In this series we publish blog posts written by our undergraduate students for the PB101 Foundations of Psychological Science course. In this post, Mia Raso explores whether music can help to relieve pain. 

Music is everywhere. It is written for adverts to persuade you to buy products; it is in the background of that one romantic film that makes you sob uncontrollably; it even comes through the phone as you are holding for that long-awaited dentist appointment. Sometimes listening to a happy song can help boost your mood, or listening to classical music can help you concentrate – but can music help to manage pain?

Let’s get physical

The use of music as a non-pharmacological pain management method has been researched since the 1980s (Bailey, 1986) and, more recently, there have been studies focusing on how music can help speed up recovery time after surgery. For example, heart disease in countries such as Iran is becoming a big problem, and using lots of medication for post-surgery recovery is expensive for the healthcare system (Jafari et al., 2012). A study conducted on people undergoing open heart surgery had patients rate their pain intensity on a scale of 0-10 post-surgery, and then again after listening to music. The control group (who did not listen to any music) reported a similar mean pain intensity immediately after surgery, 30 minutes after surgery, and an hour after surgery – their mean was around 4.7 throughout. The intervention group were asked to pick songs they were interested in from a list and listen to them, and their mean pain intensity went down significantly from 5.8 immediately after surgery, to 2.4 an hour after the intervention. The idea that someone’s pain intensity can be a 2 out of 10 after open-heart surgery not only suggests that there are some extremely brave people in the world, but also that music could be an exceptional form of alternative medicine for people suffering from physical pain. There are, of course, several limitations to this theory – there are countless other things that can help to decrease pain after surgery. According to Whitlock (2021), factors such as sleep, increased physical activity and managing stress levels all help to decrease post-surgery pain, and these are difficult to control within the experiment above. Similarly, everyone heals at different times and in diverse ways, so there are a number of reasons why music may not be the solution for a speedy recovery.

It’s all in the brain…

Image by Mohamed Hassan from Pixabay. 

However, pain is not necessarily just physical – emotional pain such as PTSD, anxiety and depression can affect us just as much. Music therapy is an alternative way of reducing stress and symptoms of mental health issues through the associations of major and minor keys (Bailey, 1986). Minor keys in music are associated with the feeling of sadness (think “Sparks” by Coldplay), whilst major keys are associated with happiness (think “I’m Every Woman” by Chaka Khan). In music therapy, music is chosen to reflect the patient’s mood and allow them to identify with their emotions. For example, someone feeling isolated would resonate with a solo instrumental piece, or someone struggling with depression might listen to something in a minor key (Bailey, 1986). The music acts as a channel to releasing that emotion, so that the patient can express their feelings and work towards a resolution; gradually the playlist shifts into happier songs with more instruments, and eventually the patient begins to mirror the mood of the music. Next time you feel upset, put your sad playlist on shuffle and release those emotions, then sing your heart out to the feel-good tunes and see how your mood changes.

This shows that music may have some curative powers, but what is the psychology behind this – what does music do within our brains? Think back to an experience you have had with music that moved you: have you ever had goosebumps, or even tears, because of a musical performance?

I’ve got chills, they’re multiplying…

Research has revealed that goosebumps/chills activate parts of the brain associated with reward and releases dopamine (Dodgson, 2018). Chills are part of the fight or flight response, an intuitive physiological reaction to stimuli in order to keep us safe. It is not entirely known why we have this response when experiencing intense emotion (such as listening to a particular soundtrack), but it is speculated that the adrenaline released when listening could activate the release of dopamine – the body’s reward hormone – causing a positive feedback loop as we want to experience more pleasure from the music.

There is also evidence that physical and emotional pain are linked, due to the areas of the brain that are stimulated when an individual experiences pain (Lumley et al., 2011). How many times have you felt so stressed about something that you get headaches, or back pain? If music can help diminish symptoms of both physical and emotional pain, and those are linked, can music cure them both simultaneously

When two worlds collide

TMS (Tension Myoneural Syndrome) is a form of back pain; it affects many adults and children, and anxiety is often the emotional stimulus for an attack of TMS (Md, 1991). Therefore, using music therapy to allow the anxiety to be expressed and alleviated could be a form of treatment for TMS. 77 per cent of back pain sufferers in a survey are between the ages of 30 and 60 – these are seen as the years where there is the most stress and anxiety to succeed in things such as work (Md, 1991). If music could help to relieve stress and anxiety, could it help to reduce the pain?

Further evidence for physical pain being linked to the brain is within one of the three fundamentals of psychology: behavioural experiences are the effect of physical causes that can be studied (Gray & Bjorklund, 2018). This cause-and-effect relationship means that physical symptoms of pain that have caused psychological problems can be treated by listening to music- if we treat the behaviour, we can treat the physical pain behind it.

Fact or fiction?

So, we have established the connection between music and pain, and how music may be able to treat it (whether that pain is emotional, physical, or both). Music certainly moves us, and it scratches a part of the brain that other arts just can’t seem to reach. Music cures us in many ways, and perhaps embracing the vulnerability that a good song exposes is the key to being pain-free.

• This post was originally written as part of PB101: Foundations of Psychological Science, which is a core course on the BSc Psychological and Behavioural Science. It has been published with the permission of the author.
• The opinions in this post are of the author, not of the Department of Psychological and Behavioural Science or LSE.
• Cover image by Pixabay from Pexels.

References

• Bailey, L. M. (1986). Music therapy in pain management. Journal of Pain and Symptom Management, 1(1), 25–28. Link.
• Dodgson, L. (2018, December 20). There’s a biological reason why some people get chills down their spine when they listen to music and others don’t. Business Insider. Link.
• Ethans, L. (2021, April 11). 6 Positive And Negative Ways Music Influences Mood. Power of Positivity. Link.
• Gray, P., & Bjorklund, D. (2018, April). Psychology (8th ed.). Macmillan Learning.
• Jafari, H., Zeydi, A. E., Khani, S., Esmaeili, R., & Soleimani, A. (2012, January 5). The effects of listening to preferred music on pain intensity after open heart surgery. Iranian Journal of Nursing and Midwifery Research. Link.
• Lumley, M. A., Cohen, J. L., Borszcz, G. S., Cano, A., Radcliffe, A. M., Porter, L. S., Schubiner, H., & Keefe, F. J. (2011). Pain and emotion: a biopsychosocial review of recent research. Journal of Clinical Psychology, 67(9), 942–968. Link.
• Md, J. S. E. (1991). Healing Back Pain: The Mind-Body Connection (1st ed.). Warner Books.
• Nusbaum, E. C., Silvia, P. J., Beaty, R. E., Burgin, C. J., Hodges, D. A., & Kwapil, T. R. (2014). Listening between the notes: Aesthetic chills in everyday music listening. Psychology of Aesthetics, Creativity, and the Arts, 8(1), 104–109. Link.
• Whitlock, J. (2021, October 8). Practical Ways to Decrease Pain After Surgery. Verywell Health. Retrieved January 10, 2023. Link.