The idea that music can heal the soul or "soothe the savage breast" is well-known. Music's healing power over the body has also attracted attention from scientists who aim to test this ancient wisdom. A growing body of research supports the claim that music can alleviate physical pain. Studies have shown music to be an effective pain reliever, both on its own and as an adjuvant in connection with other types of therapy. Long-term studies of music therapy in pain management have shown it to be associated with improved quality of life and reduced consumption of pain relievers.
If music is ever to become widely used in pain relief, we need to know more about how and why it has the effects that it does. A closer look at the nature of pain can help us understand music's role in pain management. The International Association for the Study of Pain defines pain as, "an unpleasant sensory and emotional experience association with actual or potential tissue damage." Pain is both a sensory process felt in the body, and a subjective phenomenon, influenced by the psychological and emotional processes of each individual brain. When the body sustains an injury, nerves relay information about that injury from its site through the brainstem and then on to the brain. As this process occurs, a whole cascade of events plays out in the brain, with a large network of structures and pathways activated. These pathways extend to areas directly related to the processing of emotion, and to different brain areas associated with the various autonomic, affective, cognitive, and motivational aspects of pain behavior. Stress and anxiety exacerbate the experience of pain, so anything that an individual can do to relax will help to alleviate pain.
Understanding more about these brain processes and about how music assists in pain relief is an important goal, because this knowledge will help researchers design guidelines and standard routines for the use of music in clinical settings. One possibility is that music alleviates stress and anxiety (and thereby reduces pain) by providing a distraction. But if it were as simple as that, one would expect that all music would be equally effective for pain relief. In fact, some music seems to be more helpful than other music. For a long time it has been understood that music chosen by the patient him or herself tended to be more effective. More recently, researchers have found significant correlations between certain sonic features of music chosen by patients for pain management, and measurements of pain tolerance and perceived pain intensity. In particular, music expressing contentment, no matter what its genre, was found to be most effective in reducing the experience of pain.
The emerging sciences of the brain are providing insight into some old puzzles about music's effects on the mind. An article published earlier this year in Neuroscience and Biobehavioral Reviews stressed the importance of the brain's opioid system and other neuro-chemical factors in understanding music's role in alleviating pain. Because the experience of pain is partially subjective, altering a person's perception of their pain can change their experience of that pain. Music may disrupt the brain's "pain - stress - pain" feedback loop and in doing so alter an individual's sensitivity to pain. How might this work? We know that music effects evolutionarily old subcortical areas of the brain, thereby influencing many different psychological and physiological states. Music modulates the brain's limbic system, triggering numerous accompanying neurochemical effects. The result of these changes in the brain may be to help distract listeners from negative feelings and modify the influence of past memories associated with pain. As a further result, music may promote relaxation by inhibiting the release of stress hormones and weakening arousal of the pituitary-adrenal stress axis. The brain's opioid system may also play a role. Music that listeners find emotionally engaging seems to affect the brain's opioid system, and opioids control both physical pain and the pain of social loss.
More research remains to be done and more hypotheses will have to be tested before music can be used effectively in clinical settings. Let's hope that ancient wisdom proves durable, and that one day music therapy will be generally recognized as a simple, cost-effective, and low-risk way of promoting psychosomatic healing.
Bernatzky, G., Presch, M., Anderson, M., & Panksepp, J., 2011. Emotional foundations of music as a non-pharmacological pain management tool in modern medicine. Neuroscience and Biobehavioral Reviews 35, 1989-1999.
Knox, D., Beveridge, S., Mitchell, L., MacDonald, R., 2011. Acoustic analysis and mood classification of pain-relieving music. Journal of the Acoustical Society of America 130 (3), 1673-1682
Renn, C.L., Dorsey, S.G., 2005. The physiology and processing of pain: a review. AACN Clinical Issues 16 (3), 277-290.