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 wait in emergency rooms and surgery waiting rooms (The benefits of music in hospital waiting rooms. Routhieaux RL. Tansik DA. Health Care Supervisor. 16(2):31-40, 1997 Dec., Emergency department waiting room stress: can music or aromatherapy improve anxiety scores?. Holm L. Fitzmaurice L. Pediatric Emergency Care. 24(12):836-8, 2008 Dec. [Case Reports. Evaluation Studies. Journal Article] Music while you wait. Patient acceptance of music in the preanesthetic period. Verheecke G. Troch E. Acta Anaesthesiologica Belgica. 31(1):61-7, 1980. [Journal Article]. Because music is so diverse in style, it is important to consider specific forms to evaluate the impact on patient perception. For instance, the genre of classical 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 living body by comparing the difference of influence on heart rate variability and comfort when subjects listen to music and are exposed to noise. They used rock, classical music and noise in the experiment. The following conclusions were made from the findings of the research: 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 being 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, they found that classical music tends to cause comfort and rock music and noise tend to cause discomfort. 3) A correlation was found 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 (J Hum Ergol (Tokyo). 1998 Dec; 27(1-2):30-8.Influence of music on heart rate variability and comfort–a consideration through comparison of music and noise.Umemura M, Honda K.Department of Management Science, Science University of Tokyo, Shinjuku-ku, Tokyo, 162-8601 Japan).
Furthermore, in 2006, Cepeda MS., Carr DB.nd Lau J. Alvarez H. in their literature review of music for pain relief ( Cochrane Database of Systematic Reviews. (2):CD004843, 2006.), found that when patients were able to select their own music there was no decline in pain intensity. However, significant pain relief was noted in four studies which reported the proportion of subjects with at least 50% pain relief; subjects exposed to music had a 70% higher likelihood of having pain relief than unexposed subjects. Moreover, they found post surgical patients who were exposed to music required between 15% to 18% 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 seems clear that music is impactful 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 commonly 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 (Music and Medicine, July 2010; vol. 2, 3: pp. 174-181., first published on June 25, 2010). 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.
In his article, Reflex effects of subluxation: the autonomic nervous system (Journal of Manipulative & Physiological Therapeutics. 23(2):104-6, 2000 Feb), Budgell 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 goes on to discuss 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 Redmond noted in their article, Music therapy and chiropractic: an integrative model of tonal and rhythmic spinal adjustment (Alternative Therapies in Health & Medicine. 5(2):102-4, 1999 Mar) that 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 go on to 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 serves as a starting point for the use of rhythm in the healing process. They finally state that the power of music can be used as a significant tool in chiropractic work to aid individuals in their healing process.
For a more practical application and clinical reference, anecdotal references will hopefully shed more light on the importance of including music as an integral part of chiropractic treatment. This story is about patient “CT”. CT was a 43 year old white male who was diagnosed with rectal cancer in February 2012. His course of treatment consisted of surgery followed by radiation. CT received adjunct therapy throughout his oncology treatment; including rehabilitation exercises, acupuncture, Reiki therapy, massage therapy, Mind-Body Medicine (included guided imagery), naturopathic and nutritional supplementation and chiropractic care. The patient was carefully monitored for any side effects of treatment. After surgery, CT received six weeks of radiation daily. At the completion of treatment, the patient reported that all the integrative support he received played a key role in his accelerated recovery from surgery and that he experienced minimal side effects his daily radiation treatments. He also attributed a major part of his treatment success to his chiropractic treatment which he received three times per week. He went on to report that during his initial visit, the chiropractor offered to play his choice of music genre on Pandora.. The patient, a practicing Hindu, requested chanting and stated that he believed that this opportunity facilitated and expedited his healing process and assisted in keeping his body, mind and spirit in a state of optimal wellness.
Moreover, music healing is not by any means genre specific, as emphasized by story of patient BB. BB was a 63 year old man diagnosed with adenocarcinoma of the head of the pancreas in May 2012. The patient had been a physical laborer most of his life and had a history of low back pain with stenosis and degenerative disk disease. The patient used a cane daily to help abate his pain during ambulation. During the patient’s cancer treatment, he experienced an exacerbation of back pain and requested to be seen by the chiropractor. The chiropractor took a genre request for music from the patient. The patient asked for blue grass. The music seemed to help the patient transcend from his state of pain during the treatment (which consisted of flexion distraction and drop adjustments). At the completion of his adjustment, the patient sprung up from a prone position, stood up, shook the doctors and headed out the door and down the hall for his wife. The chiropractor quickly chased after yelling down the hall, “Sir, you forgot your cane!”
In conclusion, the knowledge that chiropractic has always been a patient centered (not disease centered) healing arts profession brings to light the need to offer patients any natural and available means of healing. Chiropractic will most likely continue to be the standard course of correcting subluxation. However, using music in concert 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 chiropractors but all healthcare providers to furnish treatment rooms with media that allow for patient to be their own DJ.
By: Jeffrey A. Sklar, D.C., Eastern Regional Director of Chiropractic for Cancer Treatment Centers of America®