The Sound of Relief: Music’s Role in Easing Pain

In 2021, a fascinating study shadowed nearly 50 people during a notoriously painful experience: surgery. For five days after arthroplasty (joint) surgery, half of the group was instructed to listen to the music of their own choice in 30-minute increments. Lo and behold, the participants who listened to music reported significantly lower pain intensity and distress than those who didn’t—both in the hospital and after they returned home. 

This is just one of many studies to conclude music can be a valuable pain intervention—and one that we need now more than ever. According to the latest NIH data, approximately 21% of adults in the U.S. suffer from chronic pain, making the condition even more common than diabetes, depression, and high blood pressure. 

All pain responses are unique, multifaceted, and highly personal. This complexity makes it difficult to pinpoint how, exactly, music fits into the pain puzzle, but researchers are learning more with each passing tune. 

Why does music help ease pain?

Here are five reasons why music may help ease pain quickly, cheaply, and without side effects:

1. Music takes advantage of the “gate control theory”‍

One of the earliest theories on the pain response is known as the “gate control theory.” Introduced in the 1960s, it states that pain happens when peripheral triggers (say, a burn on your leg) send signals up the spinal cord and into the brain. The pain pathways of the nervous system act as gates that can be opened or closed, the theory says.

Listening to music may be a way to close the gates, so to speak, and prevent pain signals from reaching the brain and triggering a response. 

“If someone is listening to music [during a painful event], that would engage the auditory nerve pathway in the brain,” explains Concetta Tomaino, DA, the Executive Director of The Institute for Music & Neurologic Function and the Music Therapy Advisor at Spiritune. “Their brain networks would be engaged by music listening [and] that activation would actually close some of the upward-bound signals from the periphery into the brain.”

2. Listening to music provides a distraction from pain‍

As anyone who finds it hard to stay on-task when certain songs are playing knows, music can be distracting. But in the context of pain, a little distraction is a helpful thing.

In his book, I Heard There Was a Secret Chord, neuroscientist and musician Daniel J. Levitin writes: “The brain is bombarded with millions of inputs every hour, and we pay attention to only a small proportion of them. People who are in enriched environments—with lots of things to see, listen to, and do—experience less pain than those in simpler environments.” By this logic, he writes, music can provide a welcome distraction from pain.

This in-the-moment distraction is helpful temporarily, but it doesn’t explain why music can lead to longer-term decreases in pain (like those the joint surgery patients experienced after they returned home). To answer this question, researchers have started to dig deeper into the inner workings of the brain.

3. When we listen to enjoyable music, it releases dopamine and serotonin‍

Advancements in functional magnetic resonance imaging (fMRI) technology have made it possible to look more closely at the regions of the brain that get activated when we listen to music. 

These tests have demonstrated that music affects the brain’s pleasure pathways in a similar way to a tasty meal. When we prepare to listen to a favorite song, our brains go through a phase of expectation and anticipation. Then, when we press play, a reward is delivered in the form of positive neurochemicals. 

“When you’re listening to pleasurable music, there’s a release of dopamine and serotonin which gives you a pleasurable feeling. That ends up diminishing the pain experience,” says Tomaino. 

4. Music can soothe stress and anxiety‍

Pain and anxiety go hand-in-hand. Think about what happens when you know pain is coming, like in the case of a shot: Your anticipatory stress can make it feel even more extreme and intense. On the flip side, reducing your anxiety might also tone down your pain response.

Listening to music—particularly slow, calming music—is a well-established way to practice stress management: It can bring down cortisol levels (a stress hormone), reduce heart rate, and lower blood pressure, preventing anxiety from turning up the volume on pain.

5. Music provides the opportunity to socialize ‍

Finally, listening to (and playing!) music in a group is a wonderful way to build connections and interact with other people. The resulting social bonds can further reduce anxiety and provide a distraction from pain (as well as expand empathy, change perspectives, and incite awe).

The ins and outs of using music for pain management

With decades of experience administering music therapy in different medical settings, Tomaino has a wealth of knowledge on using music to address chronic and acute pain. Here are her top tips:

What types of music should I play?

Tomaino notes that a song that is calming and comforting to one person may not be to another. So in moments of pain, it’s best to listen to music you, personally, enjoy. 

That said, certain frequencies and tempos do seem to incite a more widespread positive response, she says. Music medicine platforms like Spiritune harness these universal sounds to help listeners of all ages, preferences, and backgrounds move from one mental state to another. Think of Spiritune’s expert-crafted playlist as “audio elixirs” you can take any time, anywhere.

How should I listen to it?

To address intense pain in the moment, Tomaino typically asks patients to give a song their full attention. “They need to slow their breath down and become mindful of the sounds of the music so they can induce a state of well-being and calm, and also distract from the pain signal,” she says.

For those with lingering dull pain, this level of attention may not be necessary. Instead, she says, “If they have something in the background that keeps them comfortable and soothed, their experience of pain should be diminished.”

In the case of chronic pain, Tomaino recommends creating a personal affirmation or mantra to call on when things get intense. You can then craft a playlist of songs that remind you of your mantra’s theme—be it power, strength, or inner peace. That way, the playlist is there for you to listen to as needed to help you break the pain cycle in the brain. Spiritune's prompts in app can be a hybrid version of the mantra approach (i.e. "I feel tense and I'm moving to peaceful").

Appreciating and accepting music's therapeutic powers is a great starting point, then taking it seriously and being intentional about your approach will help you reap the biggest rewards.  

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