Psychophysiologic therapy for chronic headache in primary care

Abstract

Background: Headaches account for a high percentage of office visita to primary care physicians, with migraine and tension-type headaches the most common. This provides a summary of psychophysiologic therapies for migraine and tension-type headache and considers psychosocial factors relevant to headache. Paychophysiologic therapy of headache consists primarily of, relaxation and biofeedback. Method: Representative controlled studies, meta-analysis, and reviews are utilized to assess the efficacy of biofeedback and relaxation for migraine and tension-type headache Results: Psychophysiologic therapy comprising biofeedback and relaxation can be provided in :standard or limited therapist contact formulas to patients as sole therapy or concurrently with medical therapy. Effectiveness has been demonstrated for thermal biofeedback- and electromyograph biofeedback-assisted relaxation with minimal or no side effects. A typical treatment protocol is offered to exemplify the integration of psychophysiologic therapy into primary care practice. Conclusion: Psychophysiologic therapy represents an important adjunctive treatment for chronic benign headache that can be incorporated into primary care. © Copyright 2000 Physicians Postraduate Press, Inc.