  • Neurofeedback monitors only the brain

Neurofeedback primarily focuses on electrical activity in the brain.

  • Biofeedback does not include brain training, while neurofeedback does

Biofeedback does not in any form train the brain in regard to quantitative electroencephalogram (qEEG) reading.

During a neurofeedback training session, the brain receives support through a visual boost (video, game, or music) presented on a screen and uses operant conditioning while biofeedback does not. It is a non-invasive, separate method using operant conditioning to train the brain to work more efficiently.

The training of neurofeedback is a sub-conscious treatment which means that the user cannot change his brain functioning but can perceive auditory or visual positive boost before him on a computer screen.

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Now with the knowledge of biofeedback and neurofeedback, let’s look at treatment options of each type.

Biofeedback Treatment Option

Biofeedback treatment options include the following.

  • Breathing

The respiratory biofeedback includes wearing the sensor bands around the abdomen and chest to watch the breathing patterns and rates. With training, the users can master how to control their breathing rate. This can be a great help in many conditions.

  • Heart rate

This option is called heart rate variability biofeedback.

There are shreds of evidence that this option might be useful in treating some disorders which include depression and asthma.

People who use this usually wear a device that is connected to sensors either in their fingers or ear or the sensor placed on their chest, torso, or wrists. These devices measure both heart rate variability and heart rate.

  • Galvanic skin response

This Biofeedback option includes measuring the quantity of sweat on the skin surfaces. Also called skin conductance, galvanic skin response is an important marker in detecting emotional arousal levels.

Apart from the distinct thermoregulatory sweat function, emotional stimulation can easily spark sweating as well. User’s skin conductance becomes stronger when they are aroused more strongly.

  • Blood pressure

This biofeedback option includes wearing a blood pressure measuring device. These devices provide the users with blood pressure details and always direct the person through relaxation techniques which may rely on breathing exercises, music, or visual cues.

  • Skin temperature

Users wear a blood flow detecting sensor on the skin in this biofeedback option. Because in times of stress, people always have a drop in their body temperature, these devices can assist people to easily discover when they are beginning to feel distressed.

  • Brain waves

This Biofeedback option, also known as ‘neurofeedback’, includes using electroencephalography (EEG) to measure the activity of the brain wave. The EEG device connects the scalp sensor. Sometimes, neurofeedback is used to treat ADHD, addictions, pain, depression, anxiety, and many other conditions as a non-invasive treatment.

  • Muscle tension

In this biofeedback option, sensors are placed on the body at various points connected to electromyography device (EMG). This device can detect any changes in muscle tension easily by watching electrical activity that causes muscle contraction.

How Effective is Biofeedback?

Biofeedback is always seen as a type of training instead of treatment.

With teaching and practicing, Biofeedback assists individuals to learn new skills which may assist them to improve, cope, or perform.

For biofeedback to be effective, it demands that the user plays a significant role in the treatment. It also requires that the user practices regularly between training sessions.

What Does the Research Say about Biofeedback?

While biofeedback has been applied in handling several health issues, there is still little evidence that it is scientifically effective for most of them. However, there are exceptions.

Multiple kinds of research show that Biofeedback can be effective for some forms of urinary incontinence and pain, which are related to extreme muscle contractions
and diabetic fecal incontinence.

Also, Biofeedback has been examined in other health problems with favorable results. They include tension headache, fibromyalgia, and Raynaud’s phenomenon.

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Neurofeedback Treatment Options

Neurofeedback treatment options include below.

  • Play Attention (for home-based)

Play attention is a neurofeedback (home-based) option that involves a body wave biofeedback armband and software that is installed on a PC or Mac.

Using play attention includes playing games while getting feedback from the armband on how you are concentrating.

  • BrainMaster

Brain Master provides several packages of neurofeedback (qEEG Based) hardware device and software.

The Brainmaster devices generally cost some thousand dollars. The software includes neurofeedback game packages and programs to analyze EEG data which are available for MS Windows.

  • Brain Train

Brain train, just like BrainMaster, makes a collage of software packages and hardware devices aimed at professionals instead of home users.

The braining training software involves both the games that were completely played through EEG data and the games played through separate controllers but that integrate EEG data.

  • NeuroOptimal

This is a neurofeedback option that targets improving relaxation, focus, and general brain function.

  • Brain State

This neurofeedback option focuses on assisting the brain to “relax and rebalance itself,” also to improve the general functioning of the brain, which includes memory, sleep, leaning, and stress resilience.

By supplying feedback through sound, it develops an “acoustic brain mirror”. This makes it different from other neurofeedback options that always utilize primarily visual feedback. This neurofeedback option is available only through licensed clinicians.

How Effective is Neurofeedback? What Does the Researcher Say?

There different findings of how effective Neurofeedback can be.

Research, a meta-analysis published on the effectiveness of neurofeedback on some of the disorder symptoms concluded the following.

  • That the use of neurofeedback may result in large scale improvement in inattention and impulsivity.
  • That it may lead to a boost in medium-scale hyperactivity.

The researchers indicated that neurofeedback might be an effective and special treatment for ADHD symptoms.

In 2011, another researcher indicated that neurofeedback might have an effect of placebo. They carried out a study where 8 young volunteers aged 8 to 15 years underwent 30 neurofeedback sessions and another 6 volunteers were given fake neurofeedback. The two groups felt a similar effect.

From 2013, researchers compared the neurofeedback effect with that of stimulants, a generally accepted ADHD treatment. Sixteen volunteers aged between 7 and 16 years were given stimulant drugs, while another sixteen underwent 30 neurofeedback sessions for 7 to 11 months. The volunteer who was given stimulant felt a reduction in symptoms of ADHD, while the people that underwent neurofeedback sessions did not.

Also, another meta-analysis published in 2014 on ADHD and Neurofeedback previous studies results where they observed teachers and parent assessments of children that underwent the treatment. Generally, parents reported improvements in inattention, hyperactive, and impulsivity but teachers only saw improvement in inattention.

Nevertheless, the study concluded that neurofeedback can be effective in children with ADHD.

Criticisms of Neurofeedback

While some research shows encouraging results, critics say that many of the studies have flowed. Many authors called for more research. Some researchers condemn neurofeedback and called it a money-generating scam, and others said that it lacks guidelines.

A 2016 study indicated that whilst neurofeedback treatment is non-invasive, the evidence available is yet to prove its effectiveness. They also noted that it is time-consuming, expensive, and the benefits do not last long. They added that it can take a longer period to give the expected improvement.

Direct Neurofeedback

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Caution! Side Effects – Can Neurofeedback Make You Worse?

Generally, most people that use neurofeedback experience little or no side effects. Many people find the sessions calming and relaxing, while many feel a new strength after. However, it is necessary to always know what to expect from any form of therapy, including the negative side effects before you jump into the treatment.

Below are some of the adverse effects some people may experience during and after a neurofeedback session.

  • Anxiety

Anxiety can come from nervousness about the electrodes that are being fixed to the head or the normal nervousness that occurs before going through any medical procedure.

There may also be anxiety during the session too, but once the treatment is underway, you will know that it is not what to be afraid of and the feelings will disappear.

  • Brain fog

Generally, neurofeedback reduces spacey feelings and brain fog. But when the practitioner is not trained properly, it might be difficult for patients to concentrate during and after a session of neurofeedback. But as the therapy continues, brain fog decreases and disappears.

  • Chattering teeth

This reaction is very rare, but some people reported that they experienced chattered teeth as if they were exposed to a very cold environment after the therapy.

  • Impaired cognitive

Although neurofeedback was designed to help and improve cognitive function, when the training is incorrectly carried out, it may affect cognitive performance adversely.

  • Depersonalization

This is when you feel as if you are disconnected from your body and mind and you are watching yourself from the outside.

Depersonalization can occur as a result of a change of electrical activity in the brain, which is higher than the patient’s overall awareness. Many people see this feeling more uncomfortable and disconcerting than others. Yet people adapt to the feeling and the new way of their consciousness.

  • Depression

Neurofeedback is a very successful depression therapy, but sometimes, when the practitioner increases the speed of slower brain waves, the patient may feel depressed. But just like anxiety, the sensation is always temporary.

  • Fatigue

Decreasing and increasing brain wave speed can make some people experience fatigue for a short period.

  • Dizziness

Some people may feel a dizzy sensation after or during the session, perhaps as a result of a change in patterns of the brain wave.

  • Headaches

This can come as a result of training the wrong sections or training higher frequencies with faster waves. Sometimes, it develops to full-blown migraines in some people.

  • Muscle tension

When therapy is not administered properly, particularly when the training is in higher frequencies like gamma and beta, it may cause muscle tension. But when it is correctly administered, neurofeedback is unlikely to affect this reaction.

  • Worsening symptoms

While Neurofeedback is recommended to enhance the function of the brain by promoting electrical activity, there is also a possibility that the change can make the symptoms of ADHD, anxiety, depression, and other diseases to worsen. This may be a result of improper training, but usually, the effects are temporary.

Can Neurofeedback Damage Your Brain?

Neurofeedback is absolutely safe and non-intrusive, though it may have some minor side effects as with other types of exercise. But they are all for a short time.

For over 40 years of neurofeedback history, it has not damaged any brain. It is just a learning technique.


Biofeedback uses a medical instrument to deliver feedback while neurofeedback involves an EEG sensor to monitor the brainwave.

Biofeedback focuses on physical pains, while neurofeedback targets emotional pain. When they are rightly administered, they can deliver effective results.


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