Music Medicine as a Component of Acute Migraine Attack Management in The Emergency Room: A Randomized Controlled Open-Label Trial

Abstract

Background: Acute severe migraine requiring Emergency Room (ER) visit is managed by giving analgesics for pain relief. Since music medicine has been beneficial in other pain syndromes, the study of its effect as a noninvasive add-on to current management is worth pursuing. Objective: To identify if music medicine in addition to medical therapy will reduce the severity and duration of an acute attack of moderate to severe migraine compared to medical management alone. Methods: An open label randomized controlled trial was conducted at the ER of a tertiary hospital in the Philippines from July 2017 to June 2018. Patients who presented at the ER with acute moderate to severe headache fulfilling the ICH-3 criteria for migraine were included. They were randomized to medical therapy or to medical therapy with music medicine. A decrease in the severity of the headache after one hour of medical treatment was the primary outcome. Results: One hundred eighty-three adult migraneurs were included without difference between group in age, gender, and occupation. There was a statistically significant reduction (p=0.037) in pain severity after one hour in 82 of 87 patients given medical treatment with music medicine (94%) compared to 73 of 86 in the medical therapy alone (85%). There were more headache-free patients at one hour in the music group (55% versus 42%, p=0.05). Conclusion: There is decreased duration and severity of pain when music medicine is added to conventional medical therapy in treating patients with an acute migraine. This is the first randomized trial done in the acute ER setting.

Music therapy as a migraine treatment: protocol for a systematic review and meta-analysis

“…The brain itself releases neurotransmitters as an answer to music which stimulates the release of endorphins, these modulate pain and as an effect is reflected a feeling of euphoria. In conclusion, listening to music by inhibiting pain and stimulating the release of endorphins, the patient's migraine improves 15 .…”

“…There are some studies that suggest that music therapy may help alleviate pain such as cancer pain 13 , procedural pain 14 and it may have a great effect in reducing the severity and duration of an acute migraine attack 15 . It has been reported that adding music to the pharmacological treatment helps decrease the pain severity, as pain impulses travel from the site of injury to the brain throughout the spinal cord in which neural gates indicate the level of pain that is allowed to pass or not to pass.…”