Chronic pain affects a large share of the population and often resists purely pharmacological approaches. Music interventions — receptive listening or supervised active music therapy — are among the most studied non-pharmacological approaches.
A moderate but consistent effect
Cochrane syntheses and several meta-analyses report a significant, though moderate, reduction in self-reported pain intensity during music interventions. The effect is generally stronger on the anxiety associated with pain than on nociception itself, pointing to partly emotional and attentional mechanisms.
Proposed mechanisms
- Descending modulation: pleasant music may activate reward circuits (dopamine) and pain-inhibitory pathways
- Attentional diversion: the cognitive load of listening reduces attention allocated to pain
- Stress reduction: lower cortisol and parasympathetic activation
Factors of efficacy
Evidence suggests that patient choice of music improves the effect, as does supervision by a certified music therapist for active protocols. Session duration, frequency and clinical context (post-operative, oncology, fibromyalgia) modulate outcomes.
Clinical relevance
Music therapy does not replace primary treatment, but it is a low-risk adjunct that may reduce analgesic consumption and improve the pain experience. Its integration into multimodal care is increasingly recommended, pending greater protocol standardisation.
Sources & références
Garza-Villarreal E.A. et al., "Music-Induced Analgesia in Chronic Pain Conditions: A Systematic Review and Meta-Analysis", Pain Physician, 2017.
Cochrane Review — Bradt J. et al., "Music interventions for improving psychological and physical outcomes in people with cancer", 2021.
Martin-Saavedra J.S. et al., "Standardizing music characteristics for pain management", 2018.
Cet article est fourni à titre informatif et ne remplace pas un avis médical professionnel.