Why does music ease pain? Researchers map the evidence

Many studies have demonstrated that music-based interventions—such as listening to music—can help reduce pain from a variety of conditions like cancer or osteoarthritis, but researchers still do not understand how or why they help. A new review study led by Joke Bradt, Ph.D., a professor in Drexel University’s College of Nursing and Health Professions, examined biological, psychological and social mechanisms that may explain the pain-reducing effects of music. The study, recently published in PAIN Reports, identified important gaps that future research on music-based interventions for pain relief should address.”In clinical care, music-based interventions may range from music listening initiated by the patient—or recommended by a health care provider, like a doctor or a nurse—to music experiences facilitated by a trained music therapist,” said Bradt, who leads the Music4Pain Research Network, a National Center for Complementary and Integrative Health-funded, multidisciplinary network that helps advance music and pain mechanistic research. “The findings from our study help explain why music can be an effective, low-risk approach for pain management and how we can maximize its potency.”Bradt and the research team found converging evidence for three promising mechanisms that contribute to the effectiveness of music-based interventions:

• positive emotional valence associated with music
• sense of control or agency, such as choosing one's own music
• synchronizing movement with music, such as tapping or drumming along with the musiThis evidence, Bradt explained, suggests that it is important for people to select their own music that they enjoy—rather than music provided by a health care provider—and that they should actively engage by tapping, playing or moving along with it when using music for pain management."One study also showed that singing along is more effective than just listening to music," Bradt said. "And brain imaging studies found that music may influence both early pain processing in the brain and higher-level cognitive and emotional responses to pain."The research team reviewed more than 600 records in search of studies that investigated mediators, moderators or predictors of music's effects on pain. Ultimately, 57 formed the review dataset.By better understanding the mechanisms through which music affects pain, clinicians and researchers can develop more targeted, personalized and effective music-based interventions for people experiencing acute or chronic pain, Bradt explained.While the review study helped explain why music-based interventions can be an effective pain management approach, it also emphasized the need for more rigorous research into the mechanisms that make interventions effective.

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