The Impact of Music on Pain

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Nathan Swan, DPT

Relaxing with music

Have you ever stopped and thought about the impact of music? I don’t mean the sound of it. I mean the fact that it exists and the effect it has on us. A novel by Arthur C. Clarke’s called Childhood’s End explores that question. In the book, the Overlords, who were highly cerebral alien beings, were puzzled that the entire species of humans would play and listen to seemingly meaningless patterns of tones. The aliens had no capacity to understand or create music. If you had no emotional response or concept of music, wouldn’t music seem bizarre to you? People devote hours of time and even lifetimes to music that appears, from a purely cerebral perspective, to be totally meaningless.

It doesn’t take neurophysiology to tell us music is emotional and affects us at a “heart” level. It is part of what make us human. Music is powerful. It can make us dance, cry, annoy us, or bring us together. Music is also a powerful tool in the medical field, specifically in regards to pain and relaxation. The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential damage, or described in terms of such damage.”1 Notice the Association describes pain in part as an emotional experience. Neuroscience has taught us that pain and the emotion centers of our brain are intimately connected with how we experience pain. Pain can greatly affect our mood and our emotions can greatly affect the way we experience pain. Our emotions can amplify our pain like a microphone or create a dampening effect to our pain. It is through the emotion centers of our brain that seemingly random frequencies of sound waves, called music, can have an effect on our pain.

Like me, you can probably think of times when music makes everything else in life disappear. It is just you and music and nothing else. In a simple sense this is how music can decrease your pain. The music affects us in such a way that our brain tunes in the music and tunes out the pain. The positive effect of music on pain has been backed by volumes of research. It has been shown that listening to music while recovering from surgery decreases pain.2 There is also new research showing that making music, whether with instruments or singing, has a positive effect on chronic pain.3 Music has proven in research to be a very valid and important complementary approach to pain management for a variety of pain etiologies, including during labor and delivery, post-operative pain in both kids and adults, chronic pain including fibromyalgia, during cancer screening tests, biopsies, and over the course of cancer treatment, and far more conditions too numerous to mention. There is even a study that reports lower stress hormone levels in very low birth weight infants in the NICU who have listened to live harp music.4

Let me sum things up both speaking as a musician and a physical therapist. Music is not the cure for your broken leg, but music can be a valuable resource to tap into for the management of pain. While the neurophysiology is complicated the practical application is simple. Find music that relaxes and gives you pleasant feelings. For most people this is music with slower tempos and music that reproduces good memories and feelings. You also can decide if it is best for you to be an active participant or passive recipient. For me, music is all or nothing. Whether I am listening or playing I totally get lost in the music and am an active participant. Other people use music to create a pleasant “vibe” while they do other things and let their sub-conscious do the work. Find the music that produces the desired effect for you. Everyone is different. Music is an experience. Let the experience go to work for you.

1. Mersky H, Bogduk N. Classification of Chronic Pain (2nd ed). 1994. Seattle: IASP Press.
2. Nilsson, U. (2008). The anxiety-and pain-reducing effects of music interventions: a systematic review. AORN journal, 87(4), 780-807.
3. Koenig, J. et al (2013). I need to hear some sounds that recognize the pain in me: An integrative review of a decade of research in the development of active music therapy outpatient treatment in patients with recurrent or chronic pain. Music and Medicine, 5, 150-161.
4. Schwilling, D. et al (2014). Live music reduces stress levels in very low-birthweight infants. Acta Paedriatr. Dec 26. 10.1111