Comparing the therapeutic effects of two Iranian musical modes with standard treatment in acute sciatica pain: a pilot study

Main Article Content

Mona Haqiqi
Fataneh Hashem-Dabaghian
Ahmad Ghandhari
Farshad Amini-Behbahani
Elham Akhtari


Low back pain, Music therapy, Music Medicine, Sciatica


Sciatica is a term that describes radiating pain to the lower extremities. The beneficial effects of music therapy and music medicine on various diseases have been studied and proven in different studies. We designed this study to evaluate the therapeutic effects of two Iranian musical modes on Sciatica pain and disability alleviation. This pilot study was a Randomized Controlled Trial (RCT) with three parallel arms. 30 patients with acute sciatica participated in this study and were randomly assigned to three groups. The intervention groups listened to the musical pieces of Iranian “Navā” and “Rāst-Panjgāh” musical modes (Dastgāh) played before sleep for ten consecutive nights. The control group received the conventional treatment. We compared the findings between the three groups on the tenth day. The primary outcome was pain intensity (Visual Analog Scale (VAS). Functional status (Roland-Morris Disability Questionnaire) and amount of painkiller use were secondary outcomes. The reduction in pain intensity (P<0.001) and disability (P<0.001) in the Navā group was significantly more than the control group, while the patients in the Rāst-Panjgāh group had no significant difference from the control group. Comparison between the three groups for Analgesic dose reduction showed no significant difference. The present study is the first to assess music medicine’s effects on sciatica in Iran. This study’s results showed that using Navā music as a supplement to pharmacologic treatment significantly reduced the pain and disability caused by acute sciatica in the participants. Navā music’s effects on sciatica pain were more than that of the Rāst-Panjgāh, while there was no significant difference between these two groups in disability reduction. We hope to gather data on the potential of traditional Iranian music in music therapy.

Abstract 186 | PDF Downloads 0 PDF Downloads 163


1. Jensen RK, Kongsted A, Kjaer P, Koes B. Diagnosis and treatment of sciatica. BMJ. 2019 Nov 19;367:l6273. doi: 10.1136/bmj.l6273. PMID: 31744805.
2. Valat JP, Genevay S, Marty M, Rozenberg S, Koes B. Sciatica. Best Pract Res Clin Rheumatol. 2010 Apr;24(2):241-52. doi: 10.1016/j.berh.2009.11.005. PMID: 20227645.
3. Harrisson SA, Ogollah R, Dunn KM, Foster NE, Konstantinou K. Prevalence, Characteristics, and Clinical Course of Neuropathic Pain in Primary Care Patients Consulting With Low Back-related Leg Pain. Clin J Pain. 2020 Nov;36(11):813-824. doi: 10.1097/AJP.0000000000000879. PMID: 32841967.
4. Cook CE, Taylor J, Wright A, Milosavljevic S, Goode A, et al. Risk factors for first time incidence sciatica: a systematic review. Physiother Res Int. 2014 Jun;19(2):65-78. doi: 10.1002/pri.1572. Epub 2013 Dec 11. PMID: 24327326.
5. Ryan C, Pope CJ, Roberts L. Why managing sciatica is difficult: patients' experiences of an NHS sciatica pathway. A qualitative, interpretative study. BMJ Open. 2020 Jun 11;10(6):e037157. doi: 10.1136/bmjopen-2020-037157. PMID: 32532780; PMCID: PMC7295411.
6. Stochkendahl MJ, Kjaer P, Hartvigsen J, Kongsted A, Aaboe J, et al. National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy. Eur Spine J. 2018 Jan;27(1):60-75. doi: 10.1007/s00586-017-5099-2. Epub 2017 Apr 20. PMID: 28429142.
7. Qaseem A, Wilt TJ, McLean RM, Forciea MA, et al., Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med, 2017. 166(7): p. 514-530.
8. Fernandez M, Ferreira ML, Refshauge KM, Hartvigsen J, Silva IR, et al. Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis. Eur Spine J. 2016 Nov;25(11):3495-3512. doi: 10.1007/s00586-015-4148-y. Epub 2015 Jul 26. PMID: 26210309.
9. Deyo RA, Mirza SK. CLINICAL PRACTICE. Herniated Lumbar Intervertebral Disk. N Engl J Med. 2016 May 5;374(18):1763-72. doi: 10.1056/NEJMcp1512658. PMID: 27144851.
10. Solt Kırca A, Kızılkaya T. Effects of music medicine on premenstrual symptoms levels and quality of life: A randomized controlled trial. Complement Ther Clin Pract. 2022 Feb;46:101542. doi: 10.1016/j.ctcp.2022.101542. Epub 2022 Feb 5. PMID: 35149373.
11. de Witte M, Spruit A, van Hooren S, Moonen X, Stams GJ. Effects of music interventions on stress-related outcomes: a systematic review and two meta-analyses. Health Psychol Rev. 2020 Jun;14(2):294-324. doi: 10.1080/17437199.2019.1627897. Epub 2019 Jul 15. PMID: 31167611.
12. Leubner D, Hinterberger T. Reviewing the Effectiveness of Music Interventions in Treating Depression. Front Psychol. 2017 Jul 7;8:1109. doi: 10.3389/fpsyg.2017.01109. PMID: 28736539; PMCID: PMC5500733.
13. Gassner L, Geretsegger M, Mayer-Ferbas J. Effectiveness of music therapy for autism spectrum disorder, dementia, depression, insomnia and schizophrenia: update of systematic reviews. Eur J Public Health. 2022 Feb 1;32(1):27-34. doi: 10.1093/eurpub/ckab042. PMID: 34595510; PMCID: PMC8846327.
14. Lee JH. The Effects of Music on Pain: A Meta-Analysis. J Music Ther. 2016 Winter;53(4):430-477. doi: 10.1093/jmt/thw012. Epub 2016 Oct 19. Erratum in: J Music Ther. 2021 Aug 24;58(3):372. PMID: 27760797.
15. Azadehfar MR. Rhythmic structure in Iranian music. Tehran Arts University Press. Tehran 2011; pp 143-153.
16. During J. The radif of Mirza Abdollah (A canonic repertoire of Persian music). Mahoor institute of culture and art. Tehran 2006; pp 9,22. ISBN 964-8772-09-6.
17. Kawkabi Bukharai, N. Ibn Saif Ghaznavi, A. an anonymous author. Three treatises on ancient Persian classical music. edited by Sabetzadeh, M. society for the appreciation of cultural works and dignitaries. Tehran 2020; pp132. ISBN 978-964-7874-10-6.
18. Kiani M. Understanding of Iranian music samae radif. Sarvsetah cultural institute. Tehran 2016; pp 542. ISBN 978-600-04-4866-0.
19. Farhat H. The Dastgah concept in Persian music. Part. Tehran 2015; pp 133. ISBN 964-5664-23-3.
20. Eldridge SM, Chan CL, Campbell MJ, Bond CM, Hopewell S, Thabane L, et al. CONSORT 2010 statement: extension to randomised pilot and feasibility trials. BMJ. 2016;355:i5239.
21. Shafshak TS, Elnemr R. The Visual Analogue Scale Versus Numerical Rating Scale in Measuring Pain Severity and Predicting Disability in Low Back Pain. J Clin Rheumatol. 2021 Oct 1;27(7):282-285. doi: 10.1097/RHU.0000000000001320. PMID: 31985722.
22. Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine (Phila Pa 1976). 2000 Dec 15;25(24):3115-24. doi: 10.1097/00007632-200012150-00006. Erratum in: Spine 2001 Apr 1;26(7):847. PMID: 11124727.
23. Mousavi SJ, Parnianpour M, Mehdian H, Montazeri A, Mobini B. The Oswestry Disability Index, the Roland-Morris Disability Questionnaire, and the Quebec Back Pain Disability Scale: translation and validation studies of the Iranian versions. Spine (Phila Pa 1976). 2006 Jun 15;31(14):E454-9. doi: 10.1097/01.brs.0000222141.61424.f7. PMID: 16778675.
24. Kullich W, Bernatzky G, Hesse HP, Wendtner F, Likar R, et al. Musiktherapie--Wirkung auf Schmerz, Schlaf und Lebensqualität bei Low back pain [Music therapy--effect on pain, sleep and quality of life in low back pain]. Wien Med Wochenschr. 2003;153(9-10):217-21. German. doi: 10.1046/j.1563-258x.2003.02081.x. PMID: 12836459.
25. Guétin S, Coudeyre E, Picot MC, Ginies P, Graber-Duvernay B, et al. Intérêt de la musicothérapie dans la prise en charge de la lombalgie chronique en milieu hospitalier (Etude contrôlée, randomisée sur 65 patients) [Effect of music among hospitalized patients with chronic low back pain: a controlled, randomized trial]. Ann Readapt Med Phys. 2005 Jun;48(5):217-24. French. doi: 10.1016/j.annrmp.2005.02.003. Epub 2005 Mar 4. PMID: 15914256.
26. Nees TA, Riewe E, Waschke D, Schiltenwolf M, Neubauer E, et al. Multidisciplinary Pain Management of Chronic Back Pain: Helpful Treatments from the Patients' Perspective. J Clin Med. 2020 Jan 5;9(1):145. doi: 10.3390/jcm9010145. PMID: 31948111; PMCID: PMC7019713.
27. Rasmussen-Barr E, Held U, Grooten WJA, Roelofs PDDM, Koes BW, et al. Nonsteroidal Anti-inflammatory Drugs for Sciatica: An Updated Cochrane Review. Spine (Phila Pa 1976). 2017 Apr 15;42(8):586-594. doi: 10.1097/BRS.0000000000002092. PMID: 28399072.
28. Grøvle L, Hasvik E, Holst R, Haugen AJ. NSAIDs in sciatica (NIS): study protocol for an investigator-initiated multicentre, randomized placebo-controlled trial of naproxen in patients with sciatica. Trials. 2022 Jun 14;23(1):493. doi: 10.1186/s13063-022-06441-3. PMID: 35701830; PMCID: PMC9194344.