Music For Educators and Trainers

Whole-Body Vibration Within Specified Frequency Range May Provide Pain Relief

DENTON, Tex-Music has long been used, albeit unscientifically, to relax patients in an effort to relieve pain. Now, a researcher from the University of North Texas College of Music is attempting an approach to music therapy that involves vibration and appears to have a neurophysiologic mechanism of action.

In his poster presentation at the 8th World Congress on Pain, Kris S. Chesky, PhD, said that the technique involves music listening for psychological effect and, for physiological effect-- music-generated whole-body vibration, with the amplitude and frequency of the vibrations controlled and measured via a device called the Music Vibration Table.

"Animal studies suggest that vibration above 60 Hz has the potential to decrease the amount of processing in the spinal cord of pain stimuli, an effect that is mediated chemically through the neural transmitter adenosine," Dr. Chesky said.

The key is the Pacinian corpuscle, a large vibration-sensitive mechanoreceptor located throughout the subcutaneous and connective tissues surrounding visceral organs and joints. This corpuscle starts to react to frequencies of 60 Hz and above. "Below that frequency, a different receptor is responding, so frequencies below 60 Hz can be used as controls in studies of the vibration table," he said.

Music is not essential for vibration-induced analgesia, as long as the levels of vibration are in the 60 to 300 Hz frequency range at amplitudes of less than 100 µm at 100 Hz. However, Dr. Chesky believes its use is important because it provides variation to the vibration. This, he says, can decrease patient fatigue and habituation of Pacinian corpuscle processing, while also making the vibration meaningful to the patient.

Dr. Chesky's vibration table has been tested in a randomized, double-blind, placebo-controlled study in fibromyalgia patients at the University of Texas Health Science Center at San Antonio. Results were favorable, and the study has been accepted for publication in the Journal of Musculoskeletal Pain. The technique has also been used on an on-call basis to help relieve pain in children in sickle cell crisis. Dr. Chesky emphasized the need for more rigorous controlled clinical trials of the technique.

An ongoing pilot project at Cooks Fort Worth Children's Medical Center involves a new strategy to use vibration prior to surgery. "Our assumption was that if we established the central state associated with vibration-induced analgesia just before surgery, it might have some preemptive analgesic value," Dr. Chesky said.

Research suggests that surgical trauma causes the neurons to become more sensitive to incoming pain signals, while vibration-induced changes cause them to be less sensitive to such signals. "If the neurons are less sensitive prior to surgery, they may also be less sensitive after surgery, thus reducing postoperative pain," he said.