A review and meta-analysis of studies investigating the effects of biofeedback on tension headaches was undertaken by researchers at Philipps-University of Marburg in Marburg, Germany.

A literature search identified 74 outcome studies, of which 53 were selected according to predefined inclusion criteria. Meta-analytic integration resulted in a significant medium-to-large effect size (d = 0.73; 95% confidence interval = 0.61, 0.84) that proved stable over an average follow-up phase of 15 months.

Biofeedback was found to be more effective than headache monitoring, placebo, and relaxation therapy conditions.  The strongest improvements resulted for frequency of headache episodes.  Further significant effects were observed for muscle tension, self-efficacy, symptoms of anxiety, depression, and analgesic medication.

Most effective of all was biofeedback in combination with relaxation. Effects were particularly large in children and adolescents. The review concluded that biofeedback constitutes an effective, evidence-based treatment option for tension-type headache.

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