Music and low-frequency vibrations for the treatment of chronic musculoskeletal pain in elderly: A pilot study

Abstract

Background Transcutaneous vagal nerve stimulation has analgesic potential and might be elicited by abdominally administered low-frequency vibrations. The objective was to study the safety and effect of a combination of music and abdominally administered low-frequency vibrations on pain intensity in elderly patients with chronic musculoskeletal pain. Methods This trial was an international multicenter, randomized controlled pilot study. Patients at age ≥ 65 years with musculoskeletal pain for ≥ 3 months and a daily pain score ≥ 4 out of 10 were recruited at three centers. They were randomized to receive either a combination of music and low-frequency (20–100 Hz) vibrations administered to the abdomen, or a combination with the same music but with higher frequency (200–300 Hz) vibrations administered to the abdomen. Low-frequency vibrations were expected to result in pain reduction measured with a numeric pain rating scale (NRS). Patients in both groups received eight treatments of the music combined with the vibrations in three weeks. Primary outcomes were safety (Serious Adverse Events) and pain intensity measured at baseline, after the last treatment and at six weeks follow-up. Multilevel linear model analyses were performed to study group and time effects. Results A total of 45 patients were analyzed according to intention-to-treat principle. After 344 treatments, 1 Adverse Event was found related to the intervention, while 13 Adverse Events were possibly related. A multilevel linear model showed that the interaction effect of group by time did not predict pain intensity (F[1, 45.93] = 0.002, p = 0.97) when comparing pain intensity at baseline, after the last treatment and at follow-up. Conclusions The combination of music and abdominally administered vibrations was found to be safe and well tolerated by the elderly patients. However, over time, neither the low-frequency treatment group nor the high-frequency treatment group provided clinically meaningful pain relief. There is no evidence that the low-frequency treatment elicited vagal nerve stimulation. Trial registration The trial was prospectively registered in the Netherlands Trial Register (NTR: NL7606) on 21-03-2019.

Exploring vibroacoustic therapy in adults experiencing pain: a scoping review

“…In this review, we found that studies on acute postoperative and experimentally induced pain (all of them being quasi-experimental studies) describe a decrease in pain sensation over time. However, the differences between experimental and control groups were mostly statistically insignificant (or both groups were significantly improved, such as in Eshuis et al ) 37. Acute pain literature is rather scarce, with small sample sizes and other methodological issues.…”

“…During the updated search (conducted on 9 January 2022), we found three research studies (one double-blind RCT pilot study,37 one pretest post-test study without a control group,38 one case study)39 and one RCT protocol published at ClinicalTrial.gov. The three studies include participants with chronic pain caused by Ehler-Danlos syndrome,38 postherpetic neuralgia39 and chronic musculoskeletal pain 37.…”

“…During the updated search (conducted on 9 January 2022), we found three research studies (one double-blind RCT pilot study,37 one pretest post-test study without a control group,38 one case study)39 and one RCT protocol published at ClinicalTrial.gov. The three studies include participants with chronic pain caused by Ehler-Danlos syndrome,38 postherpetic neuralgia39 and chronic musculoskeletal pain 37. Interventions were delivered using the Sound Oasis VTS1000 using the ‘Energise’ programme,38 a wearable music player (XINYIBAO),39 and a PaciniMedico ApS chair device playing rhythmically aligned music 37.…”

“…The three studies include participants with chronic pain caused by Ehler-Danlos syndrome,38 postherpetic neuralgia39 and chronic musculoskeletal pain 37. Interventions were delivered using the Sound Oasis VTS1000 using the ‘Energise’ programme,38 a wearable music player (XINYIBAO),39 and a PaciniMedico ApS chair device playing rhythmically aligned music 37. All studies reported improvements on pain sensation due to the intervention (although Eshuis et al 37 also reported significant improvements in the active control group).…”

“…Interventions were delivered using the Sound Oasis VTS1000 using the ‘Energise’ programme,38 a wearable music player (XINYIBAO),39 and a PaciniMedico ApS chair device playing rhythmically aligned music 37. All studies reported improvements on pain sensation due to the intervention (although Eshuis et al 37 also reported significant improvements in the active control group). Vuong et al 38 also applied the concept of intervention responders and non-responders according to the Minimal Clinically Important Difference (MCID) as a means of tracking clinically relevant improvement.…”