MUSIC IS COMMONLY HEARD IN THE LOBBIES AND WAITING ROOMS of doctors’ offices. Current literature reports how music facilitates stress reduction in patients while they sit in emergency and surgery waiting rooms.1,2,3
Because music is so diverse, it is imp ortant to consider specific forms to evaluate the impact on patient perception. For instance, the classical genre can be very relaxing. In 1998, research from the Department of Management Science, Science University of Tokyo looked at the influence of music on the body by comparing the difference of influence on heart rate variability and comfort when subjects listen to music and are exposed to noise. Researchers used rock, classical music and noise. The following conclusions were made:4 1) Hearing classical music results in a small variance of Mayer wave-related sinus arrhythmia (MWSA) component and respiratory sinus arrhythmia (RSA) component compared with a body at rest. This is because the sympathetic nerve is suppressed by the sound of classical music. With rock music and noise, however, the MWSA component increases and the RSA component decreases. 2) From a psychological evaluation, classical music tends to cause comfort, while rock music and noise tend to cause discomfort. 3) A correlation exists between the balance of the MWSA component and the RSA component and the psychological evaluation. As the comfort increases, the variance of MWSA decreases; as discomfort increases, the variance of MWSA increases.
Music for Pain Relief
A 2006 systematic review of the literature5 found that when patients are able to select their own music, there is no decline in pain intensity. However, significant pain relief was noted in four studies that reported the proportion of subjects with at least 50 percent pain relief; subjects exposed to music had a 70 percent higher likelihood of having pain relief than unexposed subjects. Moreover, researchers found post-surgical patients who were exposed to music required between 15 percent and 18 percent less opioids than patients who were not exposed.
Researchers at the Institute of Music and Neurologic Function, a non-profit research center founded in 1995 in New York City, study music’s extraordinary power to awaken, stimulate and heal as they work with severely disabled patients at the Beth Abraham long-term residential care facility. Concetta Tomaino, DA, a board-certified music therapist and the institute’s director, has seen music decrease agitation and stimulate memory in patients with dementia, help stroke patients recover the power of speech, strengthen muscle groups and increase range of motion in patients beyond the help of traditional rehabilitation.
It is clear that music makes an impact in the healing process. In addition to reducing heart rate (or increasing the heart rate depending on the genre), music may be applied to assist with some common side effects that cancer patients experience with chemotherapy. Maria Montserrat Gimeno investigated the effects of music and imagery versus imagery-only interventions on inducing relaxation and reducing nausea and emesis in cancer patients undergoing chemotherapy treatment.6 She found a significant decrease in the frequency of nausea and emesis over time, that is, across the six weeks of treatment. Because vomiting is more of a parasympathetic function than sympathetic, it is fair to say that music may offer positive effects in either activating or blocking the sympathetic or parasympathetic pathway depending on the desired applications and outcomes.
Music and Chiropractic
In 2000 in the Journal of Manipulative & Physiological Therapeutics, researcher Budgell7 states that it is the collective experience of the chiropractic profession that aberrant stimulation at a particular level of the spine may elicit a segmentally organized response, which may manifest itself in dysfunction within organs receiving autonomic innervation at that level. He discusses how this belief about the potential for somatic stimulation of spinal structures to affect visceral function has been at odds with classical views. However, after a major recent review of the literature on the influences of somatic stimulation on autonomic function and from recent original physiologic studies concerning somatoautonomic and spinovisceral reflexes, Budgell found that current neuroscience research supports a neurophysiologic rationale for the concept that aberrant stimulation of spinal or paraspinal structures may lead to segmentally organized reflex responses of the autonomic nervous system, which in turn may alter visceral function.
In exploring the application of music alongside chiropractic care, Miller and Redmond8 noted there is a philosophical basis for the integration of treatment using music therapy and chiropractic. Perception is intimately linked to the nervous system. A relationship between spinal integrity and consciousness does exist.They noted that as spinal distortions diminish and awareness increases, there is a natural attraction toward the higher or more loving state of consciousness.They say that rhythms of healing and suffering are a key concept in combining music therapy with chiropractic manipulation. Although this is conceptual, they subscribe to Donald Epstein’s model of the rhythmic stages of consciousness corresponding to prescribed physiological patterns that serve as a starting point for the use of rhythm in the healing process. They state that music can be used as a significant tool in chiropractic work to aid healing.
For a more practical application and clinical reference, anecdotal references shed light on the importance of including music as an integral part of chiropractic treatment: for example, patient CT, a 43-year-old white male who was diagnosed with rectal cancer in February 2012. His treatment consisted of surgery followed by radiation. CT received adjunct therapy throughout his oncology treatment, including rehabilitation exercises, acupuncture, Reiki, massage, mind-body medicine (included guided imagery), naturopathic and nutritional supplementation and chiropractic care. The patient was monitored for side effects. After surgery, CT received six weeks of radiation daily. At the completion of treatment, the patient reported the integrative support played a key role in his accelerated recovery from surgery and he experienced minimal side effects from his radiation treatments. He also attributed a major part of treatment success to chiropractic, which he received three times per week. He reported that during his initial visit, the chiropractic physician offered to play his choice of music genre on Pandora. The patient, a practicing Hindu, requested chanting, and he believes that this expedited his healing process and assisted in keeping his body, mind and spirit in a state of optimal wellness.
Music healing is not by any means genrespecific, as emphasized by the story of patient BB, a 63-year-old man diagnosed in May 2012 with adenocarcinoma of the head of the pancreas. The patient was a physical laborer most of his life and had a history of low-back pain with stenosis and degenerative disk disease. He used a cane daily. During his cancer treatment, he experienced an exacerbation of back pain and requested to be seen by the chiropractic physician. The DC took a genre request for music from him. The patient asked for bluegrass. The music seemed to help him transcend his state of pain during treatment (i.e., flexion distraction and drop adjustments). At the completion of his adjustment, the patient sprung up from a prone position, stood up, shook the doctor’s hand and headed down the hall. The chiropractic physician chased after him, yelling, “Sir, you forgot your cane!”
The knowledge that chiropractic is a patient-centered (not disease-centered) healing arts profession brings to light the need to offer patients any natural and available means of healing. Using music in combination with the adjustment may be a method for improving the effectiveness of the treatment as well as patient satisfaction. With the innovation of websites like Pandora, and the evidence-based literature that music can facilitate many positive physiological aspects of being, there should be mindful efforts made by not only DCs but all healthcare providers to furnish treatment rooms with music.
1. Routhieaux RL, Tansik DA. The benefits of music in hospital waiting rooms. Health Care Supervisor.16(2):31-40, 1997 Dec.
2. Holm L, Fitzmaurice L. Emergency department waiting room stress: can music or aromatherapy improve anxiety scores? Pediatric Emergency Care. 24(12):836-8, 2008 Dec.
3. Verheecke G, Troch E. Music while you wait. Patient acceptance of music in the preanesthetic period.Acta Anaesthesiologica Belgica. 31(1):61-7, 1980.
4. Umemura M, Honda K. Influence of music on heart rate variability and comfort—a consideration through comparison of music and noise. J Hum Ergol (Tokyo). 1998 Dec; 27(1-2):30-8. Department of Management Science, Science University of Tokyo, Shinjuku-ku, Tokyo, 162-8601 Japan.
5. Cepeda MS, Carr DB, Lau J, Alvarez H. Literature review of music for pain relief. Cochrane Database of Systematic Reviews. (2):CD004843, 2006.
6. Montserrat Gimeno, M. The Effect of Music and Imagery to Induce Relaxation and Reduce Nausea and Emesis in Patients With Cancer Undergoing Chemotherapy Treatment. Music and Medicine. July 2010 vol. 2 no. 3 174-181, first published on June 25, 2010.
7. Budgell, B. Reflex effects of subluxation: the autonomic nervous system. Journal of Manipulative & Physiological Therapeutics Volume 23, Issue 2, Pages 104–106, Feb 2000.
8. Miller EB, Redmond P. Music therapy and chiropractic: an integrative model of tonal and rhythmic spinal adjustment. Alternative Therapies in Health & Medicine. 5(2):102-4, 1999 Mar.