Understanding How Sound Suppresses Pain

National Institutes of Health (NIH)

Studies dating back decades have shown that music and other kinds of sound can help alleviate acute and chronic pain in people. This is true for pain from dental and medical surgery, labor and delivery, and cancer. However, how the brain produces this pain reduction, called analgesia, was less clear.

An international team of scientists set out to use mice to explore the neural mechanisms through which sound blunts pain. The team was led by researchers at NIH’s National Institute of Dental and Craniofacial Research (NIDCR); the University of Science and Technology of China, Hefei; and Anhui Medical University in Hefei, China. Their study was published in Science on July 8, 2022.

The scientists first exposed mice with inflamed paws to three types of sound: a pleasant piece of classical music, an unpleasant rearrangement of the same piece, and white noise. Surprisingly, all three reduced pain sensitivity in the mice when played just slightly louder than background noise (about the level of a whisper). The effect lasted well beyond the sound itself—for at least two days after exposure to the sound three days in a row for 20 minutes. When played louder, the sounds had no effect on the animals’ pain responses.

Pain perception can be affected by emotions and stress. However, the scientists discovered that low-intensity sound didn’t affect the mice in tests of stress and anxiety. The finding shows that this particular type of sound affected the animal’s perception of pain through another mechanism.

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Home Health Providers, Staff in For ‘Rude Awakening’ Following Public Health Emergency Expiration

Though it sometimes may not feel like it, the expiration of the public health emergency (PHE) will, one day, come.

And when it does, that will have ramifications on home health providers specifically, and home-based care more generally. With the declaration came a handful of waivers and flexibilities meant to alleviate the harsh impacts of the pandemic for home health providers.

The Biden Administration extended the PHE for another three months on Friday, but providers will need to prepare for the day it will eventually come to an end. 

The PHE was originally declared in March of 2020, retroactive to Jan. 27, 2020. This past April, the U.S. Department of Health & Human Services (HHS) extended the emergency status for 90 additional days, to July 15.

Concerns around waivers and flexibilities

Along with the PHE declaration came a number of regulatory waivers and flexibilities meant to streamline health care processes and ease the overall burden of the pandemic for providers.

One of these waivers made it possible for any of the disciplines — nursing, physical therapy (PT), occupational therapy (OT), or speech language pathologists — to conduct home health admissions based on the needs of the patient.

If the PHE ends, this waiver is not expected to become permanent, according to Cindy Krafft, the co-owner and co-founder of the consulting firm Kornetti & Krafft Health Care Solutions.

“It has deeper regulatory issues and stuff that would have to be dealt with, but it is still allowable in the waiver situation,” she told Home Health Care News. “The reason I think it’s going to be a challenge is the current staffing situation in home health. We know that several agencies are at crisis levels and the ability to move admissions to therapy and take some of that off of nursing, when appropriate, has become routine.”...

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APTA Advocacy Network Legislative Action Alert

After holding off on any big changes to home health payment in 2022, CMS plans to take some major steps in 2023 to address what it describes as the gaps between "assumed behavior changes and actual behavior changes" resulting from the Patient-Driven Groupings Model payment system implemented in 2020. Translation: The PDGM has cost significantly more than CMS hoped, so to reach its goal of budget neutrality compared with the previous system, the agency has proposed changes that would reduce payment by 4.2%, or about $810 million compared with 2022 amounts. 

The bulk of the cuts is directed at the 30-day payment rate, but even if those reductions are put into place in 2023, CMS believes more changes will need to be made in the future to recoup the payment differences that have already occurred under the PDGM — an estimated $2 billion gap so far. To that end, the proposed rule also seeks public comment on how to best make up the difference.

We need you to submit a comment to CMS on this issue. APTA is preparing comments on the rule to submit by the Aug. 16, 2022, deadline but we need your voice and your stories sent to CMS as well. Please use this template to send your comment and be sure to customize it with a personal story. Adding a personal story is important because it ensures it will be individually reviewed by CMS.

The deadline to submit comments is August 16, so we need you to act now and encourage others to send a comment of their own.

Thank you for your advocacy and making a difference on behalf of the physical therapy profession and the patients we serve.

2022 APTA Home Health Board Nominations

The APTA Home Health Nominating Committee is seeking nominations for the 2022 Home Health Board elections. The Nominating Committee is looking for volunteers to fill the following positions: 

• Vice President
• Nominating Committee Member

The nomination submission deadline is Monday, August 1, 2022. To learn more about the elections, requirements to hold office and to submit your nomination, CLICK HERE.