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Isn't There Room for Music in Chronic Pain Management?

  • Aleksi J. Sihvonen
    Correspondence
    Address reprint requests to Aleksi J. Sihvonen, Cognitive Brain Research Unit, Department of Psychology and Logopedics, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, FI-00014, Finland.
    Affiliations
    Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland

    Centre for Clinical Research, The University of Queensland, Australia
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  • Anni Pitkäniemi
    Affiliations
    Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
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  • Teppo Särkämö
    Affiliations
    Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
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  • Seppo Soinila
    Affiliations
    Neurocenter, Turku University Hospital and Division of Clinical Neurosciences, University of Turku, Finland
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Published:February 03, 2022DOI:https://doi.org/10.1016/j.jpain.2022.01.003

      Abstract

      Chronic pain with its comorbidities, such as depression, insomnia, and social deprivation, is a major cause of disability and health-economic burden. Insufficient response to pain medication and potentially serious adverse effects have led the majority of chronic pain patients to seek relief from non-pharmacological remedies. Along with this trend, pain research has paid increasing interest in critical evaluation of various complementary treatments. Music-based treatments have emerged as an efficacious and safe means to enhance the management of acute and chronic pain. We review the current position of music-based interventions in the treatment of chronic pain and present explanations for the analgesic effects of music through modulation of the primary nociception and discuss the contribution of the mesolimbic dopaminergic system to the affective component of pain perception. We propose ways to translate the novel theoretical understanding into clinical practice in different health care settings, primary health care in particular, and discuss the preconditions of successful implementation. We argue that music interventions provide low-cost, easily applicable complementary pain treatments not requiring heavy utilization of health care resources. Finally, we provide research and quality improvement frameworks and make suggestions to cover the gaps of existing evidence.

      Perspective

      This article addresses the current evidence for analgesic effects of music interventions, discusses its neurobiological basis and evaluates potential use of music in treating chronic pain patients in different health care settings. We also propose directions for future research to cover shortages in the currently published data.

      Key words

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      References

        • Allen K
        • Blascovich J
        Effects of music on cardiovascular reactivity among surgeons.
        JAMA J Am Med Assoc. 1994; 272: 882-884
        • Antioch I
        • Furuta T
        • Uchikawa R
        • Okumura M
        • Otogoto J
        • Kondo E
        • Sogawa N
        • Ciobica A
        • Tomida M
        Favorite music mediates pain-related responses in the anterior cingulate cortex and skin pain thresholds.
        J Pain Res. 2020; 13: 2729-2737
        • Baron R
        Mechanisms of disease: Neuropathic pain - A clinical perspective.
        Nat Clin Pract Neurol. 2006; 2: 95-106
        • Baron R
        • Binder A
        • Wasner G
        Neuropathic pain: Diagnosis, pathophysiological mechanisms, and treatment.
        Lancet Neurol. 2010; 9: 807-819
        • Basiński K
        • Zdun-Ryżewska A
        • Greenberg DM
        • Majkowicz M
        Preferred musical attribute dimensions underlie individual differences in music-induced analgesia.
        Sci Rep. 2021; 11
        • Bingel U
        • Tracey I
        Imaging CNS modulation of pain in humans.
        Physiology. 2008; 23: 371-380
        • Breivik H
        • Collett B
        • Ventafridda V
        • Cohen R
        • Gallacher D
        Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment.
        Eur J Pain. 2006; 10: 287
        • Crofford LJ
        Adverse effects of chronic opioid therapy for chronic musculoskeletal pain.
        Nat Rev Rheumatol. 2010; 6: 191-197
        • Dobek CE
        • Beynon ME
        • Bosma RL
        • Stroman PW
        Music modulation of pain perception and pain-related activity in the brain, brain stem, and spinal cord: A functional magnetic resonance imaging study.
        J Pain. 2014; 15: 1057-1068
        • Elliott AM
        • Smith BH
        • Penny KI
        • Smith WC
        • Chambers WA
        The epidemiology of chronic pain in the community.
        Lancet. 1999; 354: 1248-1252
        • Fayaz A
        • Croft P
        • Langford RM
        • Donaldson LJ
        • Jones GT
        Prevalence of chronic pain in the UK: A systematic review and meta-analysis of population studies.
        BMJ Open. 2016; 6e010364
        • Fu VX
        • Oomens P
        • Klimek M
        • Verhofstad MHJ
        • Jeekel J
        The effect of perioperative music on medication requirement and hospital length of stay: A meta-analysis.
        Ann Surg. 2020; 272: 961-972
        • Garcia-Larrea L
        • Peyron R
        Pain matrices and neuropathic pain matrices: A review.
        Pain. 2013; 154: S29-S43
        • Gardner WJ
        • Licklider JC
        • Weisz AZ
        Suppression of pain by sound.
        Science (80-). 1960; 132: 32-33
        • Garza-Villarreal EA
        • Pando V
        • Vuust P
        • Parsons C
        Music-induced analgesia in chronic pain conditions: A systematic review and meta-analysis.
        Pain Physician. 2017; 20: 597-610
        • Garza-Villarreal EA
        • Wilson AD
        • Vase L
        • Brattico E
        • Barrios FA
        • Jensen TS
        • Romero-Romo JI
        • Vuust P
        Music reduces pain and increases functional mobility in fibromyalgia.
        Front Psychol. 2014; 5
        • Good A
        • Russo FA
        Changes in mood, oxytocin, and cortisol following group and individual singing: A pilot study.
        Psychol Music :030573562110426. 2021;
        • Greenberg DM
        • Baron-Cohen S
        • Stillwell DJ
        • Kosinski M
        • Rentfrow PJ
        Musical preferences are linked to cognitive styles.
        PLoS One. 2015; 10
        • Hole J
        • Hirsch M
        • Ball E
        • Meads C
        Music as an aid for postoperative recovery in adults: A systematic review and meta-analysis.
        Lancet. 2015; 386: 1659-1671
        • IOM (Institute of Medicine)
        Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research.
        The National Academies Press, Washington, DC2011
        • Jespersen KV.
        • Koenig J
        • Jennum P
        • Vuust P
        Music for insomnia in adults.
        Cochrane Database Syst Rev. 2015; 2015CD010459https://doi.org/10.1002/14651858.CD010459.pub2
        • Knaster P
        • Karlsson H
        • Estlander AM
        • Kalso E
        Psychiatric disorders as assessed with SCID in chronic pain patients: The anxiety disorders precede the onset of pain.
        Gen Hosp Psychiatry. 2012; 34: 46-52
        • Koelsch S
        Brain correlates of music-evoked emotions.
        Nat Rev Neurosci. 2014; 15: 170-180
        • LeDoux JE
        Emotion circuits in the brain.
        Annu Rev Neurosci. 2000; 23: 155-184
        • Legrain V
        • Van Damme S
        • Eccleston C
        • Davis KD
        • Seminowicz DA
        • Crombez G
        A neurocognitive model of attention to pain: Behavioral and neuroimaging evidence.
        Pain. 2009; 144: 230-232
        • Lunde SJ
        • Vuust P
        • Garza-Villarreal EA
        • Vase L
        Music-induced analgesia: How does music relieve pain?.
        Pain. 2019; 160: 989-993
        • Magee WL
        • Clark I
        • Tamplin J
        • Bradt J
        Music interventions for acquired brain injury.
        Cochrane Database Syst Rev. 2017; 2017CD006787
        • Mas-Herrero E
        • Marco-Pallares J
        • Lorenzo-Seva U
        • Zatorre RJ
        • Rodriguez-Fornells A
        Individual differences in music reward experiences.
        Music Percept An Interdiscip J. 2013; 31: 118-138
      1. Mas-Herrero E, Singer N, Ferreri L, McPhee M, Zatorre RJ, Ripolles P: Rock ’n’ Roll but not sex or drugs: music is negatively correlated to depressive symptoms during the COVID-19 pandemic via reward-related mechanisms. PsyArXiv [Internet] December 2:1–57, 2020. Available from: https://psyarxiv.com/x5upn/

        • Mitchell L
        • MacDonald R
        Music and Pain: Evidence from Experimental Perspectives.
        Music Heal Wellbeing Oxford University Press, 2012
        • Mitchell LA
        • MacDonald RAR
        • Brodie EE
        A comparison of the effects of preferred music, arithmetic and humour on cold pressor pain.
        Eur J Pain. 2006; 10: 343
        • Müller-Busch HC
        • Hoffmann P
        Active music therapy for chronic pain: A prospective study.
        Schmerz. 1997; 11: 91-100
        • Nahin RL
        • Boineau R
        • Khalsa PS
        • Stussman BJ
        • Weber WJ
        Evidence-based evaluation of complementary health approaches for pain management in the United States.
        Mayo Clin Proc. 2016; 91: 1292-1306
      2. NICE: Dementia : Assessment, Management and Support for People Living With Dementia and Their Carers (NICE Guideline, NG97). National Institute for Health and Care Excellence, editor. NICE; 2020.

      3. NINDS: National pain strategy: A comprehensive population health-level strategy for pain. 2015.

        • Oomens P
        • Fu VX
        • Kleinrensink GJ
        • Jeekel J
        The effect of music on simulated surgical performance: A systematic review.
        Surg Endosc. 2019; 33: 2774-2784
        • Pando-Naude V
        • Barrios FA
        • Alcauter S
        • Pasaye EH
        • Vase L
        • Brattico E
        • Vuust P
        • Garza-Villarreal EA
        Functional connectivity of music-induced analgesia in fibromyalgia.
        Sci Rep. 2019; 9: 1-17
        • Pedersen AS
        Use of music in anesthesia and analgesia.
        Ugeskr Laeger. 1952; 114: 176-177
        • Peretz I
        • Vuvan DT
        Prevalence of congenital amusia.
        Eur J Hum Genet. 2017; 25: 625-630
        • Roy M
        • Lebuis A
        • Hugueville L
        • Peretz I
        • Rainville P
        Spinal modulation of nociception by music.
        Eur J Pain (United Kingdom). 2012; 16: 870-877
        • Roy M
        • Mailhot JP
        • Gosselin N
        • Paquette S
        • Peretz I
        Modulation of the startle reflex by pleasant and unpleasant music.
        Int J Psychophysiol. 2009; 71: 37-42
        • Särkämö T
        • Tervaniemi M
        • Soinila S
        • Autti T
        • Silvennoinen HM
        • Laine M
        • Hietanen M
        • Pihko E
        Auditory and cognitive deficits associated with acquired amusia after stroke: A magnetoencephalography and neuropsychological follow-up study.
        PLoS One. 2010; 5: e15157
        • Schorr JA
        Music and pattern change in chronic pain.
        ANS Adv Nurs Sci. 1993; 15: 27-36
        • Sharda M
        • Silani G
        • Specht K
        • Tillmann J
        • Nater U
        • Gold C
        Music therapy for children with autism: Investigating social behaviour through music.
        Lancet Child Adolesc Heal. 2019; 3: 759-761
        • Sihvonen AJ
        • Ripollés P
        • Rodríguez-Fornells A
        • Soinila S
        • Särkämö T
        Revisiting the neural basis of acquired amusia: Lesion patterns and structural changes underlying amusia recovery.
        Front Neurosci. 2017; 11
        • Sihvonen AJ
        • Särkämö T
        • Leo V
        • Tervaniemi M
        • Altenmüller E
        • Soinila S
        Music-based interventions in neurological rehabilitation.
        Lancet Neurol. 2017; 16: 648-660
        • Sihvonen AJ
        • Särkämö T
        • Ripollés P
        • Leo V
        • Saunavaara J
        • Parkkola R
        • Rodríguez-Fornells A
        • Soinila S
        Functional neural changes associated with acquired amusia across different stages of recovery after stroke.
        Sci Rep. 2017; 7: 11390
        • Toiviainen P
        • Alluri V
        • Brattico E
        • Wallentin M
        • Vuust P
        Capturing the musical brain with Lasso: Dynamic decoding of musical features from fMRI data.
        Neuroimage. 2014; 88: 170-180
        • Tracey I
        • Mantyh PW
        The cerebral signature for pain perception and its modulation.
        Neuron. 2007; 55: 377-391
        • Usui C
        • Kirino E
        • Tanaka S
        • Inami R
        • Nishioka K
        • Hatta K
        • Nakajima T
        • Nishioka K
        • Inoue R
        Music intervention reduces persistent fibromyalgia pain and alters functional connectivity between the insula and default mode network.
        Pain Med (United States). 2020; 21: 1546-1552
        • Vaajoki A
        • Pietilä AM
        • Kankkunen P
        • Vehviläinen-Julkunen K
        Music intervention study in abdominal surgery patients: Challenges of an intervention study in clinical practice.
        Int J Nurs Pract. 2013; 19: 206-213
        • Van Hecke O
        • Austin SK
        • Khan RA
        • Smith BH
        • Torrance N
        Neuropathic pain in the general population: A systematic review of epidemiological studies.
        Pain. 2014; 155: 654-662
        • Vos T
        • Flaxman AD
        • Naghavi M
        • Lozano R
        • Michaud C
        • Ezzati M
        • Shibuya K
        • Salomon JA
        • Abdalla S
        • Aboyans V
        • Abraham J
        • Ackerman I
        • Aggarwal R
        • Ahn SY
        • Ali MK
        • Almazroa MA
        • Alvarado M
        • Anderson HR
        • Anderson LM
        • Andrews KG
        • Atkinson C
        • Baddour LM
        • Bahalim AN
        • Barker-Collo S
        • Barrero LH
        • Bartels DH
        • Basáñez MG
        • Baxter A
        • Bell ML
        • Benjamin EJ
        • Bennett D
        • Bernabé E
        • Bhalla K
        • Bhandari B
        • Bikbov B
        • Abdulhak A Bin
        • Birbeck G
        • Black JA
        • Blencowe H
        • Blore JD
        • Blyth F
        • Bolliger I
        • Bonaventure A
        • Boufous S
        • Bourne R
        • Boussinesq M
        • Braithwaite T
        • Brayne C
        • Bridgett L
        • Brooker S
        • Brooks P
        • Brugha TS
        • Bryan-Hancock C
        • Bucello C
        • Buchbinder R
        • Buckle G
        • Budke CM
        • Burch M
        • Burney P
        • Burstein R
        • Calabria B
        • Campbell B
        • Canter CE
        • Carabin H
        • Carapetis J
        • Carmona L
        • Cella C
        • Charlson F
        • Chen H
        • Cheng ATA
        • Chou D
        • Chugh SS
        • Coffeng LE
        • Colan SD
        • Colquhoun S
        • Colson KE
        • Condon J
        • Connor MD
        • Cooper LT
        • Corriere M
        • Cortinovis M
        • De Vaccaro KC
        • Couser W
        • Cowie BC
        • Criqui MH
        • Cross M
        • Dabhadkar KC
        • Dahiya M
        • Dahodwala N
        • Damsere-Derry J
        • Danaei G
        • Davis A
        • De Leo D
        • Degenhardt L
        • Dellavalle R
        • Delossantos A
        • Denenberg J
        • Derrett S
        • Des Jarlais DC
        • Dharmaratne SD
        • Dherani M
        • Diaz-Torne C
        • Dolk H
        • Dorsey ER
        • Driscoll T
        • Duber H
        • Ebel B
        • Edmond K
        • Elbaz A
        • Ali SE
        • Erskine H
        • Erwin PJ
        • Espindola P
        • Ewoigbokhan SE
        • Farzadfar F
        • Feigin V
        • Felson DT
        • Ferrari A
        • Ferri CP
        • Fèvre EM
        • Finucane MM
        • Flaxman S
        • Flood L
        • Foreman K
        • Forouzanfar MH
        • Fowkes FGR
        • Franklin R
        • Fransen M
        • Freeman MK
        • Gabbe BJ
        • Gabriel SE
        • Gakidou E
        • Ganatra HA
        • Garcia B
        • Gaspari F
        • Gillum RF
        • Gmel G
        • Gosselin R
        • Grainger R
        • Groeger J
        • Guillemin F
        • Gunnell D
        • Gupta R
        • Haagsma J
        • Hagan H
        • Halasa YA
        • Hall W
        • Haring D
        • Haro JM
        • Harrison JE
        • Havmoeller R
        • Hay RJ
        • Higashi H
        • Hill C
        • Hoen B
        • Hoffman H
        • Hotez PJ
        • Hoy D
        • Huang JJ
        • Ibeanusi SE
        • Jacobsen KH
        • James SL
        • Jarvis D
        • Jasrasaria R
        • Jayaraman S
        • Johns N
        • Jonas JB
        • Karthikeyan G
        • Kassebaum N
        • Kawakami N
        • Keren A
        • Khoo JP
        • King CH
        • Knowlton LM
        • Kobusingye O
        • Koranteng A
        • Krishnamurthi R
        • Lalloo R
        • Laslett LL
        • Lathlean T
        • Leasher JL
        • Lee YY
        • Leigh J
        • Lim SS
        • Limb E
        • Lin JK
        • Lipnick M
        • Lipshultz SE
        • Liu W
        • Loane M
        • Ohno SL
        • Lyons R
        • Ma J
        • Mabweijano J
        • MacIntyre MF
        • Malekzadeh R
        • Mallinger L
        • Manivannan S
        • Marcenes W
        • March L
        • Margolis DJ
        • Marks GB
        • Marks R
        • Matsumori A
        • Matzopoulos R
        • Mayosi BM
        • McAnulty JH
        • McDermott MM
        • McGill N
        • McGrath J
        • Medina-Mora ME
        • Meltzer M
        • Memish ZA
        • Mensah GA
        • Merriman TR
        • Meyer AC
        • Miglioli V
        • Miller M
        • Miller TR
        • Mitchell PB
        • Mocumbi AO
        • Moffitt TE
        • Mokdad AA
        • Monasta L
        • Montico M
        • Moradi-Lakeh M
        • Moran A
        • Morawska L
        • Mori R
        • Murdoch ME
        • Mwaniki MK
        • Naidoo K
        • Nair MN
        • Naldi L
        • Narayan KMV
        • Nelson PK
        • Nelson RG
        • Nevitt MC
        • Newton CR
        • Nolte S
        • Norman P
        • Norman R
        • O'Donnell M
        • O'Hanlon S
        • Olives C
        • Omer SB
        • Ortblad K
        • Osborne R
        • Ozgediz D
        • Page A
        • Pahari B
        • Pandian JD
        • Rivero AP
        • Patten SB
        • Pearce N
        • Padilla RP
        • Perez-Ruiz F
        • Perico N
        • Pesudovs K
        • Phillips D
        • Phillips MR
        • Pierce K
        • Pion S
        • Polanczyk GV.
        • Polinder S
        • Pope CA
        • Popova S
        • Porrini E
        • Pourmalek F
        • Prince M
        • Pullan RL
        • Ramaiah KD
        • Ranganathan D
        • Razavi H
        • Regan M
        • Rehm JT
        • Rein DB
        • Remuzzi G
        • Richardson K
        • Rivara FP
        • Roberts T
        • Robinson C
        • De Leòn FR
        • Ronfani L
        • Room R
        • Rosenfeld LC
        • Rushton L
        • Sacco RL
        • Saha S
        • Sampson U
        • Sanchez-Riera L
        • Sanman E
        • Schwebel DC
        • Scott JG
        • Segui-Gomez M
        • Shahraz S
        • Shepard DS
        • Shin H
        • Shivakoti R
        • Silberberg D
        • Singh D
        • Singh GM
        • Singh JA
        • Singleton J
        • Sleet DA
        • Sliwa K
        • Smith E
        • Smith JL
        • Stapelberg NJC
        • Steer A
        • Steiner T
        • Stolk WA
        • Stovner LJ
        • Sudfeld C
        • Syed S
        • Tamburlini G
        • Tavakkoli M
        • Taylor HR
        • Taylor JA
        • Taylor WJ
        • Thomas B
        • Thomson WM
        • Thurston GD
        • Tleyjeh IM
        • Tonelli M
        • Towbin JA
        • Truelsen T
        • Tsilimbaris MK
        • Ubeda C
        • Undurraga EA
        • Van Der Werf MJ
        • Van Os J
        • Vavilala MS
        • Venketasubramanian N
        • Wang M
        • Wang W
        • Watt K
        • Weatherall DJ
        • Weinstock MA
        • Weintraub R
        • Weisskopf MG
        • Weissman MM
        • White RA
        • Whiteford H
        • Wiersma ST
        • Wilkinson JD
        • Williams HC
        • Williams SRM
        • Witt E
        • Wolfe F
        • Woolf AD
        • Wulf S
        • Yeh PH
        • Zaidi AKM
        • Zheng ZJ
        • Zonies D
        • Lopez AD
        • Murray CJL
        Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010.
        Lancet. 2012; 380: 2163-2196
        • Winstein CJ
        • Stein J
        • Arena R
        • Bates B
        • Cherney LR
        • Cramer SC
        • Deruyter F
        • Eng JJ
        • Fisher B
        • Harvey RL
        • Lang CE
        • MacKay-Lyons M
        • Ottenbacher KJ
        • Pugh S
        • Reeves MJ
        • Richards LG
        • Stiers W
        • Zorowitz RD
        Guidelines for adult stroke rehabilitation and recovery: A guideline for healthcare professionals from the American Heart Association/American Stroke Association.
        Stroke. 2016; 47: e98-169
        • Zatorre RJ
        • Salimpoor VN
        From perception to pleasure: Music and its neural substrates.
        Proc Natl Acad Sci U S A. 2013; 110: 10430-10437
      4. Zatorre RJ, Zarate JM: Cortical Processing of Music. In: Poeppel D, Overath T, Popper AN, Fay RR, editors. Springer, New York, 2012, pp 261–294.