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Easing Pain With Music

Posted By Prucia Buscell, Thursday, May 24, 2012

Severe burns are extremely painful, so Dr. Richard Fratianne, director emeritus of the burn unit at Cleveland MetroHealth Medical Center, figured if music therapy helped ease the pain of burn patients, it could help almost anyone.

Dr. Fratianne comes from a musical family, and he found music therapy had a profound effect on his own recovery from brain surgery to remove a tumor. Watch a Cleveland Plain Dealer video hereIn an interview on NPR’s Studio360, Dr. Fratianne explains why burn patients suffer severe pain. Scabs can’t be allowed to form, so the skin has to be broken. The burned area has to be scraped as often as three times a day, medications have to be applied and dressings have to be changed. Sedatives and tranquillizers help, he said, but only anesthesia would relieve all the pain, and the human system can’t tolerate that three times a day. Burn patients are also likely to endure intense anxiety about their condition, their prognosis and what they’ll look like after they heal.

Music requires integration of activities of many parts of the brain, Dr. Fratianne observed. Emotions, thoughts and ideas elicited by melody and lyrics, rhythms and tempos all have to be integrated simultaneously, and a trained music therapist can capture the patient’s attention—a process called entrainment—thereby actively involving the person in the music experience and diverting thoughts about pain. A patient horribly burned in the explosion of a gas grille said in the same program that listening and singing was a relief, though he still felt everything done to him during treatment. Fratianne is trying to measure patients’ stress hormones during procedures accompanied by music therapy, and he hopes scientific proof of effectiveness will eventually lead to insurance coverage. Initial studies show music can depress stress hormone levels.

Research at Glasgow Caledonian University could lead to advances in treatment of depression and physical pain, and even allow doctors to prescribe music tailored to individual need. A ScienceDaily story quotes project leader Dr. Don Knox as saying researchers want to develop a mathematical model that explains music’s ability to communicate different emotions. The analysis includes rhythm patterns, melodic range, musical intervals, length of phrases, timbre, pitch and tonality. Dr. Knox, an audio engineer, is working with music psychology professor Raymond MacDonald, who said in an interview that while perceptions of anxiety and pain can be eased when an individual listens to favorite music, certain structural features of music are important in predicting the emotional effect on listeners. The research focuses on popular music because it could have implications for the way people interact with their personal music collections and their personal players.

A WebMD story reports on research showing that being absorbed in music can provide distraction from root canals and other painful medical procedures. A PubMed item reports research showing music can reduce pain intensity and opiate requirements, but authors say the benefits are small, so the clinical importance of the study is unclear.

The University of Michigan Comprehensive Cancer Center provides musical therapy for patients, and the American Musical Therapy Association website has a video that details how music therapy helped former Rep. Gabrielle Giffords in her recovery from the bullet wound to her head. The site also lists music therapy education programs and tells how to find a music therapist.

A story in The Telegraph about the Scottish research lists songs doctors might, and might not, use therapeutically. Songs that might be used include "Comfortably Numb” by Pink Floyd, Louis Armstrong’s "What a Wonderful World,” and Gloria Gaynor’s "I Will Survive.” The maybe not list includes "The Drugs Don’t Work” by The Verve and "Another One Bites the Dust” by Queen.

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