Chronic pain is one of the most significant health problems facing Americans, with an estimated 100 million people struggling with pain on an ongoing basis. Worldwide, roughly 1.5 billion people have a chronic pain condition. Pain is a particularly distressing physical symptom, and for those who have a chronic issue, depression and anxiety are both common triggers of increased pain severity and are also frequently triggered by pain. Pain is a brain-dependent experience in that the brain determines if we register a sensation as painful, as well as how we assign meaning to the pain and assess whether it is something we can handle.
Although drugs and procedures can be vital in the effort to manage chronic pain, often these approaches fail to sufficiently reduce pain severity, may not alleviate the mood symptoms associated with pain, are costly, and can have undesirable side effects.
Music as a therapeutic intervention has many pluses. Music is low- to no-cost, has no side effects, provides a welcome distraction from painful sensations, and has been shown to reduce both subjective ratings of pain and feelings of distress. In previous research, listening to music has also been associated with reduced use of opioid pain medications.
Recent studies have found that music activates areas of the brain associated with reward, emotion, and arousal. Music might be effective at lessening pain and improving coping, as it may prompt the release of the body’s own opioids (pain-reducing chemicals). Until recently, no studies had demonstrated how music impacts specific regions of the brain associated with pain. Several studies, however, have found changes in brain activity in response to pain. Key areas impacted by pain include the amygdala, anterior cingulate cortex (ACC), somatosensory cortex, insula, and hypothalamus, to name a few.
A study recently published in The Journal of Pain used functional magnetic resonance imaging (fMRI) to examine how music alters the brain’s response to experimentally induced pain. In this study, Christine Dobek and colleagues had 12 healthy women who were not musicians undergo imaging of multiple parts of the brain and one area of the spinal cord (the dorsal horn) associated with regulating pain perception. They also examined whether areas of the brain associated with reward and emotions would respond to music.
The study included women only, because women tend to be more sensitive to pain in the area of the hand exposed to the painful stimulus than men are. Specifically, in this study, each participant was exposed during alternating periods to both the experimental (music) and control (no music) conditions. The participants were assessed during the last two weeks of their menstrual cycles to control for natural variations in pain sensitivity and opioid levels. Finally, participants were screened to rule out mood and other psychiatric symptoms prior to taking part in the study, as these are known to impact pain perception.
For the study, the women remained in the fMRI machine while receiving a painful stimulus (heat) in the thenar eminence (the fleshy part of the palm below the thumb) during alternating periods of listening to their favorite music or no music. After each session, participants rated their average and maximum levels of pain, and evaluated their self-selected music on a number of dimensions.
The researchers found that on average, participants rated their musical selections as happy, calm, pleasant, and relaxed. Music that fell into one of the latter three categories had the greatest impact on pain reduction. Participant ratings of average and worst pain were significantly lower in the music-plus-pain condition as compared to the pain-only condition. Notably, music was associated with the release of dopamine (a neurotransmitter) and the body’s own opioids, which are associated with improved coping and decreased pain. Furthermore, there were statistically significant changes in the brain, spinal cord, and brainstem responses in the music-plus-pain condition, including several structures in the limbic system, as well as the periaqueductal gray area, dorsolateral prefrontal cortex, and dorsal horn of the spinal cord, suggesting what is known as descending pain modulation (the brain changing the experience of pain felt in the body).
Although the data on which specific brain areas were affected in what ways is too complex to detail further here, this information can be found by consulting the original article below. But the take-home message is that listening to music that you like, that you would rate as calm, pleasant, and/or relaxed, is an enjoyable experience that can help change activity in several areas of the brain and spinal cord to decrease pain severity and improve pain coping. So, it’s worth adding your favorite music to your pain-management program.
Dobek, C. E., Beynon, M. E., Bosma, R., L., and Stroman, P. W. (2014). Music Modulation of Pain Perception and Pain-Related Activity in the Brain, Brain Stem, and Spinal Cord: A Functional Magnetic Resonance Imaging Study. The Journal of Pain, 15(10), 1057-1068.
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