Music Therapy Decreases Pain After Spine Surgery

Study shows the integrative and individual approach eases patient pain. With commentary by Donald S. Corenman, MD, DC.

Peer Reviewed

Providers and health care organizations continually seek more individualized patient care, and music therapy interventions may help achieve that goal. Music therapy, when combined with standard medical care, lowered pain perception in patients recovering from spinal fusion. The findings were published in the January/February 2017 issue of The American Journal of Orthopedics. 

“Conventional pain-alleviating medical interventions can be enhanced with integrative therapies that empower patients to marshal their inner resources during recovery,” wrote the study authors. “Music therapy may be particularly suited to this effort, as it is adaptable to the patient’s individual and culturally specific needs.”
Young girl wearing headphones and smiling“Music therapy may be particularly suited to this effort, as it is adaptable to the patient’s individual and culturally specific needs.”Beyond Sound: Music Therapy and Individualized Care
Researchers used a mixed-methods study design, combining standard medical treatment with individualized, integrative music therapy. The study was conducted at the Spine Institute of New York within the Department of Orthopedic Surgery at Mount Sinai Beth Israel, with music therapy coordinated through the hospital’s Louis Armstrong Center for Music and Medicine.

“We selected a mixed-methods approach to studying pain because, while we felt confident from our pilot work that we would show an impact on pain scores with music therapy, we also believed and continue to believe that the individual stories and identities of the study participants were important factors to consider,” says John Mondanaro, lead author and Clinical Director of The Louis Armstrong Music Therapy Department.

Sixty patients (35 female and 25 male) ranging in age from 40 to 55 who had an anterior, posterior, or anterior-posterior spinal fusion participated in the study. The patients were evenly split between two study groups. The experimental group received music therapy plus standard medical care, while the control group only had standard medical care.

Patients in the experimental group received one 30-minute music therapy session during an 8-hour period within 72 hours after their procedure. The music options included patient-preferred live music that encouraged relaxation through incentive-based clinical improvisation, singing, and/or rhythmic drumming, or through controlled breathing and visualization. The music therapy interventions focused on individualized treatment, where patients were encouraged to express their emotions.

Researchers primarily used visual analog scale (VAS) pain ratings before and after the interventions to measure outcomes. Secondary measurement tools included the Hospital Anxiety and Depression Scale (HADS), the Tampa Scale for Kinesiophobia (TSK), and the Color Analysis Scale (CAS).

VAS pain levels raised slightly in the control group (from 5.20 to 5.87), but the experimental group’s scores dropped by more than 1 point (from 6.20 to 5.09). The control and experimental groups’ scores on HADS Anxiety (P = .62), HADS Depression (P = .85), and TSK (P = .93) showed no statistically significant differences. Both groups saw slight increases in HADS Anxiety and slight decreases in HADS Depression.

The Human Component of Medical Treatment
The study is replicable, Mondanaro says, and could be rendered to a larger number of participants and an extended study window to shed more light on the efficacy of music therapy as an integrative treatment.

He also says continued inclusion of qualitative measures is important to capture the nuance of music therapy and the “human component of medical treatment.”

“The study delivers a solid finding that music therapy integrated into medical care of patients recovering from spinal surgery can positively impact pain reporting and increase comfort during the recovery process,” Mondanaro says. “Music therapy involving the use of live music by a therapist within a therapeutic relationship contributes to patient care outcomes because it addresses the whole person: body, mind, spirit. While this study focused on individuals recovering from spine surgery, such findings implicate that music therapy may enhance medical treatment for individuals across a range of age, diagnosis, and treatment.”

Commentary

Donald S. Corenman, MD, DC
Orthopaedic Spine Surgeon and Chiropractor
The Steadman Clinic
Vail, CO

This paper is useful for understanding pain tolerance in the post-surgical patient (or for any time period, for that matter). Pain has the capacity to overshadow day-to-day thought processes depending upon intensity. This paper indicates that pain can be brought under better control with music therapy. The individual patient can reduce the intensity of pain perception with pleasurable distraction. What is interesting is that global pain perception is reduced even when music is not present.

Music is an excellent distraction tool as long as the chosen music is favorable to that individual. For instance: If I had to listen to rap music for my recovery period, my pain tolerance would plummet, and every minute would feel like an hour.

About half of my patients already listen to their source music devices postoperatively, but I will now encourage the other half to bring their music to the hospital. All in all, a helpful paper to the treating physician.

Updated on: 03/20/18
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Donald S. Corenman, MD, DC
Orthopaedic Spine Surgeon and Chiropractor
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Vail, CO
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