Relaxation treatments and biofeedback for anxiety and somatic stress-related disorders

Relaxation techniques (TR) and biofeedback (BFB) are widely used in psychiatric and psychological practice for the treatment for anxiety and stress-related disorders.An examination of studies focusing on the correlates of psychophysiology of relaxation and biofeedback has been done, in addiction to controlled therapeutic studies that describes clinical aspects, efficacy and limits.There are different TR and BFB procedures, but they have the same goal and same physiological modifications, resulting in stress and anxiety reduction. There is a proven action to musculoskeletal, neuroendocrine and autonomic nervous system, showing similar results. Very few data on immune changes are available. Meta-Analysis show superior efficacy to no treatment or placebo in anxiety disorders, tension headache, bruxism, temporomandibular pain syndrome, rehabilitation and prevention of ischemic heart disease. Moderate efficacy is shown for chronic low back pain, cancer-related pain, rheumatoid arthritis and gastrointestinal disorders; data for essential hypertension are controversial. Variability of techniques, procedures, sampling problems, non-systematic make definitive conclusions difficult. TR and BFB are often used in combination with cognitive-behavioral and educational techniques. The association of the active relaxation technique facilitates generalization and self-control during stress situation and outside the training session.TR and BFB are effective for anxiety and somatic stress-related disorders, associated with coping and quality of life improvement and affordable costs; they are minimally invasive but needing an active participation in the treatment process. Some limits are responders' prediction, continuity of practice and limited effectiveness for depression disorders. Finally, it is shown that they are real psychosomatic therapies that are able to produce somatic peripheral changes (neuroendocrine, neurovegetative and muscular systems) generated by the mind and secondary to the involvement of central neurotransmitter circuits.