Laura Roberts had a headache for more than six years. Essentially one headache, continuously.
"When I got up I'd have a headache and when I went to bed, I'd have a headache," recalls Roberts, 24, a Maryland real estate settlement specialist. "That can really get to you after a while."
"I went to a couple of doctors and they just put me on medicine -- one medicine after another, and none of them helped. I did that for about a year. Nothing worked."
Roberts then went to a neurologist who did brain scans and sinus X-rays and put her on still another drug.
"It gave me the worst nightmares," she said. "Then they told me about biofeedback and I thought, 'Oh, God, you've got to be kidding.'
"But it worked."
Biofeedback is not a treatment. It is merely a teaching device that hooks a person up to a monitor that tells them, in essence, how tense they are. The patient can hear, through magnified beeps, the electrical activity in the smooth muscles. When the muscles are tense, the beeps are fast, almost to the point of a continuous buzz. When the muscles relax, the beeps become slower and distinct.
The machine also can measure the temperature of the fingertips, which tend to be cold when the body is tense, warmer as it relaxes. The patient can read his or her temperature on a dial, through lights or on graphs.
With the help of a trained therapist, usually a psychiatrist or psychologist, a social worker or psychotherapist, a patient can learn to relax. As the body relaxes, the patient gets immediate feedback from the slowing of the beeps or the rise in finger temperature.
Biofeedback takes a lot of practice -- at home with relaxation tapes, as well in the therapist's office on the apparatus. But it can help headache victims learn to recognize the tension level they hit just before a headache strikes, in time to head it off. Biofeedback is typically most helpful for people with muscle contraction headaches, which are caused by tenseness and painful contractions in the muscles. It can also help abort migraines, which occur when blood vessels in the head first constrict and then over-dilate. If the migraine patient can learn to raise the finger temperature and do so during the constricting phase, the over-dilation can often be averted.
For Laura Roberts -- who quite cheerfully admits today that she thought psychologist Barry Kirshner was, at best, some kind of kook when he suggested the technique -- biofeedback was the answer.
When she first saw Kirshner, Roberts was taking some 70 aspirin tablets a week. The aspirin would lower the headache's intensity sometimes, but the ache was always present and sometimes grew to a really sharp pain.
According to pain diaries all of Kirshner's patients keep, Roberts' medication began to drop as the pain intensity lessened. Eventually -- after 12 weeks -- she had her first pain-free day.
The therapy took about 22 sessions. Now she can tell when a headache is about to come on. "If I just sit and relax for a couple of minutes," says Roberts, who married a Maryland state trooper in June, "I won't get it."