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Slate's Medical Examiner: Music as Pain Relief


From NPR News, it's DAY TO DAY. For patients recovering from surgery, extreme pain usually calls for strong medication. But powerful drugs often can bring serious side effects. Painkillers derived from morphine can be addictive. The arthritis medication, Vioxx, was pulled from the market after studies showed it increased the risk of heart attack and stroke. But there is a pain killer that needs no warning label, and that is music.

Dr. Sydney Spiesel of the Yale Medical School is here to tell us about a study that looks at music's potential to relieve pain. Dr. Spiesel is the medical contributor for the online magazine, Slate. Welcome back, sir.

Dr. SYDNEY SPIESEL (Yale Medical School): Thank you.

ADAMS: Tell us how widespread this study is. How far reaching is it?

Dr. SPIESEL: Well, this study was actually a compilation of studies. The man who did it, Dr. Sapada(ph)--practices both in the country Columbian in Bogotá, and practices in Boston--put together a total of 51 different papers involving actually more than 3,500 patients that all tried to examine and tease out the value of music for pain relief.

ADAMS: 3,500 patients. That's quite a bit. They were looking at music as relief for pretty serious pain. How can you possibly tell if the music is having an effect? How does that work?

Dr. SPIESEL: Well, there are two ways. I mean, first of all, they actually looked at a wide variety of different kinds of pain: acute pain, chronic pain, pain of cancer, pain of labor, pain that happens when a ham-handed doctor tries to put an IV in and does it badly. And the first thing you can do for some of those sort of acute pains, you just ask the patient. Tell me on a scale of one to ten how much does it hurt? If you're doing something to a baby and some of these were addressed to babies, you just look at the baby's face and you see if there's a difference in babies listening to music compared with babies not listening to music in the face they make when you put in an IV or something.

ADAMS: So they play the music and they just look and take subjective results.

Dr. SPIESEL: Well that's one of the ways. But there're also objective ways of measuring pain. One of them is to say, well, we've got this patient who is a post-operative patient and we're going to give them the ability, as we often do, to pick their own amount of--let's say morphine they're getting after surgery. And if they select a lower dose while they're listening to music, it suggests that the music offers some pain relief.

ADAMS: Now, according to the study, your favorite music--you would think that would be what you would want. Let's say you're in the dentist chair. But the study says that that's not necessarily so. Explain that to us.

Dr. SPIESEL: Well, I can't explain it. It was just an interesting observation that if patients were allowed to pick music, the effect was hardly there.

ADAMS: Hmm. Maybe it's something in your mind that makes you engaged with this music that you don't like in a way that you wouldn't with something if you're listening to Adagio for strings by Samuel Barber and you like it, maybe that's just too easy.

Dr. SPIESEL: Sure. Or it may be that you're more tuned, and you're listening more closely to music which is unfamiliar rather than the music that you would have chosen because it was so familiar to you.

ADAMS: Right. So do you think it really works?

Dr. SPIESEL: Well, the answer is it clearly really works sort of.

(Soundbite of laughter)

ADAMS: That's a good way to put it.

(Soundbite of laughter)

Dr. SPIESEL: You know, it's clear that in most of the studies there was some improvement. In some of them, it showed maybe a 20 percent decrease in the need for drugs after surgery. But, it's hard to know how important that is as an effect.

ADAMS: The opinions of Dr. Sydney Spiesel. Dr. Spiesel is a practicing pediatrician and contributor to Thank you, sir.

Dr. SPIESEL: Thank you. Always a pleasure to be here. Transcript provided by NPR, Copyright NPR.