Medicine for the Heart: Massage and Music

January 29th, 2010

After finding out one has to have surgery, anxiety about postoperative pain ranks high among the stressors. Indeed, the anxiety itself is believed to increase pain levels and may be a contributor to postoperative distress. Heart surgery ranks high in patient apprehension, but massage and music therapies have been shown to lessen anxiety and reduce the need for pain medication.

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Despite the ever-growing pharmacy of pain killing drugs available, postoperative pain is something no one looks forward to. If the surgery is to be performed on the heart, perhaps the most vital of organs, one can add overwhelming anxiety to the experience as well. As massage therapists in training, we are told over and over again not to give a massage on someone who has recently undergone surgery, but more studies suggest that massage therapy given subsequent to surgery is beneficial in patient recovery and – perhaps most importantly – reduction in both pain and anxiety.

Massage Therapy Eases Post-Surgical Pain

A Mayo Clinic study conducted over a period of five months, showed so much of a reduction in post-surgical pain, they hired a full-time massage therapist to be available for patients after heart surgery. Approximately half of the 58 patients who participated in this original pilot study received massage. On a 10-point scale of pain, those who received massage had a mean pain score of less than one, while those who did not receive massage had an average score of three. In addition to the massage therapy, the Mayo Clinic has been looking into the advantages of other complementary therapies, including ambient music and guided imagery, both of which have shown to have a positive effect of patients recovering from surgery.

The Department of Veterans Affairs, VA Ann Arbor and Indianapolis Healthcare Systems conducted an even larger study involving 605 veterans, male and female, over a period of two years who had undergone major surgery (thoracic or abdominal). They were assigned to one of three groups. Approximately one third received routine care, as well as a daily 20-minute effleurage back massage each evening for up to five days. A second group got individualized attention, but no massage; and the remaining group got only standard routine care.

The purpose of the study was to see how massage and/or individualized support affected recovery after major surgery. Compared to the groups who received no massage, those who did receive massage experienced a faster rate of decreased pain intensity, pain unpleasantness and a reduction in anxiety in the first four days after surgery.

Music Reduces Pain and Anxiety

While music was not used in the above two studies, its use both pre and postoperatively has also shown to be helpful in the reduction of pain and anxiety surrounding surgery. Many studies have been conducted by the Touch Research Institute in Miami indicating that ambient music has been helpful in the reduction of cortisol levels. High cortisol levels are often present in a person with high levels of stress, anxiety and pain. At least one study consisting of 10 minutes of hand massage and music was effective in reducing agitation in a group of elderly participants.

The American Music Therapy Association’s studies on pain management and anxiety have also been successful in showing how the use of music results in measurable physiological changes, including lower blood pressure, improved cardiac output, reduced heart rate and relaxed muscle tension both pre and postoperatively.

Even though prescription painkillers are available to patients after surgery, pain is often under treated. Some patients may fear dependency or are concerned about side effects. Some may simply be uncomfortable asking, not wanting to bother anyone. There may even be doctors or nurses who lack a certain responsiveness with regard to pain management. The use of massage and music therapies supplemental to prescribed medications may be one of the best adjuncts to alleviate pain, as well as addressing the individual needs of the patient.

Massage and music therapies may not eliminate the need for prescription pain medication entirely, but it may result in lower doses or medication used for a shorter duration of time. It would seem as though the partnership of massage and music therapies can have a significant effect on both the psychological and physiological conditions connected with surgery. Reduction of anxiety and postoperative pain is important, especially in the recovery of those who have undergone cardiac surgery.

Editor’s Note: Precaution should still be taken if someone who recently had major surgery requests a massage through your private or group practice. Postoperative massage should have clearance from the person’s physician and be performed under medical supervision in a hospital setting.

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References

“Cardiovascular Surgery Healing Enhancement Program – Treatment Options.” 2008. Mayo Clinic. December 16,2008 http://www.mayoclinic.org/cv-surgery-healing-enhancement/.

“Massage May Help Ease Pain and Anxiety After Surgery.” Science Daily. December 18, 2007. 16 Dec 2008 http://sciencedaily.com/releases/2007/12/071217162531.htm.

“Mayo Researchers: complementary therapies help patients recover after heart surgery.” EurekAlert!. October 31, 2007. 16 Dec 2008 http:/www.eurekalert.org/pub_releases/2007-10/mc-mrc103107.php.

Mitchinson, Allison R. MPH, NCTMB, et al. “Acute Postoperative Pain Management Using Massage as an Adjuvant Therapy.” Archives of Surgery 142:12 (2007): 1158-1167.

“Music Therapy Research Abstracts.” 2008. Touch Research Institute. 16 Dec 2008 http:/www6.miami.edu/touch-research/Music.htm.

“Music Therapy in the Treatment and Management of Pain.” 2008. American Music Therapy Association, Inc. 16 Dec 2008 http://www.musictherapy.org/factsheets/MT%20Pain%202006.pdf.

About the Author

Linda Fehrs, LMT

Linda Fehrs, AAS, LMT is a freelance writer and massage therapy professional licensed by the New York State Department of Education. She is a professional member of the American Massage Therapy Association and the New York State Society of Medical Massage Therapists. Ms. Fehrs has actively practiced massage therapy in the Mid-Hudson Valley since 2002 with a focus on those with special needs, such as developmental and physical disabilities. She is a graduate of the Hudson Valley School of Massage Therapy as well as a former instructor at the school. Prior to becoming a massage therapist she was former managing editor of a weekly community newspaper and is a veteran of the U.S. Navy. Ms. Fehrs currently volunteers with the Red Cross, helping to educate others about emergency preparedness and disaster relief.