How Biofeedback Can Help Young Chronic Pain Patients: Part 4

Diane Poladian PT DPT OCS 25 August 2025

Autogenics

The autogenic technique is designed to address not only muscle tension but also to increase awareness of heart rate, breathing, and hand and foot temperature. It works well for chronic pain in general, but also helps with Raynaud’s Syndrome or temperature changes in the hands and feet for those with CRPS.

The Autonomic Nervous System

Autogenic technique is named after the autonomic nervous system that controls the normal functions of our body when we are awake and asleep, such as our heart rate, blood pressure, and digestion. The autonomic nervous system is divided into two systems: the parasympathetic system that is in control when we are relaxed, and the sympathetic system that is in control when we are stressed (“fight or flight”).

When the sympathetic system is activated, adrenaline is released from the kidneys. Digestion is inhibited. Heart rate is elevated. Blood flows away from the gut, hands, and feet, hence butterflies in the stomach and cold hands and feet. Blood flow is increased to the heart, lungs, and large muscles of our arms and legs to allow us to fight or run away. The sympathetic system is designed to protect us, but when chronically activated, it interferes with the parasympathetic state required for digestion and healing.

When a person is in chronic pain, the body is stressed, and the sympathetic system kicks in. It can be further stimulated by daily triggers, such as having to take a test or having to explain why you are no longer able to play on a team or participate in social activities due to pain.

In addition, one only needs to think about a stressful situation to trigger the response. The stressful situation can be something that happened in the past or a concern about a future event. The response can even occur when you know the situation is untrue. For example, I once explained how the biofeedback equipment worked to a teenager and her father. At the time, the teenager was holding her phone. Her father teased his daughter, saying, “Okay, give me your phone. I want to look at all your messages!” She knew that he was teasing, but the thought of it caused a stress response, drastically changing her biofeedback parameters.

Measuring Body Temperature

There are different biofeedback units on the market to monitor temperature. You can purchase the eSense app from Mindfield, which gives a bar graph display, video, and music displays, but I usually recommend the stress thermometer by Biomedical. It’s a simpler alternative that offers a visual display and does not utilize a phone. When applying the probe, place it on the middle finger of the non-dominant hand. (If you place it on the index finger, you may not get a generalized increase in the hand’s temperature; it is just an increase in temperature of that particular finger.)

If working on foot warming, you can place the probe on the first toe of the foot. If the child has CRPS, use the foot/hand not in pain. When they are able to successfully increase temperature on the non-painful side, switch it to the painful side, if tolerated. Always start with hand warming, as the feet are generally more challenging. Often, when the hands warm, the feet will follow.

If your child is having difficulty warming the hands or feet, placing the non-painful hand or foot in warm water or on a heating pad can be helpful. This helps the child learn what it feels like when the blood flow increases. If tolerated in the non-painful hand or foot, this can be performed on the painful side. Once the feeling of blood flow is learned using heat, the person can often raise the temperature more easily. You can start with the non-painful hand first, even if the pain is in the foot. Once the child can increase hand temperature, then progress to the feet.

Autogenic Technique

This technique involves repeating simple phrases to yourself and allowing those phrases to happen passively within you.

Begin by taking a deep breath, filling your lungs with air. Exhale slowly, releasing the tension within you. Take another deep breath, feel the pressure build in your chest walls, and then release the breath within you. Now, focus your breathing into your belly.

Repeat the following phrases to yourself (silently), allowing them to happen passively within you. Repeat each phrase twice. (Do not feel discouraged if your body does not change at first. This takes practice.)

My forehead feels cool and relaxed.
The muscles of my face are relaxed and free of tension.
My arms feel heavy.
My legs feel heavy.
My hands feel warm.
My feet feel warm.
My arms and legs feel heavy.
My hands and feet feel warm.
My belly is warm and relaxed.
My breathing is slow and easy.
My heartbeat is calm and regular.
My mind is quiet and still.
I am free of all outside thoughts and forces.
I am relaxed and comfortable.
Every day, I am becoming healthier and stronger.

Now, focus on your breathing. Allow your breathing to flow in and out of your belly. Notice how your body feels when it is relaxed. When you are ready, you may open your eyes, feeling relaxed and refreshed.

If you missed the beginning parts of this series, you can read them below.