Biofeedback uses electronic and mechanical instruments to accurately measure the action of the pelvic floor muscles and provides ‘feedback’ information to the patient so that the patient can learn to better use the pelvic muscles. Biofeedback is effective at the cellular and tissue level, causing improve permeability of cellular activity and tissue remodeling as well as stimulating remodeling the nerves to function properly in turning on and off nerves to change muscle sensitivity. Patients can learn to use the pelvic floor muscles to decrease the sudden urge to urinate, decrease incontinence, and lessen certain types of pelvic pain.
Goal of Biofeedback regarding Incontinence
The goal of biofeedback rehabilitation in the treatment of incontinence is to strengthen the pelvic muscles that help to hold back the urine, and also to help teach the patient methods of pelvic floor muscle contraction that can improve bladder control. Contractions of the pelvic floor muscles, can sometimes make unwanted urges to go away. Strengthening the pelvic floor muscles can also help to decrease leaking of urine that happens with cough, laughing, work, or exercise. Many patients also find that pelvic floor rehabilitation strengthens the pelvic floor muscles, which can benefit sexual relations.
Goal of Biofeedback regarding Pelvic Pain
Patients with chronic pelvic pain may have pelvic floor muscle tightness, or spasm, that contributes to the pelvic pain. Pelvic floor biofeedback rehabilitation can teach patients how to relax the pelvic floor muscles, which can help to reduce pelvic pain.
What are the Advantages of Biofeedback?
Biofeedback is a conservative, non-invasive treatment. In other words, although the treatment involves major changes and manipulation of bodily processes, such as blood circulation, brain-wave activity, and muscle activity, as happens in surgery.
In biofeedback, the patient is as much involved in monitoring and controlling the condition as the therapist is. In other medical treatments, the blood tests, x-rays, another laboratory data are used by us to decide what we are going to do for the patient. Biofeedback is refreshingly different. All the laboratory data is shared with the patient, and it is the patient who is given the task of changing their physiological processes to the level required.
Why Biofeedback would help
The muscles of the pelvic floor (including those controlling the anus and urinary sphincters) can become weakened due to overall loss of conditioning with age, stretching during delivery, etc. These muscles may be in fine shape, but they may have to resist more pressure than they can handle during a cough or jump. Many people do not have a good sense of when the actually have to urinate or defecate and are either fooled by sensations which are just warnings or miss the warnings entirely. Most people tense the wrong muscles when they are trying to avoid leaking. Biofeedback sensors inserted into the vaginal canal or anus or taped to the pelvic floor can easily pick-up these signals, so people can learn to recognize them by watching the biofeedback display and relating the changes in the display to sensations in their bodies.
Pressure sensors (which look like tiny balloons) can both pick up the signals and simulate them, so the signals can be produced on demand. Muscle tension biofeedback used in combination with Kegal exercises and other forms of home practice help the person strengthen the muscles and contract only the correct muscles when they should be contracted. This same methodology can be used to help patients recognize when they need to have a bowel movement and to relax the appropriate muscles in the appropriate sequence when ready.