A recent study conducted at five Cleveland hospitals has found that heavy doses of music and relaxation can significantly reduce patients' pain following surgery. The research team, working with a $709,480 grant from the National Institutes of Health, studied 500 patients aged 18-70 over a 29-month period, testing the effect of therapy during the first two days following surgery. The study results were recently published in Pain, the journal of the International Association for the Study of Pain.
One group of patients used a jaw-relaxation technique, another group listened to music and a third group used a combination of relaxation and music. A control group received nothing. The participants were able to dose themselves with morphine or Demerol by pressing a button connected to their intravenous pumps. To ensure the credibility of the study, a computerized program was used to verify that all the patients shared similar characteristics in regard to demographic factors, gender, pain history, medication use and type of surgery.
Marion Good, assistant professor of nursing at Case Western Reserve University, led the study. Good and her team of researchers measured the patients' pain before and after 15 minutes of bed rest and four times during ambulation, when patients were asked to rank their level of pain on a numerical scale. The results showed that the three treatment groups "had significantly less pain than the control groups," according to Good.
The patients treated with music were offered choices of harp music, piano, synthesizer, orchestra, or slow jazz. So would the therapy still work if your personal taste runs more toward, say, AC/DC? "Well, we think it's important to have choices," Good says. "What you like for dancing, you might not like for post-operative pain. But if you want to try it, fine."
Every year, 23 million people in the United States undergo surgery. Postoperative pain can hamper recovery by aggravating surgical stress and increasing tissue breakdown, coagulation and fluid retention. Pain also interferes with appetite and sleep and can lead to complications that prolong hospitalization.
Dr. Steven Tovian, director of health psychology at Evanston-Northwestern Healthcare in Chicago, has studied the psychological effects of postoperative recovery. He believes that music can directly counteract pain's physiological effects. "Post-surgery pain is stressful," he says. "We know that stress elevates the pulse, and we know music lowers the pulse. Blood pressure goes up postsurgery, and music can lower blood pressure. After surgery, the muscles are tense, and stress hormones get into the blood -- music can reduce the effect of all that."
But does music actually relieve the pain, or is it simply a distraction from the suffering? Both, possibly. "It's a distraction," Good says. "But it also acts on the neurological pain impulses" to slow down their transmission.
"Music generates alpha brain waves for better relaxation," Tovian says. "It makes good sense to use [music and relaxation] both postoperatively and preoperatively. Getting people to relax is always beneficial." Discussing music as a stress-buster, Tovian points to the huge sales of the Gregorian chant CD that became the preferred soundtrack for R&R in the last decade. But pain will always be painful, Tovian says, and you can't expect a musical miracle. "Just know what your expectations are."
Still, a little music can go a long way. Good believes that, for patients using music and relaxation techniques to recover from surgery, the positive effects can carry over into everyday life. "These patients may be learning a technique that can be useful for the rest of their lives."