Biofeedback as a Treatment of Chronic Pain
© Blue Cross and Blue Shield of Montana
Current Effective Date:
July 18, 2013
Original Effective Date:
October 01, 1990
July 18, 2013
June 01, 2011; June 27, 2012; April 26, 2013
Biofeedback is a technique intended to teach patients self-regulation of certain physiologic processes not normally considered to be under voluntary control. Electromyography (EMG) biofeedback has been evaluated as a method to reduce chronic or recurrent pain of musculoskeletal or psychosomatic origin.
Treatment for chronic pain is often multimodal and typically includes psychological therapy. Psychological techniques vary but may include cognitive therapy, which teaches subjects the ability to cope with stressful stimuli by attempting to alter negative thought and dysfunctional attitudes, and behavioral approaches to reduce muscle tension and break the pain cycle. Relaxation, using any of a variety of techniques including meditation or mental imagery, is considered a behavioral therapy that may be used alone or as a component of a cognitive-behavioral therapy (CBT) program. Electromyography (EMG) biofeedback has also been used for the treatment of chronic pain, with the assumption that the ability to reduce muscle tension will be improved through feedback of data to the subject regarding degree of muscle tension. While some consider EMG biofeedback to be a method to obtain relaxation, others consider biofeedback to be distinct from other relaxation procedures.
Biofeedback provides physiological information not normally available to the patient, with a concerted effort on the part of the patient to use this feedback to help alter the physiological process in some specific way. Biofeedback training is done either in individual or group sessions, alone, or in combination with other behavioral therapies designed to teach relaxation. A typical program consists of 10 to 20 training sessions of 30 minutes each. Training sessions are performed in a quiet, non-arousing environment. Subjects are instructed to use mental techniques to affect the physiologic variable monitored, and feedback is provided for successful alteration of that physiologic parameter. The feedback may be in the form of lights or tone, verbal praise, or other auditory or visual stimuli.
Blue Cross and Blue Shield of Montana (BCBSMT) considers biofeedback as a treatment of chronic pain, including but not limited to low back pain, experimental, investigational and unproven.
90901, 90875, 90876, E0746
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- Biofeedback as a Treatment of Chronic Pain. Chicago, Illinois: Blue Cross Blue Shield Association Medical Policy Reference Manual (March 2012) Medicine 2.01.30.
||Originally part of the Biofeedback medical policy.|
||Policy reviewed and updated; description, policy, rationale, and references; No change to policy statement|
||Policy updated with literature review through January 2012. References 10-12, 23 added; other references renumbered or removed. Policy statement unchanged.|
||Policy formatting and language revised. Policy statement unchanged. Removed CPT 90911.|