To assess the efficacy of electromyographic biofeedback, relaxation-response training and pain behavior management as a treatment for pediatric migraine, we studied 18 children between the ages of eight and 12 years (mean 10) in a prospective, randomized, controlled investigation. Six patients received all three treatment procedures, six received relaxation-response training and pain behavior management, and the remaining six constituted a waiting-list control group. All patients kept a record of their headaches for the 15-week study period and then for four weeks one year later. Following four weeks of baseline, the treatment groups completed nine one-hour treatment sessions in 11 weeks. Both treatment groups experienced a significant reduction in headache symptoms and were significantly improved compared to the waiting-list control group by the end of treatment. The treatment groups did not differ from each other in any of these comparisons. The reduction in headache symptoms in the treatment groups was maintained one year after treatment ended. These results suggest that relaxation-response training, with or without biofeedback training, combined with pain behavior management, is an effective alternative treatment for pediatric migraine.

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