Chronic lower back pain effects of music on fluoroscopic guided (CLEF) interventional pain procedures: a randomized controlled trial

Abstract

Introduction: Music medicine has shown promise in reducing anxiety and pain during medical procedures, but its effects during interventional pain procedures without sedation remain unexplored. Although previous studies have examined music medicine with procedural sedation, to our knowledge, no published research has yet explored music medicine during procedures without sedation in the chronic pain population, underscoring the novelty of our investigation. This study aimed to evaluate the impact of music medicine on pain intensity, unpleasantness, and anxiety during lumbar medial branch blocks (LMBB) performed without sedation.

Methods: This prospective, randomized controlled trial included 150 patients undergoing first-time LMBB. Participants were randomized to either a music medicine group (n=74) or a control group (n=76). Primary outcomes were changes in pain scores before and after the procedure. Secondary outcomes included changes in patient anxiety, satisfaction, hemodynamic parameters, pain catastrophizing, and progression to radiofrequency ablation.

Results: There were no significant differences in postprocedure pain intensity (p=0.32) or unpleasantness (p=0.4) between groups. However, the music medicine group showed a significant reduction in anxiety scores (p=0.049), particularly in patients with higher baseline Pain Catastrophizing Scale scores. No significant differences were observed in hemodynamic parameters, patient satisfaction, or desire for repeat procedures between groups.

Conclusions: While music medicine during LMBB did not significantly impact pain intensity or unpleasantness, it demonstrated a notable reduction in patient anxiety, especially in those with higher pain catastrophizing tendencies. These findings suggest that music medicine may be a valuable, nonpharmacological intervention for managing anxiety during interventional pain procedures.

Keywords: Anxiety; Back Pain; Complementary Therapies; Nerve Block; Pain Management.