Medicinal Music

Turn up your favorite song—it may actually do more than just move you

Woman listening to music
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Though often misquoted, the contention that “music has charms to soothe the savage breast” is familiar to most of us. The actual quote, which derives from a tragic play called “The Mourning Bride” by William Congreve, published over 300 years ago, goes on: “Music has Charms to soothe a savage Breast, To soften Rocks, or bend a knotted Oak.”

Making allowance for poetic license, the statement translates to a claim about the power of music over emotion and its capacity to soothe us, relieve us, and calm us.

The claim seemingly extends to a physical influence as well; the bending (or unbending) of a knotted oak immediately hints at the uncoiling of a stiff, arthritic joint. Science is catching up to suggest that both attributes of medicinal music may be much more than a playwright’s wishful thinking. 

A Proven Therapy

A systematic review and meta-analysis in the journal Pain Physician indicate ​that music functions effectively to alleviate both chronic pain and related depression. In general, music was used as adjuvant therapy in the interventions assessed, meaning in combination with other, more conventional pain treatments, rather than as a standalone substitute for them. The studies reviewed encompassed those in which patients chose their own music and others in which music was selected by the investigators.

The basic conclusions were that “music reduces self-reported pain, anxiety, and depression symptoms in a diverse range of chronic pain patients,” and that it tends to be more effective when patients are in charge of the musical selection for themselves.

The authors noted pain relief across a wide array of conditions, suggesting that the analgesic effect of music might be relevant to all chronic pain sufferers. Relief of anxiety and depression was also found to be significant, but this study could not determine whether this was a separate, primary effect of music or secondary to the relief of physical pain.

Another study, however, indicates the relief of both depression and anxiety is indeed another primary, independent effect of music. A systematic review and meta-analysis published in the Cochrane Database of Systematic Reviews, this paper examined intervention trials that compared music alone, or in combination with standard psychological and pharmacological therapies, to those standard treatments without music. The addition of music improved depressive symptoms, relieved anxiety, and enhanced function.

Other studies have indicated favorable effects of music on psychological stress and associated effects on heart-rate variability, an important predictor of cardiovascular risk.

In brief, music does have the scientifically verified capacity to soothe the troubled breast and mind, relieving both physical and psychological pain.

The How

How it does so remains uncertain, and much of the scientific literature on the topic concludes with the encouragement of research into potential mechanisms. There are some studies that have examined effects of musicality on brainwaves, and perhaps the answer resides there. Some investigators have suggested an influence in the brain that diverts attention from signals of pain and distress.

That latter possibility is in some ways very familiar to us all from childhood when we were eager to have a parent “rub a boo-boo.” 

If you pause to think about it, it’s rather counterintuitive that rubbing on a site of pain could be a good idea—but, indeed, it is. The rubbing of “boo-boos” activates sensory receptors around the site that send the signal of the rubbing up the spinal cord. Those mechanisms compete with the pain signals and actually travel faster; sensory neurons are wrapped in myelin, which accelerates transmission, whereas pain fibers are not. This, too, by the way, is familiar to anyone who has ever stubbed a toe in the dark: You feel that you’ve stubbed your toe and have to think “oh, no!” while waiting for it to start throbbing.

That interval between awareness and pain, albeit quick, represents the differential speed of sensory and pain fibers.

This mechanism is called “gating,” because sensory input can crowd and, thus, block the gateway to the brain that pain signals also must traverse. In essence, sensory input gets the brain’s attention so that pain messages get less of it. Music may act in a related way, although, if so, the effect seems to be directly in the brain, rather than a gating mechanism in the spinal cord.

Embracing the Unconventional

The idea that a medical treatment can be shown to work before we know exactly how it does so is of general importance where conventional and “alternative” medicine divide. Conventional medical treatments are often developed based on mechanism, so it’s unusual, although not unheard of, for modern treatments to be developed without a fairly clear understanding of how they work when they do. In contrast, alternative medical practices are often based on long-experience and traditional remedies, adopted before the capacity to explore and elucidate scientific mechanisms was in place. The evolving understanding of medicinal music is a reminder that we can know something works before knowing how.

The other important and timely message here is that there are often therapeutic opportunities in the domain of lifestyle that struggle to compete with the power centers of conventional medicine. Consider, for instance, how the use of opioids for pain has evolved into a national crisis of drug use, abuse, and addiction, while the potential role of such remedies as music and other modalities to reduce the reliance on drugs has received so little attention. The capacity of music to soothe our troubled nerves is a reminder of the need to think holistically about human health and make full use of lifestyle as the kinder, gentler, safer medicine it can so often be.

I love music, and one of my slightly guilty pleasures is watching The Voice with my wife. Hearing the contestants talk about the transformative role of music in their lives, and the celebrity coaches about the power of music to move people, I have at times wondered if they might be overstating the case.

Apparently not. A 300-year-old play and modern science alike are on their side. Music moves us and soothes us. Music is medicine.

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