How a Chronic Headache Condition Became Resolved with One Session of Breathing and Posture Coaching


  • Erik Peper San Francisco State University
  • April Covell San Francisco State University
  • Nicole Matzembacker San Francisco State University



headache, breathing, posture, awareness, electromyography


This case example reports how a 32-year-old female student with chronic headaches since age 18 became headache-free after one session of breathing and posture coaching. She self-medicated and took between 2 and 10 Excedrin tablets per week. The class coaching session focused on shifting her habitual thoracic breathing to slower lower abdominal diaphragmatic breathing and posture retraining. While working at the computer, she used an app installed on her computer that provided visual and auditory feedback each time she slouched. She used the app 2–6 hours per day for 2 weeks, and each time in response to the slouching feedback she sat up erect and breathed slower and lower. After the first coaching session and for the following 14 weeks, she has been headache-free and not used any medications. After implementing breathing and posture changes, she also reported significant reduction in shoulder pain, back pain, depression, anxiety, and improvement in motivation. We recommend that when college students report headaches, anxiety, and gastrointestinal distress that they are first offered self-mastery interventions.

Author Biography

Erik Peper, San Francisco State University

Professor Institute for Holistic Health Studies Department of Health Education


Ahmed, S., Akter, R., Pokhrel, N., & Samuel, A. J. (2021). Prevalence of text neck syndrome and SMS thumb among smartphone users in college-going students: A cross-sectional survey study. Journal of Public Health, 29, 411–416.

Bauer, A. Z., Swan, S. H., Kriebel, D., Liew, Z., Taylor, H. S., Bornehag, C.-G., Andrade, A. M., Olsen, J., Jensen, R. H., Mitchell, R. T., Skakkebaek, N. E., Jégou, B., & Kristensen, D. M. (2021). Paracetamol use during pregnancy — A call for precautionary action. Nature Reviews Endocrinology, 17, 757–766.

Charles, N. E., Strong, S. J., Burns, L. C., Bullerjahn, M. R., & Serafine, K. M. (2021). Increased mood disorder symptoms, perceived stress, and alcohol use among college students during the COVID-19 pandemic. Psychiatry Research, 296, 113706.

Elizagaray-Garcia, I., Beltran-Alacreu, H., Angulo-Díaz, S., Garrigós-Pedrón, M., & Gil-Martínez, A. (2020). Chronic primary headache subjects have greater forward head posture than asymptomatic and episodic primary headache sufferers: Systematic review and meta-analysis. Pain Medicine, 21(10), 2465–2480.

Greden, J. F., Victor, B. S., Fontaine, P., & Lubetsky, M. (1980). Caffeine-withdrawal headache: A clinical profile. Psychosomatics, 21(5), 411–413, 417–418.

Küçer, N. (2010). The relationship between daily caffeine consumption and withdrawal symptoms: A questionnaire-based study. Turkish Journal of Medical Sciences, 40(1), 105–108.

Kuehn, B. M. (2021). Increase in myopia reported among children during COVID-19 lockdown. JAMA, 326(11), 999.

MacHose, M. & Peper, E. (1991). The effect of clothing on inhalation volume. Biofeedback and Self-regulation, 16, 261–265.

Peper, E., Booiman, A., Lin, I.-M., Harvey, R., & Mitose, J. (2016b). Abdominal SEMG feedback for diaphragmatic breathing: A methodological note. Biofeedback, 44(1), 42–49.

Peper, E., Gilbert, C. D., Harvey, R. & Lin, I.-M. (2015). Did you ask about abdominal surgery or injury? A learned disuse risk factor for breathing dysfunction. Biofeedback, 43(4), 173–179.

Peper, E., Lin, I.-M., Harvey, R., & Perez, J. (2017b). How posture affects memory recall and mood. Biofeedback. 45(2), 36¬–41.

Peper, E., Mason, L., Harvey, R., Wolski, L., & Torres, J. (2020). Can acid reflux be reduced by breathing? Townsend Letter, The Examiner of Alternative Medicine, 445/446, 44–47.

Peper, E., Mason, L., & Huey, C. (2017a). Healing irritable bowel syndrome with diaphragmatic breathing. Biofeedback, 45(4), 83–87.

Peper, E., Miceli, B., & Harvey, R. (2016a). Educational model for self-healing: Eliminating a chronic migraine with electromyography, autogenic training, posture, and mindfulness. Biofeedback, 44(3), 130–137.

Peper, E., Wilson, V., Martin, M., Rosegard, E., & Harvey, R. (2021). Avoid Zoom fatigue, be present and learn. NeuroRegulation, 8(1), 47–56.

Schulman, E. A. (2002). Breath-holding, head pressure, and hot water: An effective treatment for migraine headache. Headache, 42(10), 1048–1050.

Tsai, H.-Y., Peper, E., & Lin, I.-M. (2016). EEG patterns under positive/negative body postures and emotion recall tasks. NeuroRegulation, 3(1), 23–27.

Veenstra, L., Schneider, I. K., & Koole, S. L. (2017). Embodied mood regulation: the impact of body posture on mood recovery, negative thoughts, and mood-congruent recall. Cogntion and Emotion, 31(7), 1361–1376.

Wilson, V. E., & Peper, E. (2004). The effects of upright and slumped postures on the generation of positive and negative thoughts. Applied Psychophysiology and Biofeedback, 29(3), 189–195.






Clinical Corner