Surface Electromyography (sEMG) biofeedback is rated as "Efficacious" (Level 4) for the prophylactic treatment of tension-type headaches. The primary goal is down-training resting muscle tension in the frontalis and upper trapezius muscle groups.
Frontalis sEMG Down-training
Clinical Targets
- Placement: Bilateral frontalis (narrow placement) or wide placement incorporating temporalis.
- Resting Baseline: Achieve resting tension < 2.0 microvolts (µV) in adults.
- Recovery Time: Rapid return to baseline (< 3 seconds) following voluntary contraction.
Patients are often unaware of chronic low-level bracing in the facial and neck musculature. sEMG provides immediate visual or auditory feedback (e.g., a tone that drops in pitch as tension decreases), allowing the patient to learn voluntary relaxation of these motor units.
Thermal Biofeedback (Hand Warming)
Clinical Targets
- Placement: Palmar surface of the distal phalanx of the dominant index finger.
- Target: Increase peripheral temperature to > 94.0°F (34.4°C).
Often combined with autogenic phrases, thermal biofeedback is particularly effective for vascular migraines. By voluntarily increasing peripheral blood flow (vasodilation), sympathetic nervous system arousal is decreased, which frequently aborts or prevents the vasospastic phase of migraines.