Applied Psychophysiology and Biofeedback

, Volume 27, Issue 2, pp 163–181

Behavioral Management of Recurrent Headache: Three Decades of Experience and Empiricism

  • Donald B. Penzien
  • Jeanetta C. Rains
  • Frank Andrasik

DOI: 10.1023/A:1016247811416

Cite this article as:
Penzien, D.B., Rains, J.C. & Andrasik, F. Appl Psychophysiol Biofeedback (2002) 27: 163. doi:10.1023/A:1016247811416


In the past three decades, behavioral interventions (chiefly relaxation, biofeedback, and stress-management) have become standard components of the armamentarium for management of migraine and tension-type headaches. Meta-analytic literature reviews of these behavioral interventions have consistently identified clinically significant reductions in recurrent headache. Across studies, behavioral interventions have yielded approximately 35–50% reduction in migraine and tension-type headache activity. Although we have only recently begun to directly compare standard drug and nondrug treatments for headache, the available evidence suggests that the level of headache improvement with behavioral interventions may rival those obtained with widely used pharmacologic therapies in representative patient samples. In recent years, some attempts have been made to increase the availability and cost effectiveness of behavioral interventions through alternative delivery formats and mass communications. Recent developments within diagnosis and classification are summarized, pointing out implications for behavioral researchers. Select future directions are discussed, which include impact of the triptans, cost and cost effectiveness, and integration of behavioral treatments into primary care settings, the place where the great majority of headache sufferers receive treatment.

tension-type headache migraine headache behavioral treatment biofeedback relaxation stress-management meta-analysis primary care 

Copyright information

© Plenum Publishing Corporation 2002

Authors and Affiliations

  • Donald B. Penzien
    • 1
  • Jeanetta C. Rains
    • 2
    • 3
  • Frank Andrasik
    • 4
  1. 1.UMC Head Pain CenterUniversity of Mississippi Medical CenterJackson
  2. 2.Center for Sleep Evaluation, Elliot HospitalManchester
  3. 3.Department of PsychiatryDartmouth Medical SchoolLebanon
  4. 4.Institute for Human and Machine CognitionUniversity of West FloridaPensacola

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