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Heart rate variability biofeedback shows mixed results for PTSD symptoms and perceived pain in veteransHeart rate biofeedback may help veterans with PTSD and pain

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Key Takeaway
Note that HRVB shows mixed results for PTSD and may only serve as a supportive rather than standalone intervention.

This scoping review evaluates the evidence for heart rate variability biofeedback (HRVB) as a treatment for veterans experiencing tinnitus, post-traumatic stress disorder (PTSD), and chronic pain. The review synthesized findings from a limited number of studies to assess the impact of HRVB on various clinical outcomes.

Regarding PTSD, the review reported mixed findings: two studies showed improvements in overall PTSD symptoms, while one study reported a reduction limited only to intrusion symptoms. For other conditions, one study reported improvements in depressive symptoms, and one study reported reductions in perceived pain following HRVB training. No studies investigated the relationship between HRVB and tinnitus.

The authors noted several limitations, including small sample sizes, methodological heterogeneity, and variability in HRV measurement approaches. Due to these limitations and the limited scope of the evidence, the authors conclude that HRVB cannot be recommended as a standalone intervention for PTSD or chronic pain. It may, however, have potential as an adjunctive or supportive approach.

How this fits prior evidence

This scoping review addresses a gap in evidence regarding non-pharmacological interventions for veterans. While prior coverage noted that structured physical exercise programs significantly reduce PTSD symptom severity and propranolol shows potential for managing PTSD, this review explores HRVB as a potential adjunctive approach. The findings regarding mixed results for PTSD symptoms and reported improvements in depressive symptoms and perceived pain provide a different perspective on complementary therapies for these conditions.

Living with the constant weight of post-traumatic stress disorder (PTSD) or chronic pain can be exhausting. For many veterans, finding the right way to manage these symptoms is a long and difficult journey. Recent research looked into a technique called heart rate variability biofeedback (HRVB) to see if it could offer some relief.

In the review of existing studies, researchers found mixed results regarding PTSD. While some studies showed improvements in overall symptoms, others only showed a reduction in intrusion symptoms. For depression, one study reported improvements, and another showed that HRVB training could reduce perceived pain. However, no studies were available to see if this method helps with tinnitus.

It is important to note that the evidence is still limited. Because of small sample sizes and different ways of measuring heart rates, we cannot say if HRVB works as a standalone treatment for PTSD or chronic pain. It may, however, work well as a supportive tool alongside other treatments. Talk to your doctor to see if this approach fits your specific needs.

What this means for you:
Heart rate biofeedback may support veterans with PTSD and chronic pain, but more research is needed.

Common questions

Can heart rate biofeedback help with PTSD symptoms?

The evidence is mixed. Some studies showed improvements in overall PTSD symptoms, while another study showed a reduction only in intrusion symptoms. Because the data is limited, it is not currently recommended as a standalone treatment for PTSD.

Does this treatment help with chronic pain or depression?

One study reported that heart rate variability biofeedback training could reduce perceived pain. Another study reported improvements in depressive symptoms. However, more research is needed to determine if these work well without other treatments.

Can heart rate biofeedback help with tinnitus?

Currently, there are no studies available to determine if heart rate variability biofeedback has any effect on tinnitus. You should speak with a healthcare provider regarding your specific symptoms.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
IntroductionTinnitus, post-traumatic stress disorder (PTSD), and chronic pain are prevalent chronic conditions among veterans and frequently co-occur. These conditions have been associated with alterations in autonomic nervous system (ANS) functioning. Heart rate variability biofeedback (HRVB) is a non-pharmacological intervention intended to modulate autonomic regulation. This scoping review aimed to identify HRVB interventions used for tinnitus, PTSD, and chronic pain in veterans and evaluate the extent and characteristics of the existing evidence in this population.Materials and methodsA systematic search of PubMed, Embase, and CINAHL was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Studies examining the effects of HRVB, alone or in combination with other non-pharmacological interventions, on chronic symptoms in veteran-only populations were included.ResultsOf 69 records identified, five studies met inclusion criteria. Four studies examined HRVB in relation to PTSD symptoms, with mixed findings: two reported improvements in overall PTSD symptoms, while one reported reduction limited to intrusion symptoms. One study also reported improvements in depressive symptoms. A single study examined chronic pain outcomes and reported reductions in perceived pain following HRVB training. No studies investigated HRVB in relation to tinnitus. Across studies, small sample sizes, methodological heterogeneity, and variability in HRV measurement approaches limited comparability and interpretation of findings.ConclusionCurrent evidence on HRVB in veterans is limited and does not allow conclusions regarding its efficacy as a standalone intervention for PTSD or chronic pain, although it may have potential as an adjunctive or supportive approach. Notably, no studies have examined HRVB in relation to tinnitus in veterans. These findings highlight the need for rigorously designed studies to evaluate the feasibility, safety, and potential relevance of HRVB in well-characterized veteran populations, including those with tinnitus and co-occurring conditions.
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