Music, art, and the perception of pain

As a young child, my family was poor and we had to go to a public clinic for dental work. Since we were being seen by dental students, often the process was painful and took much longer than it should have. It was a tremendous relief when my uncle opened a swanky dental practice with a lake view, and soothing '70s rock wafted out over the audio system. I'm pretty sure my uncle was a better dentist than the students who had been seeing me before, but it also seemed like just the environment in his office contributed to me feeling better when he had to do an awful procedure like filling a cavity.

I felt like the total environment in the office contributed to my sense of well being -- his pretty young assistants, his elegant timber-framed reception area, the splashing waters of Lake Union against the pier. But recent research suggests the primary factor may have simply been the music. While the results haven't been consistent, there is some evidence that playing music for patients who've undergone painful medical procedures may help mitigate their sensation of pain.

The problem in the research comes in identifying the kind of music to play. Some researchers have focused on finding the ideal type of music for all patients -- "anxiolytic" music that is supposed to reduce anxiety and relax patients. But different people have different music preferences. Music that Jim finds relaxing seems obnoxious and grating to me. Music that I find relaxing seems obnoxious and grating to Greta. Greta and Nora like Broadway musicals, which I enjoy too, but in much smaller doses.

People nowadays are used to creating their own personal audio environment on their iPods. Wouldn't it make sense to let them choose their own music as a way of distracting them from medical pain?

A team led by Laura Mitchell recruited 80 people to bring their favorite song to the laboratory, where they would be paid to dip their hands in frigid water for as long as they could tolerate it. The musical selections they chose ranged from works by Johnny Cash, to The Verve, to Rancid. The volunteers first dipped their hand in warm water to bring it to a consistent 32°C. Then they held it in a circulating cold water bath at 5°C -- close to freezing! This was repeated three times -- once while listing to their favorite song, once while staring at a blank wall, and once while looking at a work of art they selected from 15 chosen by the experimenters. They were told to hold their hand in the water as long as they could stand it, or five minutes, whichever came first. Did listening to the music affect their ability to tolerate pain? Here are the results:

As you can see, people held their hands in the water significantly longer while listening to the music (look at the blue line and the scale on the left) and they also perceived significantly less pain (the green columns correspond to the scale on the right, which extends of 1 to 100). Viewing the artwork had no effect on these results -- the difference between pain ratings for art-viewing and no-distraction conditions was not significant. But the artwork did have one interesting effect. The participants were also asked to rate how well they were able to distract themselves from the pain. Now the effect of viewing art was significant:

While listening to music was best, participants who viewed the artwork rated their ability to distract themselves from the pain as significantly higher compared to when there was no distraction (again, on a scale of 0-100).

Perhaps it was the combination of factors: the music, the scenery, the comfort in being cared for by a family member, which combined to make me feel better at my uncle's office compared to the public clinic. But in any case, it seems clear that allowing patients to choose their own music while experiencing pain does indeed go a long way toward mitigating that pain.

The researchers point out that there are some limitations to their study. If you undergo a surgery procedure or are experiencing chronic pain, there's no way to escape it. If you're a real patient, you can never just remove your hand from the frigid water to remove the pain, and in these circumstances music may have a different effect.

But it certainly makes intuitive sense that putting patients in a pleasant environment where they have some degree of control would be a good start to helping reduce their experience of pain.

Laura A. Mitchell, Raymond A. R. MacDonald, Christina Knussen (2008). An investigation of the effects of music and art on pain perception. Psychology of Aesthetics, Creativity, and the Arts, 2 (3), 162-170 DOI: 10.1037/1931-3896.2.3.162