(VICUS.COM (23 March 2000) -- Complementary
therapies will complement each other and benefit the patient only when
both are treated as equal partners in care. But can we recognize the
benefits of music therapy and chiropractic in clinical practice?
A 1999 article in Alternative Therapies in Health and Medicine
by Eric Miller and Peter Redmond presents an extensive rationale in
support of an integrative model using music therapy combined with
chiropractic spinal manipulation. Their thesis is based on
philosophical as well as physiological grounds.
They point out that there is a philosophical basis for integrating
music therapy and chiropractic. Perception is intimately linked to the
nervous system, and a relationship between spinal integrity and
consciousness exists. Furthermore, according to Miller and Redmond, as
spinal distortions diminish and awareness increases, there is a
natural attraction toward the higher or more loving state of
Chiropractor Donald Epstein, founder of the system of network
spinal analysis (NSA), has noted that "through suffering, we are
able to experience an amplification of the rhythm of self and of the
isolated alienated, repressed, denied, or ignored rhythms of
energy." Suffering, according to Epstein, "is what makes us
aware, even if not consciously, that our actions and thoughts are not
in harmony with the greater rhythms that guide our lives."
Based on this perception, the role of the music therapist then, is
to facilitate conscious awareness of the existing disparate tones and
rhythms of the body. "Conscious awareness" in this context,
does not necessarily refer to cognitive understanding. However, it is
important that the music therapist coordinate this amplification
process with the chiropractorís phase of adjustment. In other words,
this is highly individualized therapy.
Music therapy has been applied to the treatment of mental health,
emotional and social disorders, with some attention to neurological
disorders such as Parkinsonís disease. Cues that the music therapist
can use during chiropractic adjustment include respiratory rate,
somatic oscillation and muscle tonus as well as the chiropractorís
motion and rhythm during contact.
The results of preliminary research using biofeedback and music
therapy interventions with NSA indicate there are decreased levels of
sympathetic nervous system activity during adjustment as measured by
electrodermographic readings. Surface electromyograms also tend to
decline. These pilot studies suggest that the combination of NSA and
music has profound physiologic effects and can be measured in terms of
to treatment of muscle-tension headaches
It is an appealing strategy to combine music therapy with
chiropractic for improved outcomes. Unfortunately, a literature search
for peer-reviewed studies with practical outcomes such as a change in
frequency of complaint, change in time to follow-up visits or change
in range of motion revealed only one study published online at The
Chiropractic Association of South Africa website. It assessed the
combined effects of music therapy and chiropractic treatment in the
management of muscle-tension headaches.
Unfortunately, this study, as published on the Internet, is
deficient in reporting key aspects of its design. So much so that
positive results, had they occurred, would have been dismissed. It is
instructive however, to review this study as an example of the
shortcomings that can occur as a result of oversimplified mass
application of complementary interventions.
Based on available information, an unknown number of patients with
muscle- tension headaches were studied by multiple researchers.
Headaches were most commonly attributed to psychological or
occupational stress on the posterior neck musculature (i.e., an
increase in muscle tension), as measured using an electromyogram.
Music therapy considered by a majority of researchers as most likely
to be beneficial was slow baroque or classical music. It is important
to note that this decision seemed to be made at the beginning of the
study without individualized patient assessment and in the absence of
input by the patients or a music therapist.
Patients were assigned to either a control group (chiropractic
treatment) or a treatment group (music therapy and chiropractic
treatment). For the next five weeks, they received twice weekly
chiropractic manipulation and were requested to play the pre-selected
audiotape of music as often as possible. At the conclusion of
treatment, patients were requested to not receive any treatment for
their muscle-tension headache for one month.
No differences were reported between groups. Both groups showed a
decrease in the severity, duration and frequency of their headaches.
Tablet consumption by both groups decreased significantly, and there
was a significant decrease in pain disability for both groups between
the initial visit and the follow- up consultation. However, there was
no change in range of motion of the cervical spine for either group.
The researcher concluded that music therapy did not enhance the effect
of chiropractic management of muscle tension headaches.
This study stands in stark contrast to the integrative model
described by Miller and Redmond where the role of the music therapist
is to "facilitate conscious awareness of the existing disparate
tones and rhythms of the body." The potential contributions of
music therapy to chiropractic appear subtle (although potentially
significant) when applied by a qualified music therapist who works in
concert with a chiropractor to individualize therapy. This is a far
cry from giving tapes of baroque music to people and asking them to
listen as often as possible.
Complementary therapies complement each other and benefit the
patient when both are treated as equal partners in care.
Russo, Jr., PharmD, is senior vice president of medical
communications at Vicus.com. He is a pharmacist and medical writer,
with more than 20 years of experience in medical education.