A recent study published in the Journal of Pain Research has found that music therapy helps patients with sickle cell disease cope with pain. Sickle cell disease is a serious global burden, affecting millions of people around the world. It is most common in Africa, the Middle East, and India. While the exact number of people with sickle cell disease in the United States is unknown, estimates put the number around 100,000, which disproportionately affects Black individuals at about one out of every 365.
Patients with sickle cell disease can experience severe chronic pain, which can require hospitalization in some cases. Along with chronic pain, people with sickle cell are also at risk for serious health issues such as anemia, stroke, and organ damage. To better understand the implications of this study, it’s first important to understand what sickle cell disease is, and how it can cause chronic pain.
What Is Sickle Cell Disease?
Sickle cell disease, sometimes referred to as sickle cell anemia, is a group of inherited red blood disorders. The condition affects the shape of red blood cells, which are responsible for carrying oxygen to all parts of the body. Typically, red blood cells are round and flexible, which allows them to move easily within the blood vessels. In someone with sickle cell disease, some red blood cells become shaped like sickles or crescent moons. Along with taking on a new shape, these cells also become rigid and sticky, which can slow or even block blood flow.
Since sickle cell disease is an inherited condition, symptoms typically appear around six months of age. Depending on the type and severity of sickle cell disease, these symptoms can vary or change over time. One of the major symptoms of sickle cell is periodic episodes of extreme pain, called pain crises. This happens when sickle-shaped red blood cells block blood flow through tiny blood vessels to the chest, abdomen, and joints.
Pain crises can vary in intensity and can last from a few hours to several days. Some people may only experience a few pain crises a year, while others may experience a dozen. It is fairly common for some adolescents with sickle cell disease to develop chronic pain, which can result from bone and joint damage, ulcers, and other symptoms of the condition.
This frequent battle with pain is what scientists from the University Hospitals Connor Whole Health set out to study. What they found was that music therapy could serve as an effective alternative treatment for sickle cell pain. But, what is music therapy, and how can it help with pain? Let’s take a look.
Understanding Music Therapy
Music therapy is an evidence-based treatment that has been shown to help with a variety of disorders through the use of music. Along with its newfound use for sickle cell pain, music therapy has been shown that music therapy can help patients with cardiac conditions, depression, autism, substance abuse, and Alzheimer’s disease. Other studies have demonstrated the therapy’s effectiveness with memory, lowering blood pressure, improving coping, reducing stress, and improving self-esteem.
Formal music therapy was first defined and used by the United States War Department in 1945. It helped military service members recovering in hospitals with occupational therapy, education, recreation, and physical reconditioning. Since then, music therapy has been used by healthcare professionals throughout the medical discipline and has shown real, measurable success for thousands of people.
Music therapy can involve several different aspects of music. During a standard session, a patient may listen, sing, compose, or create music, all of which have different uses and effects. Using these various approaches, the team from UH Connor, led by Samuel Rodgers-Melnick, MT-BC, a music therapist and integrative health research and data specialist with UH Connor, has been providing music therapy to hundreds of adults with sickle cell disease for the past decade.
How Music Therapy Can Improve Pain
The study, named MUSIQOLS, evaluated a six-part music therapy intervention that integrated in-person music therapy sessions with exercises such as music-based breathing, progressive muscle relaxation, imagery, and active music-making. It was comprised of 24 patients with sickle cell disease, all of whom had self-reported severe chronic pain.
Rodgers-Melnick said this mixed-methods randomized controlled trial, “Allowed us to enhance our understanding of participants’ daily pain, experience with the music therapy exercises, and perceived acceptability of the music therapy intervention.”
Participants were randomly assigned to either a six-part, in-person music therapy intervention or a waitlist control group. Those who were selected to be in the music therapy group were subjected to education and music-based exercises that were personalized to their preferred music genres. All participants completed daily electronic pain diary entries, as well as quality-of-life measures before and after study conditions.
At the conclusion of the nearly eight-year study, Rodgers-Melnick and his colleagues interviewed the music therapy group to see if it had any improvement in their pain levels.
“As evidenced by the content of the qualitative interviews, it appears participants gained new self-care skills through the music therapy interventions, which led to improvements in their perceived ability to manage pain from sickle cell disease. When patients experienced pain at home, they could utilize the music exercises in such a way that pain was not as burdensome to their daily lives,” he said.
Rodgers-Melnick says that he believes having a tool that can produce a relaxation response played a key, valuable role in helping patients manage their pain. He added that further research is needed to investigate patients’ physiological responses to MUSIQOLS.
Bottom Line on Music Therapy for Sickle Cell Disease
While studies such as the one conducted by Rodgers-Melnick and UH Connor are compelling, there is still much more work to be done before music therapy can be declared a definitive treatment for sickle cell disease pain.
“We plan to continue this research in settings outside University Hospitals to determine whether demonstrated improvements persist at 6 months and 1 year after intervention; whether the use of music exercises influences the use of pain medication; whether early intervention with music therapy influences the development of chronic pain in youth with sickle cell disease; and the comparative effectiveness of music therapy virtually vs. in person,” said Rodgers-Melnick.
He said that he and his team have recently begun a quality improvement initiative at the university to screen youth between the ages of 8 and 18 with sickle cell disease for chronic pain. Using this data, Rodgers-Melnick says they hope to recruit some of these patients to investigate the use of virtual music therapy.
Studies such as these are an important step toward helping patients manage chronic pain without opioids or other medications.
“Our research over the past 8 years supports the efficacy of music therapy for addressing both acute and chronic pain in adults with sickle cell disease, but more research is needed across integrative modalities to best optimize treatment,” said Rodgers-Melnick.
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