studies – Skillfully Well & Painfully Aware

Listening to music can reduce pain, improve functional mobility, increase sleep quality, and reduce depression in people with fibromyalgia.

How Listening to music improves fibromyalgia

It is a truth universally acknowledged that we may not all like the same music, but we all like music. Our favourite artists help us celebrate the good times, express our emotions in the difficult times, and while away the time in between.

I’ve seen many article headlines, written by authors with chronic illnesses, acknowledging the role that music has played in helping them get through flare-ups, and other health problems. I’m not going to lie though, around the time that I was diagnosed, I mostly stopped listening to music on my own. You know how a song can carry you back to a moment in your past, like a soundtrack to your memories? Well, I didn’t want to be transported back to a time when I was healthy and free, by listening now to the music I played then. I also didn’t feel like finding new music. I’m not sure why, except that I didn’t feel that certain joie de vivre it takes to explore new things in life.

Research on the Impact of Music on Fibromyalgia

Then, I came across a study that made me rethink this choice: Listening To Music Can Reduce Chronic Pain And Depression By Up To A Quarter.[1] Researchers found that when people with chronic pain listen to music for an hour a day, they experienced up to a 21% reduction in pain and a 25% reduction in depression. Another important finding was that listening to music made participants feel less disabled by their condition and more in control of their pain. It did not appear to matter whether individuals listened to their favourite music or relaxing music selected by the researchers.

I decided to do some further research to find out whether these findings applied to fibromyalgia. It seems that I wasn’t alone in asking that question. Several studies have investigated the impact of music on fibromyalgia.

A recent study looked at whether listening to a relaxing water and wave sound CD could reduce pain in individuals with fibromyalgia. There was a significant reduction in pain levels among participants who listened to the CD over a two week period, compared to a control group who did not listen to music at all. The study concluded by recommending music therapy for pain management in patients with fibromyalgia.[2] That’s an exciting finding, but since I don’t have access to the exact CD used in the study, how can I take advantage of these findings? I decided to delve a little bit deeper.

A second study investigated whether listening to your favourite music can reduce your pain levels if you live with fibromyalgia. One caveat of this study is that the self-chosen music was relaxing and pleasant. The study found that pain did indeed decrease after listening to music, becoming less intense and less unpleasant.[3] In addition, participants who listened to music also experienced improvements in their functional mobility, measured by the ease of getting out of a chair and walking. This effect lasted even after the music stopped. This suggests that music might be able to help individuals with fibromyalgia perform everyday activities more easily because of its pain relieving effects! Patients in the control group, who listened to “pink noise” (the sound of static) did not experience pain reduction.

But pain isn’t the only unwelcome fibromyalgia symptom. What about sleep? Listening to music designed specifically to improve sleep was found to be effective in a small study of patients with fibromyalgia. After four weeks of listening to the music at bedtime, individuals reported significant improvements in sleep quality.[4] The sleep music was embedded with delta sound waves, which pulsate within specific frequencies of brain wave activity that are associated with deep sleep (0.25-4 hz). Delta brain waves, which are the slowest type of brain wave, are associated with deep sleep. Listening to delta sound waves is thought to stimulate the production of delta waves in your brain. While this may sound like high tech science, unavailable to the average patient, finding this music is as simple as searching for “sleep music delta waves” in YouTube. Personally I have found this really valuable for falling asleep, getting back to sleep and resting during the day.

Why Music Improves Fibromyalgia Symptoms

The nerd in me wanted to know why music seems to have this pain relieving effect.[5] One possibility is that music is an effective distraction from pain (research has found that distraction activities, like memory tests, can help reduce pain). Listening to music is associated with the release of dopamine, a neurotransmitter that is known to have a role in the body’s natural pain relieving mechanisms. Music also produces relaxation, which in turn can help reduce pain levels.

Researchers of this last study believe it is important to listen to music you know and enjoy, because familiarity is helpful for sustaining attention. When we pay attention, where more likely to experience the benefits of listening to music. In another case of science proving the obvious, studies have shown that music has a powerful effect on emotions and mood, and that emotions and mood can affect pain. If you enjoy the music you are listening to, it may be more likely to improve your pain levels.

Needless to say, I’ve decided to put my headphones back on.

How Listening to Music Improves Fibromyalgia Symptoms

References:

[1] Blackwell Publishing. (2006, May 24). Listening To Music Can Reduce Chronic Pain And Depression By Up To A Quarter ” ScienceDaily. <www.sciencedaily.com/releases/2006/05/060524123803.htm>

[2] Balcı, Güler & Babadağ, Burcu & Ozkaraman, Ayse & Yildiz, Pinar & Musmul, Ahmet & Korkmaz, C. (2015). Effects of music on pain in patients with fibromyalgia. Clinical Rheumatology. 35. DOI 10.1007/s10067-015-3046-3.

[3] Garza-Villarreal EA, Wilson AD, Vase L, Brattico E, Barrios FA, Jensen TS, Romero-Romo JI and Vuust P (2014) Music reduces pain and increases functional mobility in fibromyalgia. Front. Psychol. 5:90. doi: 10.3389/fpsyg.2014.00090

[4][4] Picard, L. M., Bartel, L. R., Gordon, A. S., Cepo, D., Wu, Q., & Pink, L. R. (2014). Music as a sleep aid in fibromyalgia. Pain Research & Management : The Journal of the Canadian Pain Society, 19(2), 97–101.

[5] Garza-Villarreal EA et al. (2014)

Evidence for New Fibro Drug Therapies: Options to Take to Your Doctor if You Current Treatments aren't Working

New research into drug therapies helps people with fibromyalgia increase their treatment options. Learning about these new medication options can help you and your doctor you find the best treatment regimen for you.

If you live with fibromyalgia, you know firsthand that one of the primary features of this condition is a lower pain threshold compared to healthy people. There are a number of changes in the body caused by fibromyalgia that increase our sensitivity to pain. One set of changes affect how the spinal cord relays pain sensations from the body to the brain. Several drugs target specific receptors, called NMDA receptors, which are located in deep spinal neurons that carry sensory information to regions in the brain that relate to pain processing. NMDA receptors are activated by signals relayed to the spinal cord by peripheral neurons that sense pressure in muscles, tendons, etc. This type of receptor is activated by the neurotransmitter glutamate. Studies have shown elevated levels of glutamate in the brain and spinal cord of patients with fibromyalgia.[i] There is a strong correlation between elevated glutamate and increased pain in people with fibromyalgia. NMDA receptors can amplify pain signals in patients with fibromyalgia because they are activated to a greater degree by the presence of increased glutamate concentrations in the brain/spinal cord, which trigger pain signals sent to the brain by the deep spinal neurons.

NMDA receptors can be prevented from firing by certain compounds. Two drugs in particular seem effective at decreasing NDMDA receptor activation. One is called memantine. Memantine blocks NMDA receptors and decreases glutamate levels. “A randomised, double-blind study in 63 patients with fibromyalgia compared memantine… with placebo over a 6-month period. Compared to placebo there was a significant reduction in pain and pain threshold and improvement in global function, mood and quality of life”.[ii] Memantine was originally developed to treat diabetes, but has also been used to treat dementia; it has been found to also be effective in treating chronic regional pain syndrome.

Ketamine is another potent NMDA receptor blocker (yes, the illegal party drug). Studies have shown that it can effectively reduce pain for a subset of fibromyalgia patients “Thus, of 58 patients with fibromyalgia in the above 3 studies, 33 (57%) responded to low dose ketamine (0.3mg / kg) infusion, as defined by a reduction of pain by 50% or more.”[iii] However, studies have not adequately investigated long term use of ketamine. However, ketamine has been proven effective in treating chronic regional pain syndrome, which shares many similar characteristics to fibromyalgia.

Another interesting tip focuses on diet changes that can help lower pain levels. Glutamate is found in MSG (monosodium glutamate). Other related compounds, called excitotoxins, like aspartame, can cause harmful over-activity in the brain. “One study showed that 4 weeks of exclusion of monosodium glutamate (MSG), aspartame, and other excitotoxins, resulted in over 30% improvement in fibromyalgia symptoms in 84% of those who completed the diet”.[iv]

What about inflammation and fibromyalgia? A number of studies have found increased levels of pro-inflammatory messengers (called cytokines) in blood collected from FM patients.[v] A drug called low-dose naltrexone has been investigated for its potential benefits in treating fibromyalgia because of its anti-inflammatory properties.[vi] Naltrexone is primarily used to treat opioid overdoses, but when taken at a low dose before bed, studies have found a statistically significant reduction in FM pain compared to the placebo. A recent study found that “after eight weeks of LDN administration, plasma levels of a range of broadly pro-inflammatory cytokines were decreased. In addition, we found that participants reported less pain and symptoms following LDN. Combined, these results support the hypothesis that LDN may help chronic pain conditions, such as fibromyalgia, by acting as an atypical anti-inflammatory medication”.[vii] Pain reduction was found to be 15% and symptom reduction 18%. While these results are modest, for many FM patients desperate for options, low-dose naltrexone could be a valuable part of their treatment regimen.

Evidence for New Fibro Drug Therapies: Options to Take to Your Doctor if You Current Treatments aren't Working

Works Cited

Littlejohn, G., & Guymer, E. (2017). Modulation of NMDA Receptor Activity in Fibromyalgia. Biomedicines 5 (5), 15-27.

Parkitny, L., & Younger, J. (2017). Reduced Pro-Inflammatory Cytokines after Eight Weeks of Low-Dose Naltrexone for Fibromyalgia. Biomedicines 5 (2), 16.

Ross, R., Jones, K., Bennett, R., Ward, R., Druker, B., & Wood, L. (2010). Preliminary Evidence of Increased Pain and Elevated Cytokines in Fibromyalgia Patients with Defective Growth Hormone Response to Exercise. Open Immunol J, 3, 9-18.

Citations

[i] (Littlejohn & Guymer, 2017)

[ii] (Littlejohn & Guymer, 2017)

[iii] (Littlejohn & Guymer, 2017)

[iv] (Littlejohn & Guymer, 2017)

[v] (Ross, Jones, Bennett, Ward, Druker, & Wood, 2010)

[vi] (Parkitny & Younger, 2017)

[vii] (Parkitny & Younger, 2017)