(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 consciousness.

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 chiropractor’s 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 Parkinson’s disease. Cues that the music therapist can use during chiropractic adjustment include respiratory rate, somatic oscillation and muscle tonus as well as the chiropractor’s 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 standard stress.

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.

John 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.