Sound and chronic pain in the nervous system

Musical research can explain changes in the experience of pain through attention, emotion and nerve modulation. Rest and autonomous regulation offer additional connections to understand integrated accompaniment. [R17, R18]

Two paths that connect sound and pain experience

The first is relatively direct: listening → attention and emotional dimension → modulation of pain processing. Neuroimaging studies and musical essays provide evidence for parts of that journey. The second is indirect: experience of rest and preparation for sleep → possible better rest → different conditions for processing pain. We propose to consider both in an integrated accompaniment, with agreed daily objectives.

The dream-pain bridge has its own support. A review of human and animal studies found that loss of sleep increases sensitivity to pain and that its interruption can alter downward controls of nociception. That is, rest can be relevant to how pain is processed, as well as being valuable in and of itself. This makes it reasonable to relate these pages: a possible contribution to rest could have indirect consequences for the experience of pain. R28

Autonomous regulation constitutes another relationship. A meta-analysis found lower high-frequency HRV in people with chronic pain compared to controls, with significant heterogeneity. The association links persistent pain and parasympathetic cardiac regulation, but it does not establish which causes which. We use it to explain physiological convergence, not as proof that increasing HRV eliminates pain. R29

Body stimulation can provide a third input to the model. The acupressure and contact findings described on the stress page show autonomous responses to certain stimuli. Linking them to pain is an inference, different from tests that directly measured pain.

Pain and Nociception Are Different Phenomena

Nociception is the nervous process that encodes potentially harmful stimuli. Pain is a personal experience with sensory and emotional components, influenced by biological, psychological and social factors. The International Association for the Study of Pain distinguishes both concepts: the entire pain experience cannot be deduced solely from the activity of sensory neurons. R16

This distinction makes it possible to understand why the context can change how much pain hurts or how much it disturbs. It also requires respect for what the person feels. The involvement of attention or emotion does not make pain imaginary or allow it to be automatically attributed to stress. R16

Attention and emotional dimension

Intensity describes how much it hurts; unpleasantness describes how unpleasant the experience is. An intervention can modify one dimension without producing the same change in the other.

A functional resonance study with painful stimuli in healthy people found less discomfort during music, with no significant difference in intensity. He also observed differences in network connectivity that encompasses the cortex and brain stem. The result helps to formulate mechanisms, but it does not in itself predict the relief of a person with chronic pain. R18

Downward pain modulation

Pain processing includes connections from brain regions to the brain stem and spinal cord. Structures such as the periaqueductal gray matter, or PAG, and the rostral ventromedial region of the bulb, or RVM, participate in these pathways. Your activity can influence how nociceptive information is processed. R17

Dobek and collaborators studied thermal pain with functional resonance during music chosen by the participants and during silence. They found less perceived pain and changes in activity in brain, brain stem and spinal regions compatible with the involvement of downstream mechanisms. R17

Functional resonance imaging records variations in a signal related to blood oxygenation; it does not directly measure “how many endorphins were released”. This experiment provides mechanistic evidence under laboratory conditions. It does not demonstrate injury repair or validate a fretboard technique. R17

Expectation and neurotransmitters

Musical analgesia is often explained by saying that music releases dopamine or endorphins. That explanation needs more precision. In a study with 48 healthy participants, Lunde and collaborators compared hearing conditions and administered drugs to block opioid or dopaminergic pathways. Musical analgesia was not eliminated by these blocks; expectations about pain were related to the reported experience. R19

The result questions a universal explanation based on these neurotransmitters. Nor does it rule out any possible contribution of these ways in other contexts. It helps to consider attention, expectations and the meaning of the stimulus together with physiology. R19

What chronic pain trials show

A 2025 review and meta-analysis brought together nine randomized trials with 787 patients. The combined pain result favored musical interventions: a standardized mean difference of −0.51, with a 95% confidence interval between −0.72 and −0.30. The heterogeneity was I² = 62%, which indicates significant variation between results. R20

A standardized difference allows different scales to be combined; −0.51 does not mean half a point on a scale of 0 to 10 or a 51% reduction. The review included different conditions and formats. It also found a favorable outcome in depression, but did not establish benefits in anxiety or quality of life. It is not appropriate to transform their subgroups into a universal dose or to transfer them to our session. R20

Listening and body vibration

Vibroacoustic therapy uses devices that transmit mechanical vibration to the body. In an exploratory study of fibromyalgia, 19 women received ten sessions with low-frequency body stimulation. Changes in symptom measures were observed, but there was no control group; the design does not allow them to be safely attributed to the intervention. R21

This modality needs to be described by device, form of contact, frequency, intensity and time. A body transducer, the sound of a gong and an applied tuning fork are different stimuli. Sharing physical property doesn't make your results equivalent.

It is also important to check if an article retains its editorial validity. A trial published in 2019 on rhythmic sensory stimulation and fibromyalgia was retracted by PLOS ONE in 2020: true simulated control was lacking and the editors considered that the efficacy conclusions were not supported. We don't use it as proof of benefit. R22

The relationship with an individual session

In Human Instrument we integrate sound, Acutonics, breathing or visualization and silence. In a person living with pain, we can talk about comfort and everyday goals of accompaniment. The evidence on this page justifies studying the experience and distinguishing its dimensions; it does not establish the efficacy of our combination for a specific painful condition.

Reading traditional Chinese medicine patterns is part of our framework. Findings on brain networks do not in and of themselves validate an action on meridians. Nor do we equate a BioWell record with a measurement of nociception, inflammation, or tissue repair.

What should be observed

As a follow-up proposal, it is important to separate intensity of pain, interference with activities, rest and sustained changes. Other treatments and events that may influence should also be recorded. An improvement immediately after listening to sound may be relevant to the person, but it does not by itself demonstrate a lasting change or cause.

The support is integrated with the care you need for the pain. Read Chronic Pain and Our Process to learn about their objectives and How We Work to understand each component.

Authorship

Written by Leonardo Murillo, sound therapist at Human Instrument. It is not a medical review or a peer review.

References

• R16 — IASP. Terminology. Definitions of Pain and Nociception.
• R17 — Dobek and collaborators, 2014. Music modulation of pain perception and pain-related activity in the brain, brain stem, and spinal cord: a functional magnetic resonance imaging study. Journal of Pain. Summary.
• R18 — Powers and collaborators, 2022. Music to My Senses: Functional Magnetic Resonance Imaging Evidence of Music Analgesia Across Connectivity Networks Spanning the Brain and Brainstem. Frontiers in Pain Research. Full text. DOI: 10.3389/fpain.2022.878258.
• R19 — Lunde and collaborators, 2022. Music-Induced Analgesia in Healthy Participants Is Associated With Expected Pain Levels but Not Opioid or Dopamine-Dependent Mechanisms. Frontiers in Pain Research. Full text. DOI: 10.3389/fpain.2022.734999.
• R20 — Chen and collaborators, 2025. The effect of music therapy for patients with chronic pain: systematic review and meta-analysis. BMC Psychology. Full text. DOI: 10.1186/s40359-025-02643-x.
• R21 — Naghdi et al., 2015. The effect of low-frequency sound stimulation on patients with fibromyalgia: A clinical study. Pain Research and Management. Summary. DOI:10.1155/2015/375174.
• R22 — PLOS ONE Editors, 2020. Retraction: A parallel randomized controlled trial examining the effects of rhythmic sensory stimulation on fibromyalgia symptoms. Retraction Note. DOI: 10.1371/journal.pone.0230395. It is cited to explain the exclusion from the trial, not as evidence of efficacy.
• R28 — Kourbanova, Alexandre and Latremoliere, 2022. Effect of sleep loss on pain—New conceptual and mechanical avenues. Frontiers in Neuroscience. Full text. DOI: 10.3389/fnins.2022.1009902.
• R29 — Meta-analysis, 2016. Meta-analytic evidence for decreased heart rate variability in chronic pain implicating parasympathetic nervous system dysregulation. Pain. Summary.