Heart rate variability biofeedback improves co-occurring posttraumatic stress disorder and chronic pain symptoms: A...

Posttraumatic stress disorder (PTSD) and chronic pain (CP) are highly co-occurring conditions, characterised by poor treatment outcomes and shared mechanisms that exacerbate symptom severity and functional impairment. This randomised, waitlist-controlled trial evaluated the efficacy of a six-week heart rate variability biofeedback (HRVBF) intervention in improving concurrent symptoms of PTSD and CP. Data of 73 Australian participants (mean age: 42.2; 14 male, 59 female), meeting clinical criteria for both conditions, were analysed following either six weeks of HRVBF or waitlist control. Symptom changes were assessed using validated psychometric measures. The HRVBF group demonstrated significant reductions in PTSD symptoms, with a 24.3 % decrease in PTSD Checklist total scores (d = -1.89) and improvement across all symptom clusters, compared to no significant change in the waitlist group. Similarly, trauma-related distress (Impact of Events Scale) decreased by 18.9 % (d = - 0.93) post-intervention. Pain interference (Brief Pain Inventory - short form) improved significantly (24.9 % reduction; d = - 1.14), whereas reductions in pain intensity and pain disability did not differ significantly between groups. These results highlight the potential of HRVBF as an effective intervention for co-occurring PTSD and CP.