More on Music and Pain

Dear Pain Matters blog readers,

More on relaxing music and pain –

A study by Peter Vuust et al (Aarhus University, Denmark) found that in 22 fibromyalgia patients, (1) the intensity of pain as well as (2) its unpleasantness (‘pain affect’) were both reduced after listening to their favourite (self-selected) relaxing music.

In other words, because this self-chosen, relaxing music was considered pleasant by the patients (likely, evoking positive emotions), it resulted in reductions in both the intensity of pain as well as the unpleasantness of pain in fibromyalgia patients.

Consequently, pain management strategies that also include relaxing and pleasant (self-selected) music therapy may enable pain medication dosages to be reduced, hence reducing side effects from medication.

Improvement in mobility was also noted following music therapy.

Another study by Guétin et al also confirmed the benefits of music therapy as an additional pain management strategy for chronic pain patients.  This study involved 87 chronic pain patients including patients with lower back pain and fibromyalgia (reference below).

It is possible that increased parasympathetic nervous system activity results when we listen to our own favourite relaxing and pleasant music (and/or pursue other deeply relaxing therapies/hobbies each day).  This may increase efferent vagus nerve activity that leads to decreased local inflammation….and hence, reduced inflammatory pain (more later).

Further research is warranted whether relaxing and pleasant music therapy leads to specific physiological effects including:

– reduced heart rate,

– increased heart rate variability, and

– reduced respiratory rates/deeper breath intakes

in chronic pain patients.  The consequence of these physiological effects may equate to reduced intensity of pain.

If you’d like to listen to the relaxing songs that were selected by the fibromyalgia patients, they are listed in the back of the paper by Garza-Villarreal et al (Table 2 in the Appendix).  A small sample from this Table 2 is also provided below:

Secreto de Amor

Vivaldi – Four Seasons – Spring Allegro Pastorale

So blog readers, what are your favourite relaxing and pleasant songs?

Until soon,

Sabina Walker

PS  I would like to share the latest press release on this topic (13 August 2015):

Music improves recovery and lowers pain after surgery, says study published in the Lancet

http://www.smh.com.au/national/health/music-improves-recovery-and-lowers-pain-after-surgery-says-study-published-in-the-lancet-20150812-gixprn.html

References:

(1) Garza-Villarreal et al; Music reduces pain and increases functional mobility in fibromyalgia; Front Psychol (Feb 2014); 5:90.

doi: 10.3389/fpsyg.2014.00090

http://www.readcube.com/articles/10.3389/fpsyg.2014.00090

(2) Music can relieve chronic pain. Science Nordic (March 25, 2014)

http://sciencenordic.com/music-can-relieve-chronic-pain

(There is also a Danish link.)

(3) Guétin et al; The Effects of Music Intervention in the Management of Chronic Pain: A Single-Blind, Randomized, Controlled Trial;

Clinical Journal of Pain (May 2012); 28(4); Pages 329–337.

doi: 10.1097/AJP.0b013e31822be973

http://journals.lww.com/clinicalpain/Abstract/2012/05000/The_Effects_of_Music_Intervention_in_the.8.aspx

(4a) Hole et al; Music as an aid for postoperative recovery in adults: a systematic review and meta-analysis; Lancet.

DOI: http://dx.doi.org/10.1016/S0140-6736(15)60169-6

(4b) Dreaper; Music ‘reduces pain and anxiety’ for surgery patients; BBC News (13 August 2015).
http://www.bbc.co.uk/news/health-33865448

Can Music Reduce Pain Levels?

Dear Pain Matters blog readers,

An interesting question exists:

Can certain types of music lessen the intensity of pain in some patients?

Intuitively, I’ve always felt that music can have a deep effect on us.  Some types of music are deeply relaxing, while at the other end of the music spectrum, it can literally ‘shake us out of our boots’.

Depending on the type of music being listened to, music can evoke 1 or more of a complex range of emotions in the listener including positive emotions such as awe/reverence/gratitude, love, joy, and/or lust/passion (in our imagination or otherwise), or negative emotions such as grief/sadness, hate, and/or anger.

Hans-Joachim Trappe reports that music can cause changes in  heart rate as well heart rate variability.  Cerebral blood flow can be significantly reduced when listening to ‘Va pensioero’ (from Verdi’s ‘Nabucco‘).  A study found that relaxing, preoperative music decreased anxiety levels more effectively than oral midazolam (both ‘before’ and ‘after’ an operation)….with fewer side effects than midazolam.  Stress-related cortisol levels were significantly reduced in the music group after 30 minutes of bed rest, post-operation, compared to the non-music group.

Depending on the patient’s taste in different types of relaxing music, music involving classical and meditation music had the best results.

It is important to note that if the patient prefers meditative music over classical music, then it is likely that classical music will not reduce their pain levels at all.  In these patients, meditative music may be more effective at reducing pain levels.

This was clearly demonstrated by Montreal researchers who reported that only the ‘pleasant‘ parts of music (that induce positive emotions) resulted in significant reductions in both pain levels and unpleasantness due to experimental thermal pain in healthy people.  Thus, the ‘pleasant‘ music reduced pain significantly, while the ‘unpleasant‘ music did not change pain.

It is important to note that the notion of ‘pleasant‘ versus ‘unpleasant‘ music may vary from one person to the next.

In other words, just as ‘beauty is in the eye of the beholder’, the ‘pleasantness of relaxing music is in the ear of the beholder’.

Some people may prefer to listen to more relaxing music than others.  Still others may prefer the sound of silence over relaxing music.

Reduced heart rate, increased heart rate variability, reduced respiratory rate, etc, are all important parameters that may be regularly monitored to assess (and confirm) their links with reduced pain levels.  More research is warranted.  More on this topic in future posts…..

Have a great day,

Sabina Walker

References

(1) Bernardi et al; Dynamic interactions between musical, cardiovascular, and cerebral rhythms in humans. Circulation 2009; 30(119):3171–80.

http://circ.ahajournals.org/content/119/25/3171.full.pdf+html

(2) Roy, Peretz, Rainville; Emotional valence contributes to music-induced analgesia. Pain 2008 Jan; 134(1-2):140-7.

http://www.ncbi.nlm.nih.gov/pubmed/17532141

(3) Hans-Joachim Trappe; Role of music in intensive care medicine; Int J Crit Illn Inj Sci. 2012 Jan-Apr; 2(1): 27–31.

doi: 10.4103/2229-5151.94893

PMCID: PMC3354373

http://www.ncbi.nlm.nih.gov/pubmed/22624099

(4) Hans-Joachim Trappe; [Music and health–what kind of music is helpful for whom? What music not?].  [Article in German]; Dtsch Med Wochenschr. 2009 Dec; 134(51-52):2601-6.

doi: 10.1055/s-0029-1243066.

http://www.ncbi.nlm.nih.gov/pubmed/20013543