What Is Biofeedback Therapy?
Biofeedback therapy may help to gain control over pain, anxiety and even incontinence by focusing on your physical responses to stimuli. Some examples of the physical responses that this therapy targets include muscle tension, heart rate, breathing patterns, skin temperature and sweating.
Although biofeedback involves learning how to control your body's physical reactions, it's not something you can just do by yourself. It requires specialized equipment that turns these physical signals into visual or audio cues that you can interpret and respond to. A biofeedback therapist is usually also needed to help you interpret these cues and learn how to recognize and change your responses.
How Biofeedback Therapy Works
Biofeedback is a drug-free, pain-free way to help improve symptoms linked to a variety of physical and mental health conditions. Many people find it effective for managing stress, anxiety, chronic pain, migraines and even incontinence, but it's not a total cure for any health condition. Biofeedback requires active participation and doesn't work for everyone.
Many long-term conditions, like anxiety or chronic pain, are driven or amplified by dysregulated nervous system signaling (Hill, 2018; Teed et al., 2022). The body loses its ability to self-regulate its response to stress or pain, and responds with chronically tense muscles, narrow heart rate variability and other physiological changes.
Several of these physical changes are signs that the sympathetic nervous system is overstimulated. While the sympathetic nervous system is useful for dealing with acutely stressful situations, it can have a negative impact on your health when it remains chronically activated.
Biofeedback works to consciously slow down sympathetic activity and increase parasympathetic activity (the part of the nervous system involved in rest and relaxation) by focusing on controlling the related physical changes.
During biofeedback therapy, participants focus on controlling physical changes that are related to the negative health symptoms they're experiencing. This can include focusing on:
Skeletal muscle relaxation (such as in the back/neck for headaches or back pain)
Lowering your heart rate or increasing your heart rate variability (useful for anxiety and stress management)
Reducing your breathing rate (useful for anxiety and stress management)
Pelvic floor muscle training (for incontinence)
Reducing skin sweating (useful for anxiety and stress management)
This is done using a biofeedback machine that translates your body's electrical signals into other signals you can more easily understand.
Electrodes will be placed on the area of the body you're targeting that measure your body's response to pain or stress. The machine will then translate this into a noise, flashing light or image on a screen.
A trained biofeedback therapist can then help you to develop the skills to change these responses, using the machine to show you which techniques are effective at changing your body's responses. Once you've learned how to manage these physical responses with the help of the machine, you'll practice these skills without it so you can continue with the techniques long-term.
Who Biofeedback Therapy Helps
People who can benefit the most from biofeedback therapy tend to have health conditions related to chronic pain, stress, muscle tension and nervous system overarousal (Malik & Dua, 2021). This includes conditions like:
Chronic low back pain
Migraines and tension‑type headaches
General anxiety
Insomnia
Urinary and/or fecal incontinence
Pelvic floor dysfunction or pelvic pain syndromes
Conditions that flare up with stress or anxiety (like irritable bowel syndrome, high blood pressure and Raynaud's syndrome)
Conventional medicine typically manages these conditions with medication. Muscle relaxants are prescribed for muscle tension, beta-blockers/antidepressants for migraine prevention and anxiety-reducing medication for stress disorders. While these medications can be very effective, they're not suitable for everyone and can come with side effects.
Biofeedback is an alternative therapy for people who would prefer not to take medications, or who are looking for an add-on therapy to use alongside them.
Common Uses
Major American health organizations recommend biofeedback as a treatment for certain health conditions in specific cases.
Published in 2017, the American College of Physicians' guidelines on chronic low back pain recommend electromyography biofeedback for initial therapy when trying to avoid medication (Qaseem et al., 2017). They suggest using biofeedback alongside physiotherapy exercises and multidisciplinary rehab.
The American College of Gastroenterology's 2021 guidelines recommend using anorectal biofeedback for people with chronic constipation (Wald et al., 2021). Biofeedback therapy can help to increase the strength and coordination of the external anal sphincter without contracting the abdominal wall muscles.
In their 2021 consensus statement, the American Headache Society recommends biofeedback as an effective preventive treatment for migraines, with Grade A evidence (Ailani et al., 2021). They recognized that the evidence behind biofeedback for treating acute migraines is less clear.
Although biofeedback is also used for other conditions, including pelvic floor disorders and mental health conditions, it's less clear how effective it is in these situations due to lack of or lower quality evidence.
What the Evidence Supports
Data from nine randomized controlled trials (RCTs) demonstrates that biofeedback can significantly reduce migraine frequency (Paudel & Sah, 2025). Biofeedback is also a migraine prevention therapy recommended by the American Headache Society with level A evidence (the highest, most reliable type) (Ailani et al., 2021).
Lower back pain is another condition where there's a lot of supportive evidence for biofeedback therapy. Clinical guidelines and data from RCTs demonstrate that biofeedback can help avoid the need for medication and one RCT even found that movement sensor biofeedback was more effective than standard care (Kent et al., 2023; Qaseem et al., 2017).
Data from 11 RCTs suggests biofeedback therapy is effective for dyssynergic defecation (chronic constipation) patients who fail conservative therapy, which is confirmed by American College of Gastroenterology's guidelines (Moore & Young, 2020; Wald et al., 2021).
Urinary incontinence is another treatment area with a reasonable amount of evidence behind it. A meta-analysis of 21 RCTs found that invasive biofeedback-assisted pelvic floor muscle training can improve pelvic floor strength, reduce urine loss and increase the improvement/cure rate of urinary incontinence (Liu et al., 2026). However, there were flaws within the methodologies of several included studies and a risk of bias, so further research is needed into this topic.
Although clinical guidelines don't routinely recommend biofeedback therapy for psychological conditions, several studies have found potential benefits -- particularly with therapy focusing on heart rate variability.
One meta-analysis of biofeedback focusing on controlling heart rate variability found this therapy was associated with large reductions in self-reported stress and anxiety (Goessl et al., 2017). Another meta-analysis of 58 RCTs on heart rate variability biofeedback showed that therapy was linked to a small-to-moderate improvement in anxiety, depression, anger, and athletic performance (Lehrer et al., 2020).
Other studies have shown promising results for neurofeedback (a type of biofeedback where you focus on changing your brain activity rather than physical responses) in people with depression (Melnikov, 2021). Learn more about this therapy in our guide to neurofeedback.
Where the Evidence Is Limited
Most of the data we have on biofeedback therapy is based on short-term outcomes. More research is needed into the long-term impacts that biofeedback can have when used to treat almost all health conditions (Calderone et al., 2025).
More research is needed into biofeedback therapy and conditions like irritable bowel syndrome and Raynaud's syndrome where small studies have shown promising results but more high-quality data is needed (Goldenberg et al., 2019; Kondo et al., 2019).
Safety and Regulations
Biofeedback is generally considered safe and side effect free, although some people do experience mild and non-specific side effects like headaches or tiredness.
While biofeedback therapy itself isn't FDA-approved, many biofeedback devices are.
Biofeedback therapy is regulated in the US through state-level laws rather than through specific licenses for biofeedback practitioners themselves. The Association for Applied Psychophysiology and Biofeedback sets the standards on the level of training that biofeedback therapists should have. Their guidelines aren't the law, but they recommend all practitioners should achieve certification from Biofeedback Certification International Alliance on the type of biofeedback they provide (such as general, pelvic floor etc.).
The Experience
During biofeedback, you'll typically visit a clinic/hospital and a non-invasive device will be attached which monitors your physiological signals (like heart rate, muscle tension, breathing rate etc.) Most types of biofeedback focus on one type of signal, but some monitor several different types.
These signals are displayed on a screen or app so you can practice techniques to shift patterns toward calm or balance.
Sessions tend to last 30-60 minutes and emphasize active practice. How often you attend will depend on which area your therapy focuses on, but it's typical to attend 1-2 sessions a week for between 6 and 12 weeks.
You'll need to practice the techniques from these sessions at home for the best results.
The Future of Biofeedback Therapy
Biofeedback therapy is becoming more accessible as wearable devices become more popular and affordable. New portable devices to measure heart rate variability and stress are helping people to take part in biofeedback therapy at home.
AI-powered biofeedback is being used to translate physiological data into engaging games that help people change their physical responses more easily and continue making these changes (Blackmore et al., 2024).
However, as these technologies are emerging, more research is needed (especially on the long term effects). It's important that these technologies are used alongside experienced biofeedback therapists to make sure the results are effective.
Takeaway
Biofeedback therapy uses sensors to monitor and display real-time physiological signals like heart rate variability, muscle tension or skin temperature. This helps you learn how to voluntarily control these responses, which in turn can help with certain health conditions including migraines, incontinence and chronic back pain.
As this therapy tends to come with few or no side effects, it can be a good option for people hoping to improve their condition without using invasive treatments or medications. However, it's key to remember that biofeedback therapy offers symptom relief by retraining the nervous system's capacity for self-regulation and doesn't provide total disease reversal or a cure.
