Researchers at Drexel University have made a significant discovery regarding the impact of music on pain reduction, as outlined in a recent scoping review published in PAIN Reports. Led by Joke Bradt, Ph.D., from the College of Nursing and Health Professions, the study aimed to understand the underlying factors that contribute to the effectiveness of music-based interventions in alleviating pain. By analyzing 663 records from five databases, the team identified 57 studies that explored the mechanisms, moderators, or predictors of music’s effect on pain, with data current up to February 2026.
Uncovering the Mechanisms of Music’s Pain-Relieving Effects
The majority of existing research focuses on prerecorded music, with relatively few studies examining the benefits of active music making, such as singing or playing instruments. However, the available evidence suggests that three key factors contribute to music’s pain-reducing properties. Firstly, the degree to which a listener enjoys the music, also known as positive emotional valence, is consistently associated with lower pain ratings across various pain models.
Notably, the emotional label assigned to a piece of music is less important than the individual’s personal enjoyment of it. Secondly, having control over the music selection, or cognitive agency, is also linked to reduced pain and increased tolerance in laboratory settings. This finding resonates with a separate clinical observation, where music therapy’s benefits for advanced cancer patients were partly attributed to the patients’ growing confidence in managing their own pain.
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A third mechanism is physical in nature, where participants who engage with music through movement, such as tapping or drumming, experience greater pain relief than those who simply listen. This phenomenon is thought to be related to music’s ability to engage the motor system, in addition to emotional and cognitive circuits. Neuroimaging studies have corroborated these findings, detecting changes in the spinal cord and brainstem, as well as the prefrontal cortex, where pain signals are processed and assigned emotional significance. Furthermore, research on individuals with fibromyalgia has shown that self-selected music can alter connectivity in brain regions associated with self-focused thought, potentially disrupting the rumination that often exacerbates chronic pain.
Implications for Clinical Practice and Future Research
The review’s findings are particularly relevant in the current healthcare system, where payers and health systems are increasingly adopting non-pharmacological approaches to pain management. A 2026 industry roundtable hosted by HLTH noted that payers and providers are giving greater consideration to covering music-based interventions, driven by the potential for lower-cost, lower-risk alternatives to traditional pharmacologic pain treatment. As the authors note, “Insights into their mechanisms of action could help increase clinical credibility and uptake and guide more precise application of MBIs into patient care.”
