Sound therapy: does it really work for back pain?
Sound therapy is non-invasive. It is effective because it treats the true source of pain – the brain. A recent study about sound therapy published in the scientific journal, Nature, makes some fascinating observations about the impact sounds have on how someone perceives their back pain, or specifically stiffness in the lower back.
The researchers started out with an interesting, counter-intuitive hypothesis that the pain or stiffness was not coming from the affected part of the back:
By showing that feelings of stiffness do not relate to biomechanical stiffness measures and that biomechanical measures of stiffness do not differ between those with and without feelings of stiffness, this suggests that information other than actual joint stiffness is influencing this perceptual inference.
The researchers undertook three tests with small groups of patients, and control groups too. One of the experiments involved applying pressure to the injured lower back whilst playing sounds. When their study participants heard negative sounds, they perceived more pain than what was actually being applied.
One of the sounds was creaking, like an old house with a heavy wooden door that no longer fits the frame. In response to the sound, people felt more tense and defensive and thus rated the stiffness in the back as higher.
As expected by the researchers, when a gentle whooshing sound was played, like softly falling water, the participants bodies took on the buoyancy and relaxation communicated in the sound and they responded considerably less to forces being inflicted on them by the researchers.
The study concluded that:
Feelings of back stiffness are a protective perceptual construct, rather than reflecting biomechanical properties of the back. This has far-reaching implications for treatment of pain/stiffness but also for our understanding of bodily feelings.
If sounds can increase and decrease your perception of pain, what can words do?
Medical advice coming out the USA tells us that words can influence how we think about and respond to back pain. The words doctors choose to discuss a medical condition, to how people discuss their pain among colleagues and family alters the way the brain perceives the injury. A focus on the negative sets off a ripple effect of catastrophisation, but a focus on the positive promotes calmness and objectivity.
At a recent conference for medical insurers, claim handlers were being encouraged to reframe their language with injured workers to help reduce the expense caused by back injuries. Presenters suggested making substitutions for common words and phrases. For example, swapping a conversation about the “intensity of pain” to the “recovery process”. Or, instead of talking about “pain”, say “progress”, and frame the purpose of treatment in the positive, “to return life to normal” rather than the less enticing prospect of “getting back to work”. With the focus on recovery, the patient isn’t left dwelling on how bad the situation is, rather, the process of returning to their usual self.
Mary O’Donoghue from MedRisk Inc in Boston believes that “an overlooked element of the injury is what is going on in a suffering worker’s head. The medical is easier; it’s more black and white. But getting inside the psychosocial is very gray, yet that’s not a reason to shy away from it.” What medicine may have been missing for years in the crucial psychological component that empowers a person to get better by treating brain – the true source of pain and recovery.
