A Guide to How Biofeedback Can Help Young Chronic Pain Patients | Part Two

This is part two of five. Find part one here.

Home Biofeedback Units
Using a home biofeedback unit (an “EMG unit” or “electromyography unit”) to monitor muscle contraction can reinforce learning. Several units are on the market, and their prices vary. When looking at biofeedback units, avoid TENS or NMES—they are not biofeedback units, but they do come up when searching for home biofeedback units online.

Consider units from www.biofeedback-neurofeedback-therapy.com or other sites that feature a unit that measures muscle activity. Some advertise that they will increase muscle contraction for sports, but they can also be used to reduce muscle tension. Contact the company before purchasing. The feedback may be in numbers, graphs, or sounds.

Electrodes are placed on the skin (which should be cleansed first) and can be placed over an area of tension. The electrodes do not need to be placed over a painful area, such as in cases with CRPS. Instead, choose a site that is pain-free. If addressing tension headaches, the electrodes can be placed over the temples or on the forehead above the eyebrows. They can also be placed on the belly if there is belly pain or on the inner forearms for general relaxation.

Before starting the relaxation technique, play with the equipment to see how to make the numbers go up and down. If you're wearing the electrodes on your temples, make funny faces. If you're wearing them on your inner forearms, notice if the tension goes up if you move your fingers, lift your shoulders, wiggle your toes, etc.

Progressive Relaxation Training
This is a great technique to start with, especially for those who have difficulty meditating while they are actively tightening muscle groups. This technique aims to make you more aware of when your muscles are tense and to help you release the tension when you are aware of it.

When performing this technique, you may keep your eyes open or closed. If you prefer to keep your eyes open, gently focus on something in the room. The total time required is generally 10-20 minutes. Don't tense if there is a pain concern when tightening a certain muscle. Just see if you can release any muscle tension within it. If using a biofeedback unit, you can gaze at the unit or check it periodically.

All relaxation and mindfulness techniques require practice. It is okay if you do not experience full relaxation initially. It is important to be kind to yourself and allow yourself to learn at your own pace.

1. Find a comfortable position.

You may sit supported or lie down.

2. Breathe

Begin by taking a deep breath, filling your chest and belly with air. Feel the tension build in your chest walls. Exhale slowly, releasing the tension within you. Repeat.

Now, focus on breathing slowly into your belly.

3. Tense and relax the following muscle groups (repeat each one twice):

Tense and relax facial muscles.

• Raise your eyebrows upward. Note the tension in your forehead. Now relax the muscle and note how it feels when the forehead muscle releases the tension. Notice what it feels like when it is relaxed.

• Close your eyes tight and feel the tension build within your eyes and around your eyes. Now relax your eyes and note what it feels like when your eyes relax.

• Wrinkle your nose and feel the tension build in your nose muscles. Now relax those muscles and notice what it feels like when those muscles relax.

• Pucker your lips. Now relax those muscles and notice what it feels like when those muscles relax.

• Keeping your teeth slightly apart, gently tense your jaw muscles. Notice what it feels like when those muscles are tense. Now relax those muscles and notice what it feels like when those muscles relax.

• Notice what it feels like when the muscles of your face are relaxed. Notice the pleasant sensations.

Tense and relax neck and shoulder muscles.

• Tuck in your chin to tense the muscles in the front of your neck. Notice what it feels like when those muscles are tense. Now relax those muscles and notice what it feels like when those muscles relax.

• Tense the muscles in the back of your neck by gently pressing your head back into a pillow (if lying down) or the back of a chair (if seated). Notice what it feels like when those muscles are tense. Now relax those muscles and notice what it feels like when those muscles relax.

• Tense your shoulder muscles by shrugging your shoulders toward your ears. Notice what it feels like when those muscles are tense. Now relax those muscles and notice what it feels like when those muscles relax.

• Pinch your shoulder blades together and feel the tension build between them. Now relax the muscles and notice what it feels like to release the tension.

Tense and relax the arm and hand muscles.

• Tense your upper arms by bending your elbows. Notice what it feels like when those muscles are tense. Now relax those muscles and notice what it feels like when those muscles relax.

• Make a fist with your hands. Notice what it feels like when those muscles are tense. Now relax those muscles and notice what it feels like when those muscles relax.

• Open your hands and fingers. Notice what it feels like when those muscles are tense. Now relax those muscles and notice what it feels like when those muscles relax.

• Notice how your arms feel when the muscles are relaxed. You may feel a sense of heaviness in your arms and shoulders.

Tense and relax buttock and leg muscles.

• Tense your buttocks by squeezing your buttock muscles. Notice what it feels like when those muscles are tense. Now relax those muscles and notice what it feels like when those muscles relax.

• Now tense the muscles in the front of your thighs (quads) by straightening your knees as much as possible. Notice what it feels like when those muscles are tense. Now relax those muscles and notice what it feels like when those muscles relax.

• Tense the muscles in the back of your thighs (hamstrings) by bending your knees slightly and pressing your heels downward. Notice what it feels like when those muscles are tense. Now relax those muscles and notice what it feels like when those muscles relax.

• Tense the back of your calf muscles by pointing your toes downward. Notice what it feels like when those muscles are tense. Now relax those muscles and notice what it feels like when those muscles relax.

• Flex your ankles to tense the muscles in the front of your lower legs. Notice how those muscles feel. Then, relax them and notice how they feel.

• Now, notice the pleasant sensation in your legs as you allow your muscles to become more deeply relaxed. You may feel heaviness in your legs.

4. Relax
Focus on your belly breathing and associate the feelings of relaxation with your breath. Continue to relax for as long as you like. When you are ready, you may open your eyes, feeling relaxed and refreshed.

Note: If you associate the feelings of relaxation with your breath, you will eventually be able to focus on your breath to allow you to relax when performing normal daily activities.