Neurofeedback: Chronic Fatigue
During the past several years in working with Chronic Fatigue Syndrom (CFS) and Fibromyalgia (FM), various clinicians have observed considerable evidence for the effectiveness of EEG neurofeedback training as a modality for assisting in the remediation of these symptoms. In Canada for example, Dr. Stuart Donaldson and his colleagues have found that neurofeedback (followed by a small amount of physical therapy or EMG [muscle] biofeedback) produced substantial improvement in 77% of FM people on long term follow-ups. Neurofeedback training for CFS and FM appears to usually increase energy levels, to assist in alleviating cognitive deficits (memory and concentration), and restless and non-restorative sleep. As these things improve in FM, the pain generally decreases and becomes localized to small areas, rather than being diffuse over the entire body. Physical therapy, trigger-point work, or muscle biofeedback may then assist in reducing the limited pain that remains. When used with people who are not entirely disabled by the condition, it has allowed many to return to full-time productive activity within a few months. In severe cases, the impact of training has generally been very helpful, although full remediation may not always occur.

No claim is made that the training directly addresses the fundamental cause of Chronic Fatigue Syndrom (CFS) or Fibromyalgia (FM), although it might assist in overcoming deficits resulting from a viral influence. The improvements in the quality of life in reported cases, and in the preliminary research, is encouraging. But given the absence of large, carefully controlled studies, this procedure would still be regarded by many people as experimental. However, in doing work for more than 25 years with somewhat similar and abnormally slow brainwave activity in attention deficit disorder and epilepsy, Dr. Joel Lubar and Dr. Barry Sterman, and others have verified that neurofeedback training can be effective in improving symptoms and reconditioning brainwave activity. These changes are usually maintained as documented on long-term follow-up research studies

Using Neurofeedback Therapy to Manage Chronic Pain
By Dr. Clare Albright

There are few physical ailments more frustrating than chronic pain. If you are a chronic pain sufferer, you may have spent many hours in your doctor’s office trying to find the source of your pain. The fact is that, regardless of where in your body you experience the pain, it actually originates in the brain. Chronic pain is often the ghost of an old injury that has long since healed; the problem is that the brain and the nervous system have failed to realize this fact.

The Standard Method of Treating Pain
Failing to find and treat the real cause of the pain, the doctor will usually resort to using some form of prescription medication to provide relief for the patient. While these medications do a fine job of masking the pain and easing the patient’s suffering, they do absolutely nothing to remove the “ghost in the machinery.”

If you do not eliminate the phantom pain signal that resides in your brain and nervous system, your pain may never go away and you could find yourself needing stronger and medication, and needing it more frequently, as your body adapts to each new level of medication. While narcotics can bring much needed temporary relief of your pain, they do nothing to release the “ghost” pain signals from the brain and nervous system. In addition, many of these drugs are highly addictive and can have some serious side effects, including liver and kidney damage. But is there any alternative to relying on medication in order to be free from the pain?

The Best Way to Eliminate Chronic Pain
If you were to tell someone who suffers from chronic pain that they could survive without their medication, the response you get might not be printable. However, if you told them about a type of therapy called neurofeedback that would allow them to be weaned off the medications that might be ruining their body and life, they might think about it. If you sweetened the pot and told them that they would never have to deal with this pain again and could throw away their prescription forever, they would probably ask where they can sign up.

Neurofeedback has proven so effective in eliminating chronic pain that many view it as a step up from hypnosis, which has also been widely used to treat chronic pain. Since all pain occurs in the brain, the only truly effective way to treat this symptom is at its source. With neurofeedback, the pain “pathways” that the brain uses may be altered, and patients often experience a significant recovery, even from pain that has been unresponsive to other forms of treatment. If your doctor has confirmed that you have no real injury remaining, then you could very well benefit from neurofeedback therapy to free you from your chronic pain.

How Does Neurofeedback Therapy Work for Chronic Pain?
Neurofeedback training teaches a person to control their internal physical responses using an EEG and biofeedback machine. This helps you to find the source of the phantom pain and attempt to eliminate it for good. You may learn to control responses that were previously considered automatic. Using the feedback from your brain on a computer monitor, you may gradually learn to control which wavelengths your brain uses.

Many patients experience a significant recovery and rarely suffer from any remissions, going on to lead a full, normal life practically free of the pain that has plagued them for years. Neurofeedback is changing lives every day, allowing people to return to a normal life, unhampered by chronic pain.

EEG Biofeedback Training for Chronic Pain 
EEG biofeedback has been shown to be very helpful with chronic pain. Since these results may be somewhat unexpected, they present perhaps the best challenge to our understanding of the mechanisms of EEG biofeedback. When we regard pain sensors alongside other sensory systems, such as vision and hearing, we observe a unique distinguishing characteristic. In the general case, when human sensory systems are presented with a constant stimulus there is a gradual decrease in response to that stimulus. The only known exception to this general rule is the body’s pain response to persistent challenge. In this case, the response is to gradually *increase* sensitivity to the stimulus, i.e. a lowering of the local pain threshold. Thus pain can survive even when the original provocation is removed, resulting in chronic pain. A self-sustaining interaction takes place between the cortex and the apparent source of the pain, perpetuating the sensation of pain. This explanation by no means denies the reality of the pain experience. It simply defines it in terms of a self-reinforcing, self-sustaining activity involving the brain as well as the “periphery”. That is, the brain defines what is to be perceived as painful.

A striking correlation has been observed between the occurrence of chronic pain and a history of abuse or trauma in childhood. One study found that such abuse was present in as many as 85% of cases of chronic pain. Clearly, then, more than a “purely” physiologically-based phenomenon is at issue. Why, then, should a technique which appeals strictly to the underlying physiology be effective? We conjecture that there is a mutual relationship between the phenomenon of chronic pain and a state of depression. The physiological state of depression (to which the person may be susceptible due to the prior abuse) may bring in train disregulation of the pain threshold; or the causal chain may go the other way: the persistence of chronic pain may bring about a chronic state of depression, to which the person is particularly vulnerable. In any case, we observe symptoms characteristic of underarousal. The EEG training is presumptively effective in remediating the chronic underarousal condition, effecting a normalization of mood and of the pain threshold. Effectively, then, the brain has simply recalibrated the pain threshold. It no longer interprets the incoming stimuli as being sufficient to constitute “pain”.

This view may, however, be an oversimplification. Frequently, persons undergoing the EEG training for chronic pain will, after a few sessions, experience vivid recollections of long-suppressed traumatic memories. This occurs with such regularity that we always encourage persons undergoing the EEG training for chronic pain to undergo concurrent therapy as well, in order to deal with what comes up. In the larger view, then, the remediation we effect may involve dealing comprehensively with the larger, underlying issues which manifest in chronic pain and in depression.

Undoubtedly both mechanisms play a role during the full course of EEG training. In case there is any doubt, however, about the specific role and benefit of EEG training in remediation of chronic pain, it should be said that the two mechanisms operate on very different time scales. Reports of alleviation of pain can occur even within the first session; further progress can be charted from one session to the next. The surfacing of suppressed memories may not take place until sessions 6-15, and the therapeutic benefit of adjunctive therapies not until after that. Hence, there is clearly a role implied for the EEG training.

It is noteworthy that the field of pain management has seen the first truly comprehensive, multi-disciplinary approach emerge, one in which biofeedback plays an indispensable role. Up to the present time, the predominant use of biofeedback has tended to be relaxation training. The implications of our work with EEG training to remediate chronic pain are that emphasis should perhaps be placed more on the achievement of regulation and control, rather than relaxation.

(above material from