Emotional foundations of music as a non-pharmacological pain management tool in modern medicine.

This paper reviews the use of music as an adjuvant to the control of pain, especially in medical procedures. Surgery causes stress and anxiety that exacerbates the experience of pain. Self-report of and physiological measures on post-surgical patients indicate that music therapy or music stimulation reduces the perception of pain, both alone and when part of a multimodal pain management program, and can reduce the need for pharmaceutical interventions. However, multimodal pain therapy, including non-pharmacological interventions after surgery, is still rare in medical practice. We summarize how music can enhance medical therapies and can be used as an adjuvant with other pain-management programs to increase the effectiveness of those therapies. As summarized, we currently know that musical pieces chosen by the patient are commonly, but not always, more effective than pieces chosen by another person. Further research should focus both on finding the specific indications and contra-indications of music therapy and on the biological and neurological pathways responsible for those findings (related evidence has implicated brain opioid and oxytocin mechanisms in affective changes evoked by music). In turn, these findings will allow medical investigators and practitioners to design guidelines and reliable, standardized applications for this promising method of pain management in modern medicine.