Listening to music eases pain in people with fibromyalgia (FM) by lowering brain activity related to pain and inducing activity that helps to distract, relax, and foster positive emotions, a study suggests.
The study, “Functional connectivity of music-induced analgesia in fibromyalgia,” was published in the journal Nature.
Fibromyalgia (FM) is a chronic pain syndrome accompanied by fatigue, sleep disorders, anxiety, depression, and memory issues. Research suggests that pain signals are amplified in people with FM, making them more sensitive to pain and other types of input such as noise.
Brain scans of fibromyalgia patients using functional magnetic resonance imaging (fMRI) — which identifies active areas of the brain by increased blood flow — have shown that these people have alterations in brain areas involved in pain intensity, pain processing, and lack of pain inhibitory capabilities.
Studies also suggest that music can lower perceptions of pain in people with chronic pain conditions such as FM, low back pain, and osteoarthritis — a phenomenon known as music-induced analgesia (MIA).
MIA is thought to originate in the brain and not in pain receptors, making it a “top-down” process induced by distraction from pain, familiarity to the music, emotions, relaxation, and reward.
However, only one study details the effects of music on chronic pain, using neuroimaging techniques like fMRI to identify the underlying mechanism of MIA.
Researchers in Mexico wanted to expand on their previously mentioned study, and recruited a group of 20 FM patients to undergo fMRI brain scans while listening to music to help identify areas of the brain most affected.
All were women between the ages of 22 and 70 (average age of 46.4), and findings compared with those from 20 healthy, age-matched women serving as controls.
Before the fMRI scans, all participants answered these pain-associated questionnaires: the Pain Self-Perception Scale (PSP), Pain Catastrophizing Scale (PCS), the State-Trait Anxiety Inventory (STAI), and the Center for Epidemiologic Studies Depression Scale (CES-D).
The questionnaires were conducted to establish clinical and behavioral differences between patient and control groups. As expected, pain self-perception, pain catastrophizing (pain exaggeration), anxiety, and depression were significantly different between the two.
While in the MRI scanner, participants listened for five-minute periods to either music or pink noise like the sound of rain. Music was chosen by participants prior to the study and had to be familiar, highly pleasant, and slow-paced.
To assess pain in FM patients while in the scanner, a verbal rating scale (VRS) was used, where 0 indicated no pain and 10 the worst possible pain. The scale measured pain intensity and pain unpleasantness, or the emotional dimension of pain, before and after the music or pink noise.
Results found that FM patients reported lower pain levels after listening to music compared to listening to pink noise.
The fMRI analysis showed that several regions of the brain linked to pain — known as the pain matrix — were altered in patients compared to controls. Listening to music reduced the activity in these regions, which also correlated with lesser pain on the verbal rating scale.
In contrast, scans in healthy controls after listening to music showed increases in brain activity in pain matrix regions. Even though “these regions are not exclusively related to pain,” the researchers wrote, these results confirmed that “listening to music affected each group differently.”
An analysis of identified changes in the brain found that listening to music in FM patients shifted brain patterns from pain-related areas to parts of the brain responsible for executive function — thinking processes that control behavior such as planning, organizing, and paying attention.
From these results, the authors concluded “that music-induced analgesia in fibromyalgia is a top-down mechanism, probably originated by distraction, relaxation, positive emotion, or a combination of these mechanisms.”
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