Chronic Pain and Fibromyalgia

Pain is a key sensory system that warns us when we need to stop and take care of ourselves.  It has considerable survival value, however when we’ve dealt with the situation, or the wound has healed, we’d rather the pain would subside, completely, as it’s now more of a distraction to the pursuit of our daily lives.  Pain perception and active coping involves specific brain areas.  With neurofeedback we can train these areas for a more optimal approach.

Chronic pain affects between 35-50% of the UK population, yet pain management is inadequate in 40-60% of cases.

Dealing with chronic pain has always been a challenge.  Drugs and medication offer temporary reprieve; this often comes at the expense of side effects, and the risk of habituation or even addiction.  Moreover, our brain might even become resistant to the dose and the pain continues, should we not use even more.

Furthermore, pain is subjective – it manifests itself in many facets, including emotions, fear, helplessness, and at the very least it’s a distraction.  When it’s chronic, we may be able to mask its effects, but that’s not to say the sensation infiltrates our general conduct and behaviour, our interactions, our mental calm and decision making.  Increased agitation will affect our sleep and demeanour.

Pain is a perception.  We integrate sensory stimulus with information from previous experiences, including emotions, amount of attention, and expectations about the pain.  This means that if we can target higher order processes that regulate how we manage this information assimilation, and reduce its sensitivity to manageable levels, we can potentially break the cycle.  This is what neurofeedback aims at.  Recent clinical outcomes indicate that the technique of EEG (brain wave) biofeedback can be used to break the cycle and lead to a major decrease or (more rarely) even the total elimination of chronic pain.  Calming, both physical and emotional, is what neurofeedback aims at, and this can be a valuable intervention in the negative feedback cycle that is chronic pain. 

Neurofeedback is not a substitute for finding the underlying cause of pain, which should be thoroughly investigated by medical means as a primary remedy. 

Contact Us for more publications on the topic of pain and neurofeedback.

Research Supporting Neurofeedback Efficacy for Chronic Pain

Chronic Pain patients experienced a 44% reduction in pain following neurofeedback.

Chemotherapy patients experienced a 45% reduction in pain, reporting a significant improvement in pain severity, numbness, fatigue and quality of life, with effects still upheld four months after neurofeedback treatment. 

Fibromyalgia patients saw an 82% reduction of fatigue, depression and anxiety, and an increase in social and physical functioning; these effects were upheld.  Another fibromyalgia study with different neurofeedback protocols achieved a 39% improvement, and another found a 55% improvement.  Neurofeedback training improved functional connectivity in somatomotor areas leading to reduced impact of fibromyalgia and pain symptoms and improved quality of life.

Complex regional pain syndrome sufferers achieved a 42% reduction in pain, muscle spasm, muscle tension, and in increase in well-being.

Central Neuropathic Pain resulting from Chronic Spinal Cord Injury saw a clinically significant 33% reduction in pain, interestingly using home-based equipment.  Central neuropathic pain has a 40% incidence in patients with spinal chord injury.  Another study found a 30% reduction in pain with a concurrent “pleasant warmth replacing unpleasant sensations”. 

Case examples from the EEGInfo Institute in Los Angeles demonstrate how neurofeedback can be effective:

“A case in point is “Ted” (not his real name), who was nearly electrocuted. Three years later he was still “…suicidal with agony.” He had been to a number of psychiatrists, and some of the
medications they provided helped for a while, but the pain always returned. In great desperation, he came in to have his pain sensitivity retrained with EEG biofeedback. After only a few sessions, his pain was reduced to where it no longer bothered him, and he returned to a normal life.

Another example is “Jack,” who came in with a diagnosis of fibromyalgia, a kind of whole body pain, along with chronic fatigue syndrome. Within three weeks, he was free of what he described
as “bone-crushing pain” for the first time in six years. He went on and did a number of additional sessions of EEG biofeedback to consolidate his gains, but the major difference was made early on

One of the most gratifying examples of the power of EEG biofeedback to relieve pain was the case of “Doris,” who underwent hip-replacement surgery in April of 1996. After several months, the pain was still at “six” on a scale of 1-10 despite heavy medication, and she continued to require crutches to walk. She began a program of EEG biofeedback and within a month the pain had been reduced by half. By November she was no longer using crutches and began to be able to make dance movements, while having greatly reduced episodes of significant pain. As of the writing of this article, she is essentially pain-free, and only uses medication occasionally at night. Now she is even able to do a bit of running.”

Source:  “New Hope for Sufferers of Chronic Pain” by Siegfried Othmer

Subjective pain perception was significantly reduced in acute whiplash patients in this study.

Neurofeedback is a form of complementary therapy and should not be seen as a replacement for conventional medicine.  qEEG brain map-based neurofeedback training takes a more holistic approach to brain functioning, rather than just focusing on medical symptoms.  It is not intended as a form of diagnosis nor medical intervention nor medical advice per the disclaimer.

Neurofeedback for Fibromyalgia

Fibromyalgia patients report significantly improved pain severity and interference, fibromyalgia symptom severity, sleep latency and sustained attention following eight weeks of neurofeedback training.  

A separate study finds significant improvement in cognitive dysfunction, fatigue, pain, sleep, depression and overall activity level in fibromyalgia sufferers,  further illustrating the debilitating comorbidities of this condition. 

Fibromyalgia patients saw an 82% reduction of fatigue, depression and anxiety, and an increase in social and physical functioning; these effects were upheld.  Another fibromyalgia study with different neurofeedback protocols achieved a 39% improvement, and another found a 55% improvement.  Neurofeedback training improved functional connectivity in somatomotor areas leading to reduced impact of fibromyalgia and pain symptoms and improved quality of life.

Chronic pain sufferers of Spinal Chord Injury found immediate and lasting effects on pain intensity from neurofeedback training. 

Brain Maps and Personalised Brain Training

Personalised Brain Training is a neurofeedback training method devised by founders of the field, Barry Sterman and David Kaiser.  

 

Every Brain is individual and different, therefore Personalised Brain Training neurofeedback

We take a holistic approach to healthy brain self-regulation, rather than categorisation or diagnosis.  In our view, and experience, symptoms resolve when our system is balanced.

Neurofeedback Training calms the mind and restores functionality

A brain map is an analysis of brain wave behaviour as measured by a qEEG recording.  We record 20 minutes of the brain activities with a 19-sensor qEEG recorder.  There is no stimulation, and contact between the sensors and the head is via an easily removable gel applied to specific points.  From this recording, we can generate a brain map using Kaiser Neuromap software.  

qEEG recording of brain waves is analysed to generate a brain map in form of a Kaiser Neuromap

The functional connectivity between various brain areas allows us to see vulnerabilities to character traits or behaviour patterns.  

Kaiser Neuromap brain maps show character traits for neurofeedback

Neurofeedback training is a process where we give the brain feedback about its own activity at a particular cortical site in real time, via visual, auditory or tactile means.  There is no direct stimulus to the brain and the sensors attached are for measurement of cortical EEG, or tiny electrical currents detectable on the surface of our head.  This signal is then amplified and analysed by software in real-time, and this information is used to provide feedback to our brain.  

Neurofeedback process illustrated by electrode measurement analysed and transformed into feedback via a movie in visual and auditory form for the preconscious mind to process and adapt its behaviour to in a learning process.

 We use a movie of choice as the feedback mechanism – our conscious mind engages with the film, and feedback is delivered by small changes in volume or picture size.  Our pre-conscious mind adapts its behaviour to preserve the more comfortable volume and picture size, and learning occurs.

Neurofeedback helps restore functional connectivity in key neural networks

Neurofeedback training is safe, effective and non-invasive. 

Neurofeedback training is safe and non-invasive shown in a picture using Othmer Method

Neurofeedback is evidence-based. 

Neurofeedback is evidence based therapy with a wealth of over 3,500 peer-reviewed research reports per PubMed neurofeedback

 

Guided by a Kaiser Neuromap, our neurofeedback training targets specific brain areas, neural hubs and networksThis improves integration of the  brain area we are training, as well as its network and sub-cortical connections.

Developed by a founder of the field of neurofeedback, and with a wealth of over 3,000 brain maps and thirty years’ of experience, Personalised Brain Training uses advanced neurofeedback protocols.

qEEG-brainmap takes under an hour to obtain and is a non-invasive process.  A nineteen-sensor cap is comfortably fitted and we record about twenty minutes of brain activity.  Using specialised software, we obtain a visual analysis which we will communicate verbally.  This also forms the basis of our training plan.  Note that we do not provide diagnosis.

qEEG brain map for personalised brain training in neurofeedback

This brain map approach is unique in that it analyses the connectivity of a functional brain area, rather than simply geographic areas of the brain.  

Connectivity is a measure of regional integration of specific brain areas with other areas and key networks.  This is a relative measure – to be meaningful, it has to be referenced to a baseline.  Rather than use an average as a reference, we compare results to a set of hand-picked individuals who are both high-performing professionals and well-balanced individuals.  Our ability to engage with others, form friends and alliances, and make consensual decisions is deemed as important for success as professional specialisation and technical performance.

functional brain area, as first delineated by Korbinian Brodmann in 1909, was first defined by variations in the number of layers in its grey matter.  This difference in physical property still holds as a valid way to separate brain regions, and each has its own function while being connected to other areas of the cortex via white matter, as well as to the brainstem, in particular, the thalamus.  With a brain map, we gain insights into both cortical integration (how well the area connects with its surrounding areas), as well as its thalamo-cortical integration. 

Neurofeedback training relies on real-time EEG measurement, analysis and translation into feedback

Neurofeedback Training Sessions

Personalised Brain Training aims to optimise the cortical connectivity, as well as promoting improved thalamo-cortical connection.  Neuroplasticity, the ability of neural networks in the brain to make new connections, is an essential and continuous process that underpins our ability to learn.  With brain training, we can promote this process.  

Protocols are generally around 30-45 minutes per brain area that we train; as such, training sessions are ideally around 90-120 minutes.  This corresponds to the average length of a movie.  This is also the length of our ultradian rhythms – attention cycles that govern our day, letting us perform at more than 100% at peak, and less than this at trough – think of the lull we experience around lunchtime.  By training the brain throughout a complete cycle, we are more likely to provide the brain with a challenge at different points in its attention cycle for a more comprehensive training. 

The primary feedback mechanism in Personalised Brain Training is auditory, that is, a subtle change in volume.  The brain recognises this, preconsciously, while our conscious mind is focused on the movie, and corrects its behaviour to preserve the continuity of the watching (or listening) experience.  A secondary, visual feedback mechanism can be activated, whereby the picture size changes too, though this is optional in cases of high visual sensitivity (e.g. migraines).   

We can track progress by remapping the brain at intervals, usually after every 20 hours of training.  Ten sessions will give a good indication of responsiveness, which besides subjective feedback we can ascertain with a further remap.  With neurofeedback training, we are showing the brain a more efficient state during a session.  Upon repetition, the brain learns to adopt this new state.  The person has to then implement this new learning in their life.  Internal changes have to be externalised.  Training success depends on this ability thus results can vary.  

Neurofeedback training begins with two to three sessions per week and the frequency of training can then be adjusted to need and symptom improvements.  Intensive courses involving two or more sessions per day can also be accommodated.

Contact Daniel on +44 (0)7966 699430 or daniel@neurofeedback.io to arrange sessions.

The Process

Brain Map

We record qEEG brain activity for about 15-20 minutes.  This process takes about 30-45 minutes overall and we discuss results a few days later via call or in person.  This provides the basis for the Personalised Brain Training Plan. 

Neurofeedback Sessions

 Comfortably watching a movie of choice, we train specific brain areas per our Personalised Brain Training Plan.  Sessions are two hours (shorter if necessary), and ideally we aim to do two or three per week.  Alternatively, intensive courses can accommodate two sessions per day.  Generally, we would look to do 40 hours or 20 sessions.

Contact Daniel on +44 (0)7966 699430 or daniel@neurofeedback.io to arrange sessions.