Temperature biofeedback, also known as psychophysiological feedback, is a type of treatment that uses a person’s body temperature to assess that person’s physical state. Over time, a person can be trained to control their body temperature by monitoring real-time changes to their thermal state and, as a result, have a level of control over certain physical issues such as mental/physical stress, Raynaud’s Syndrome or “white finger”, anxiety disorder, panic attack, tension and migraine headaches, etc.

The temperature at the surface of the skin changes according to blood circulation through body tissue. The small blood vessels (arterioles) crossing through the tissue are surrounded by fibers of smooth muscle, which are controlled by the sympathetic nervous system.

In a state of increased exertion, excitement and stress, these muscle fibers contract, causing stenosis of the vasculature. This leads to a reduction of skin temperature since blood circulation through the tissue is reduced. In contrast, in a state of relaxation, the musculature is also bound to relax, causing the vasculature to expand. Hence, the skin temperature rises.

Mental stress often leads to lower peripheral perfusion and a decrease of skin temperature at the hands, caused by increased activity of the sympathetic nervous system. This has a sense of evolution because tension and anxiety originally served the preparation for an impending flight or an attack. As a result, as much blood as possible is available in the working muscles (upper arms, thighs and torso), which is achieved by the narrowing of vessels in the hands, feet and forearms.

For example, think of a speech that you gave in front of an audience or a job interview panel. If you were anxious in those situations, can you remember having cold (and sweaty) hands?

This physiological stress reaction can be useless or even harmful in many contexts in modern society (e. g. mental exertion, worries, psychosocial stress, and anxiety disorder). Conscious control of physiological stress can help you react in a more relaxed and efficient manner in many situations. Biofeedback is an established way to learn this kind of control!


Thermal biofeedback, also known as psychophysiological feedback, is a type of treatment that uses a person’s body temperature to assess that person’s physical state. Over time, a person can be trained to control their body temperature by monitoring real-time changes to their thermal state and, as a result, have a level of control over certain physical issues.

To reduce stress and its vegetative symptoms, biofeedback training can be conducted by striving for a rise in skin temperature.
Biofeedback with skin temperature is mainly applied in relaxation exercises. It’s easy to handle and learn. Experience with this technique shows a high rate of success and improvement of subjective well-being. In the therapeutic field, skin temperature biofeedback is often and effectively used in the management of migraine and chronic pain, high blood pressure, insomnia, pain, stress, digestive disorders, and many, many other ailments. If you suffer from a serious disorder or medical condition, always consult a professional physician or therapist, and do not attempt to treat yourself.

Biofeedback training does not require the use of drugs or surgery to alter the body but teaches your body to alter itself. Once a biofeedback skill has been acquired, the patient usually then has no need for further use of training equipment and may use feedback only to occasionally tune or validate the utilization of their skill.


A particularly easy and effective biofeedback method is hand warming training. It works with the temperature sensor attached to a finger, or simply held between the thumb and index fingers. The temperature readout is then shown on a digital screen to the patient, who can track his or her body temperature by the minute. How tense a person is can be measured by a drop in temperature in their hands. This is because, during times of stress, the body will divert blood from the surface area of the body to the muscles and organs, allowing us to better respond to a nearby threat. This is also referred to as the “fight or flight” response. When our surface temperature is high, it typically means we are in a relaxed or sleepy state.

You will learn through direct feedback to intentionally raise the temperature of your fingers, thus increasing perfusion in your hands.
When measuring hand temperature the following items should be considered. This will allow for the best feedback on body temperature.
– Readings should always be taken in a neutral temperature room, in which one is neither hot nor cold (20-22°C / 68-72 °F) and where there are no phones and sources of distraction.
– The records of the temperature should always be taken from the same finger.
– The tape for fixing the temperature sensors should not be adhering too tight, or circulation will be inhibited.
– The areas where fans, air conditioners, heaters, drafts, and breezes are present should be avoided.
– The contact with warm or cold objects such as drinks or outdoor exposure should be avoided.

Thermal biofeedback can be performed at home. A person would only need the proper equipment and a bit of patience and imagination, in this case, imagination to visualize conditions to help control body temperature. For example, someone could use mental visualization to imagine sitting in a cold room to help drop their temperature or vice versa. Children tend to be more successful in practicing thermal biofeedback at home because they are naturally more imaginative than adults.


There are many different ways to increase hand temperature. It is suggested that a person should try them all, and find the method that works best for him/her. The basic idea behind each of these methods is to focus the consciousness on the experience of being profoundly relaxed.

One of the most common ways used to relax is deep breathing. It has an ancient therapeutic history. It is accomplished by taking deep diaphragmatic breath and then exhaling for a longer count than the inhalation.

The muscle tensing use is accomplished through sessions of tensing muscles and then completely relaxing them. It is believed that the relief you experience after tensing your muscles is an analog of the conscious relaxation process you are trying to learn.

In an imaginary method, the relaxation response is activated by having the person think about a very peaceful, warm and calm place, such as lying on your beautiful imaginary beach. It is helpful if the person imagines the warmth along with imagining themselves there.

It is well known the impact of the music on relaxation. Many people find it quite easy to increase their hand temperature by just sitting in a comfortable chair and listening to appropriate soft music.

In the method with the use of autogenic phrases, positive, present tense statements are said to one’s self. Examples would be: I feel quite relaxed. My hands are beginning to feel warm. My muscles are all loose and comfortable. I can feel the blood running into my hands. My hands feel heavy and warm. This is a very popular method and works for most people.

On open focus, the training person tries to imagine an interior portion of space in the body. Examples might be: Can you imagine the space between your eyes? Can you imagine that your hands and fingers are filled with space? Each statement is made and then the pause briefly concentrating for about 10 seconds on the specific area.


When used consistently and under proper conditions, the practice of thermal biofeedback can be used to remedy the effects of stress and tension in the body. It is particularly beneficial for the reduction of migraines in headache sufferers. In fact, studies have shown that the use of thermal biofeedback in the treatment of migraines can be more successful when used in combination with traditional migraine medications.

It is also beneficial in the treatment of Raynaud’s Syndrome or “white finger”, which causes discoloration in a person’s fingers or toes. This is caused by blood vessels constricting and slowing down blood flow to the fingers or other areas of the body. It can be extremely painful for a person who develops it and the effects of stress or cold are normally the causes of it. In this case, thermal therapy is an ideal treatment for such a condition, especially for someone who is unwilling to undertake traditional medical treatment or take prescription medications.

Besides helping to alleviate various medical issues, thermal biofeedback can also improve one’s mental state and overall mood. By improving one’s mood, a person will be able to perform at higher levels of concentration and subsequently, higher levels of success. This can be applied to job performance, athletics or even just day to day activities.

Overall, thermal biofeedback is an effective and fairly inexpensive therapy for one to use, as a person can use it simply and within the comfort of their own homes. With just a little guidance and thorough practice, anyone can be able to use the technique to improve their physical state and being.


Hand warming training aims to show a person their skin temperature and help them get direct control over the blood circulation in their outer limbs. Biofeedback training consists of four training stages. For the first training, schedule about 60 to 90 minutes of free time in which you can conduct the training undisturbed and at a stretch.

To train successfully, find a quiet room with a temperature of 20-22°C / 68-72 °F and where there are no phones and sources of distraction. Make sure the room has convenient seating and that you are wearing comfortable clothing. As skin temperature depends also on ambient temperature, you should try to perform each training session under similar ambient conditions.

You should get accustomed to the ambient temperature for at least five minutes (acclimatization), letting the training start while your body is in a relaxed and constant state. This phase of acclimatization can already raise your hand temperature by several degrees.


In the first stage of the temperature biofeedback, it is necessary to observe and determine the initial status.

In comparison with other biofeedback techniques, it will require 6-10 sessions for a reliable success. To keep focused throughout the entire session, it is necessary to limit each session’s length to about 30 minutes. If you start feeling tired while training, you should shorten your sessions and practice more often instead.

In your first session, take ten minutes and try to relax. How you do this is up to your personal preferences and possibilities.
At the beginning of each session, it is necessary to record the baseline state for 2-3 minutes, letting the sensor temperature adapt to the finger. Sit upright and comfortable and DO NOT WATCH THE TEMPERATURE in the app but simply let the device measure! The temperature should reach a constant level for the actual training to begin.

In a room of normal temperature, when you are neither deeply relaxed nor stressed, starting hand temperature will be in the mild or high 26-27°C / 80°F. Finger temperature of 26-27°C / 80°F is cool, 23-24°C / 75°F is cold and 21°C / 70°F or below is very cold; 32°C / 90°F is warm.

The training goal is 34-35°C / 95-96° F for 10 minutes.

If your hands are quite cold, the temperature may increase very slowly. Only after several minutes of training, if your hands are in the low-mid 26-27°C / 80°F, the temperature may increase rapidly.

If your hands are in the low-mid 32°C / 90°F, the temperature may increase slowly; with only a few degrees of increase, but at that level, a few degrees are a significant change.

Training is about measuring whether relaxation already leads to a higher temperature in your finger.

AFTER RELAXING LOOK at the measured values and whether you have already caused an increase in temperature by relaxing. Were there sections of rising values? Did the level remain constant? Or does the curve drop slowly during the measurement? How do you rate your ability to relax during the measurement?

You may already be able to determine a relationship between the curve and the tension or relaxation you are feeling. Regardless of whether you’ve succeeded, observe the measured values and test whether you are able to influence the temperature at will. After that, the first training phase is over.

Of course, the day also plays a role here; it may make a difference whether you are measuring after a stressful working day (or even at work) or at the end of a relaxing weekend. Before taking another measurement, try to pay attention to the daily activities during which you are more likely to have hot or cold hands. These observations may be useful later in further sessions.

In the Second stage of temperature biofeedback training, the temperature feedback is performed

The second stage consists of multiple sessions. These sessions should always follow the following scheme. Start every session with a 2-3-minute baseline measurement WITHOUT watching the values to reach a steady state.

After that you can start to train conscious relaxation, using the feedback signal. WATCH the temperature values while relaxing and try to find ways to bring them up. It can be helpful to imagine yourself lying in the sun, relaxing in a sauna, or putting your hands into warm water. You can also work with autosuggestion techniques, telling yourself sentences like, “My left hand feels warm…it feels even warmer now…” Feel free to experiment.

As with every activity, regular practice is the key to success. You should be able to raise your skin temperature by several degrees unless your baseline is already at 33-34°C / 91-93°F. The colder your hands are in the first place, the more potential you have to raise their temperature. In general, your hands can reach a temperature of more than 36°C / 97°F, which is the temperature of your body’s core.

In the third stage, the learned relaxation skills should be used without feedback

In the third stage, you can check if a state of deepened relaxation, and the corresponding rise in skin temperature, can already be achieved without feedback.
After measuring the baseline, as usual, you should alternate between watching and not watching the feedback (two minutes each way). The longer and more often you can keep the temperature up without the feedback, the better your self-control has already become. When you are not using the feedback, don’t look at the values in the app.

Perform multiple sessions in the third stage. When you can keep your skin temperature up for a prolonged time and mainly without feedback, you have successfully completed this stage.

Training sessions should always be performed under identical conditions (same time of day, electrode position and type) and of approximately identical duration for the best comparability of training results.

In the fourth stage, the provocation (relaxation and stress stimulus) should be used during a biofeedback session

In the final fourth stage, you should check if you have acquired improved stress resilience. Start a session with the baseline as usual, and then keep your skin temperature on elevated levels (well above 30°C / 86°F) for a couple of minutes.

After that try to bring yourself into a strenuous situation recalling previously memorized everyday situations in which you had cold hands or situations that made you tense and angry. You can also move to a stressful environment or ask another person to exert a stressful stimulus upon you. Keep the stress situation short and do not overload your ability to cope with it. Under the stress, observe if the temperature drops, and still try to keep the temperature at a high level and avoid temperature drops.

Always change phases of stress and targeted relaxation.

If you can sustain elevated levels of skin temperature during strenuous situations, ideally at levels above your personal maximum in the first stage, you have learned to remain relaxed and calm even in difficult and stressful situations.

You have fully reached the goal of hand warming training!

Temperature eSense Biofeedback home-use device

BioSignals Biofeedback 3 sensors device 3

Biofeedback BioSignals Green Box 4 sensors

BioSignals Combined Multimodal Biofeedback Home-Use Device