Underlying Music Mechanisms Influencing the Neurology of Pain: An Integrative Model

Abstract

Pain is often debilitating, and is associated with many pathologies, as either a cause or consequence. Pharmacological interventions, such as opioids, to manage pain may lead to potential problems, such as addiction. When pain is controlled and managed, it can prevent negative associated outcomes affiliated with disease. Music is a low-cost option that shows promise in the management of painful circumstances. Music therapy has provided potent options for pain relief across a variety of ages and populations. As a nonpharmacological alternative or complement lacking side effects, music interventions are growing in clinical application and research protocols. This article considers the neurological implications of varying kinds of pain to provide working considerations that preempt the use of music and music-therapy applications in treating pain.

The psychophysiology of music-based interventions and the experience of pain

“…There is increasing evidence that music-based interventions are inexpensive, safe, non-invasive and useful aids in the clinical treatment of a range of medical, neurological and psychiatric conditions, including helping to reduce perceptions of pain and distress (e.g., Nilsson, 2008;Hsieh et al, 2014;Hole et al, 2015;van der Heijden et al, 2015;Lee, 2016;Garza-Villareal et al, 2017;Kühlmann et al, 2018;Martin-Saavedra et al, 2018b;Lunde et al, 2019;Chai et al, 2020;Ginsberg et al, 2022;Loewy, 2022;Powers et al, 2022;Ting et al, 2022;Lee et al, 2023). Indeed, the belief that music, whether listening or performing, can alter the human pain experience has a long history, dating back to the ancient Greeks, and its potential healing properties have long been appreciated by indigenous cultures around the world (Thaut, 2015).…”

“…ii. when listening to music: the type of music that is presented, when and for what period(s) of time, whether it is live or pre-recorded, and the presence or absence of lyrics (e.g., Sakamoto et al, 2018;Martin-Saavedra et al, 2018b;Richard-Lalonde et al, 2020;Wu et al, 2021;Loewy, 2022;Chow et al, 2023;Lee et al, 2023). When listening to favorite music chosen by a patient, pleasant and relaxing choices are often shown to be the most effective (Nilsson et al, 2005;Nilsson, 2008;Roy et al, 2008;Dobek et al, 2014;Hsieh et al, 2014;Garza-Villareal et al, 2017;Lin et al, 2019;Lunde et al, 2019;Antioch et al, 2020;Howlin and Rooney, 2021;Howlin et al, 2022;Colebaugh et al, 2023;Lu et al, 2023;Valevicius et al, 2023).…”

Effect of music intervention on subjective scores, heart rate variability, and prefrontal hemodynamics in patients with chronic pain

“…Psychology argues that music interventions can improve motivation, elevate mood, and relieve pain by intentionally distracting people from unpleasant sensations and reducing the perception of pain or anxiety (Kristjánsdóttir and Kristjánsdóttir, 2011). On the other hand, neural mechanism theories suggest that the melody and rhythm of music influence autonomic nervous system regulation and pain perception by influencing the limbic system and hypothalamus to reduce the secretion of catecholamines (Loewy, 2022). Musical melodies of 8-13 Hz stimulate alpha brain waves to relax consciousness Abbreviations: VAS, visual analog scale; HRV, heart rate variability; fNIRS, functional near-infrared spectroscopy; HbO, oxyhemoglobin; HbR, deoxyhemoglobin; ECG, electrocardiogram; HR, heart rate.…”