Nurse Rod Salaysay works with all kinds of instruments in the hospital: a thermometer, a stethoscope and sometimes his guitar and ukulele.
In the recovery unit of UC San Diego Health, Salaysay helps patients manage pain after surgery. Along with medications, he offers tunes on request and sometimes sings. His repertoire ranges from folk songs in English and Spanish to Minuet in G Major and movie favorites like “Somewhere Over the Rainbow.”
Patients often smile or nod along. Salaysay even sees changes in their vital signs like lower heart rate and blood pressure, and some may request fewer painkillers.
“There’s often a cycle of worry, pain, anxiety in a hospital,” he said, “but you can help break that cycle with music.”
Salaysay is a one-man band, but he’s not alone. Over the past two decades, live performances and recorded music have flowed into hospitals and doctors’ offices as research grows on how songs can help ease pain.
Scientists explore how music affects pain perception
The healing power of song may sound intuitive given music’s deep roots in human culture. But the science of whether and how music dulls acute and chronic pain — technically called music-induced analgesia — is just catching up.
No one suggests that a catchy song can fully eliminate serious pain. But several recent studies, including in the journals Pain and Scientific Reports, have suggested that listening to music can either reduce the perception of pain or enhance a person’s ability to tolerate it.
What seems to matter most is that patients — or their families — choose the music selections themselves and listen intently, not just as background noise.
How music can affect pain levels
“Pain is a really complex experience,” said Adam Hanley, a psychologist at Florida State University. “It’s created by a physical sensation, and by our thoughts about that sensation and emotional reaction to it.”
Two people with the same condition or injury may feel vastly different levels of acute or chronic pain. Or the same person might experience pain differently from one day to the next.
Acute pain is felt when pain receptors in a specific part of the body — like a hand touching a hot stove — send signals to the brain, which processes the short-term pain. Chronic pain usually involves long-term structural or other changes to the brain, which heighten overall sensitivity to pain signals. Researchers are still investigating how this occurs.
“Pain is interpreted and translated by the brain,” which may ratchet the signal up or down, said Dr. Gilbert Chandler, a specialist in chronic spinal pain at the Tallahassee Orthopedic Clinic.
Researchers know music can draw attention away from pain, lessening the sensation. But studies also suggest that listening to preferred music helps dull pain more than listening to podcasts.
“Music is a distractor. It draws your focus away from the pain. But it’s doing more than that,” said Caroline Palmer, a psychologist at McGill University who studies music and pain.
Scientists are still tracing the various neural pathways at work, said Palmer.
“We know that almost all of the brain becomes active when we engage in music,” said Kate Richards Geller, a registered music therapist in Los Angeles. “That changes the perception and experience of pain — and the isolation and anxiety of pain.”
Music genres and active listening
The idea of using recorded music to lessen pain associated with dental surgery began in the late 19th century before local anesthetics were available. Today researchers are studying what conditions make music most effective.
Researchers at Erasmus University Rotterdam in the Netherlands conducted a study on 548 participants to see how listening to five genres of music — classical, rock, pop, urban and electronic — extended their ability to withstand acute pain, as measured by exposure to very cold temperatures.
All music helped, but there was no single winning genre.
“The more people listened to a favorite genre, the more they could endure pain,” said co-author Dr. Emy van der Valk Bouman. “A lot of people thought that classical music would help them more. Actually, we are finding more evidence that what’s best is just the music you like.”
The exact reasons are still unclear, but it may be because familiar songs activate more memories and emotions, she said.
The simple act of choosing is itself powerful, said Claire Howlin, director of the Music and Health Psychology Lab at Trinity College Dublin, who co-authored a study that suggested allowing patients to select songs improved their pain tolerance.
“It’s one thing that people can have control over if they have a chronic condition — it gives them agency,” she said.
Active, focused listening also seems to matter.
Hanley, the Florida State psychologist, co-authored a preliminary study suggesting daily attentive listening might reduce chronic pain.
“Music has a way of lighting up different parts of the brain,” he said, “so you’re giving people this positive emotional bump that takes their mind away from the pain.”
It’s a simple prescription with no side effects, some doctors now say.
Cecily Gardner, a jazz singer in Culver City, California, said she used music to help get through a serious illness and has sung to friends battling pain.
“Music reduces stress, fosters community,” she said, “and just transports you to a better place.”
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