Ana Monroy Yglesias connects music therapy to chronic pain reduction and management. Andrew from OTB provides some pain relieving sounds to accompany.
Most of us have favorite songs that never fail to put us in our feels; there's no denying music can evoke a range of emotions. Scientific research has found that music can even reduce pain, including chronic pain. For individuals with chronic pain, not only is the regular experience of pain difficult, it can also impact mental health by increasing anxiety, depression, and feelings of isolation. Several studies have focused on people with fibromyalgia, a chronic pain condition that causes musculoskeletal pain throughout the body, and have found patients report less pain after listening to music they enjoy.
A 2014 study led by Eduardo A. Garza-Villarreal discovered that music reduced pain and increased mobility of fibromyalgia patients. The participants listened to 10 minutes of enjoyable music before being asked to stand up, walk and sit back down, and reported less pain and easier movement. The researchers explain that "the pain in fibromyalgia (FM) is difficult to treat and functional mobility seems to be an important comorbidity in these patients that could evolve into a disability," meaning music therapy can increase their quality of life and lifespan.
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They continue, explaining that the brain's response to music seems to play a key role in pain reduction. "Notably, this mobility improvement was obtained with music played prior to the motor task (not during), therefore the effect cannot be explained merely by motor entrainment [syncing physical movement to the beat] to a fast rhythm. Cognitive and emotional mechanisms seem to be central to music-induced analgesia [a.k.a. pain relief]. Our findings encourage the use of music as a treatment adjuvant [a.k.a. facilitator] to reduce chronic pain in FM and increase functional mobility thereby reducing the risk of disability."
The researchers also explain that prior studies suggest that music's pain-relieving effect "may be secondary to cognitive and emotional effects that arise from listening to music: distraction from the pain, pleasantness, and pleasure, memory evoked emotions and relaxation… Preferred or self-chosen music is likely to be especially proficient at reducing pain as self-chosen music is already liked, which provides an easily achievable sustained attention and entrainment." Music distracts the brain from the pain the body is feeling, and also releases dopamine, which also plays a part in central analgesia. Furthermore, pleasant music impacts the descending pain modulation pathway and decreases the perception of pain (while unpleasant music does the opposite), and the relaxation effect of music also contributes to its pain reduction.
Fibromyalgia pain is complicated and not fully understood; those experiencing it are more sensitive to pain and other sensory inputs, and tend to think their pain is worse than it is, compared to other chronic pain patients. This sensitivity may positively influence music’s impact on them.
A 2015 study led by Garza-Villarreal continued their research by studying the resting state connectivity in the brains of the same patients using a 3T MRI scanner as they listened to music. They suggested "that the analgesic effect in this study is a consequence of top-down mechanisms, by either placebo analgesia, distraction, positive emotions, or a combination of these mechanisms."
The idea that placebo analgesia, or simply thinking that something will cause pain relief aids in feeling less pain, is supported by British doctors Rosie and John Holden in their 2013 scientific article titled "Music: a better alternative than pain?" They posit that giving chronic pain patients a renewed sense of control over their pain may reduce anxiety and improve "quality of life through independence and ability to cope." They advocate for music as a useful tool for chronic pain patients, and, citing a 2007 survey of chronic pain patients in Glasgow, point out many may not realize pain reduction is a benefit of listening to music they enjoy.
"Music is one of a number of non-pharmacological methods of relieving chronic pain, along with exercise and cognitive behavioral therapy, that have been found to be effective in randomized controlled trials. It can be controlled by the listener and can capture attention strongly, shifting it away from unpleasant sensations," the Holdens write.
A 2019 study led by Victor Pando-Naude (also including Garza-Villarreal) supported earlier research with its conclusion that fibromyalgia patients reported feeling less pain after listening to pleasant music for just five minutes, all of which points to music therapy as a safe treatment option to reduce the need for analgesic drugs (which include opioids and other painkillers). Expanding on the 2015 Garza-Villarreal study, their research also focused on observing the shifts in the brains of fibromyalgia patients and healthy control subjects while resting and listening to music, via 3T MRI, to further identify how music has an analgesic effect.
The researchers explain that fibromyalgia patients' brains become wired differently due to their experience of chronic pain, and tend to be more sensitive to pain and noise. "Recent resting-state fMRI studies have found alterations in brain connectivity in FM patients, involving networks related to pain intensity and analgesia. FM patients have shown increased resting state functional connectivity (rs-FC) of areas related to pain processing, and reduced connectivity in regions involved in pain inhibitory modulation."
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And when listening to enjoyable music, the pain pathways are impacted. "It seems that the main feature of the analgesic effect in fibromyalgia relies on shifting connectivity patterns from pain-related areas to executive and cognitive control areas. Hence, we suggest that music-induced analgesia in fibromyalgia is a top-down mechanism, probably originated by distraction, relaxation, positive emotion, or a combination of these mechanisms."
This study also found that the healthy participants—who were screened to confirm they were free of pain on the day of testing—also displayed significant changes in their brain connectivity after listening to music.
In a 2021 article in Practical Pain Management by music therapist Laurie Crosse, she cites various studies that find music therapy can decrease depression, anxiety and pain, lower blood pressure, increase the production of the feel-good brain chemical oxytocin and decrease the production of stress-related hormones. Specifically for those living with chronic pain, it can "enhance self-efficacy, motivation, empowerment, and social engagement," in addition to reducing pain and depression.
As the article explains, music therapy encompasses a variety of techniques that involve engaging with sound, and can be led by a trained professional like Crosse, or self-led. It can be as simple as listening to music you enjoy and noticing how it makes you feel, singing along to your favorite tunes, or even making up songs about your daily life. Any kind of mindful movement to music—be it dancing around or just moving your arms—is another great way to engage in music therapy, as well as chronic pain management.
There is really no wrong way to engage with music as a tool for healing—unless you're listening to music you really don't like, or thrashing around to it in a way that hurts your body. So, when you're having a hard day or experiencing physical pain, put on your favorite tunes and let them soothe you. As the wise Bob Marley famously sang in "Trenchtown Rock," "One good thing about music, when it hits you feel no pain. So hit me with music."
