The Healing Power of Music: How a Nurse's Ukulele is Transforming Pain Management in Healthcare

Research indicates that listening to music can decrease pain perception. (Representative)

At UC San Diego Health, Nurse Rod Salaysay employs various tools in his work: medical equipment like thermometers and stethoscopes, alongside musical instruments such as his guitar and ukulele.

Working in the recovery unit, Salaysay assists patients with post-surgical pain management. In addition to conventional medications, he offers musical performances upon request, often singing for patients. His musical selections span from folk songs in multiple languages to classical pieces and popular movie soundtracks including "Somewhere Over the Rainbow."

Patients frequently respond positively with smiles and rhythmic nodding. Remarkably, Salaysay observes measurable changes in their vital signs, including decreased heart rates and blood pressure, with some patients requesting fewer pain medications.

"Hospitals often create a cycle of worry, pain, and anxiety," he explains, "but music can effectively disrupt this pattern."

While Salaysay performs solo, he represents a growing trend. Over the last twenty years, both live and recorded music have increasingly been incorporated into healthcare settings as evidence mounts regarding music's pain-relieving capabilities.

The therapeutic effects of music may seem intuitive given its deep cultural significance throughout human history. However, scientific understanding of how music alleviates both acute and chronic pain—technically termed music-induced analgesia—is still developing.

No one claims music completely eliminates severe pain, but recent research published in journals including Pain and Scientific Reports suggests that music can either reduce pain perception or enhance pain tolerance.

The most critical factor appears to be patient agency—allowing patients or their families to select music themselves and encouraging active listening rather than treating music as background noise.

"Pain is a multifaceted experience," explains Adam Hanley, a psychologist at Florida State University. "It comprises physical sensations, our cognitive interpretation of those sensations, and our emotional responses."

Pain perception varies significantly between individuals with identical conditions or injuries. Even the same person may experience different pain levels from day to day.

Acute pain occurs when pain receptors in specific body regions transmit signals to the brain, which processes temporary pain. Chronic pain typically involves long-term structural or functional brain changes that heighten sensitivity to pain signals—a mechanism researchers continue to investigate.

"Pain signals are processed and interpreted by the brain," explains Dr. Gilbert Chandler, a specialist in chronic spinal pain at Tallahassee Orthopaedic Clinic, "which can either amplify or diminish those signals."

Research confirms music diverts attention from pain, reducing sensation. Studies also indicate that listening to preferred music more effectively reduces pain than other auditory stimuli like podcasts.

"Music functions as a distraction, redirecting focus away from pain. However, it accomplishes more than simple distraction," notes Caroline Palmer, a McGill University psychologist studying music and pain.

Scientists continue to map the various neural pathways involved in this process, Palmer adds.

"Nearly the entire brain activates during musical engagement," explains Kate Richards Geller, a registered music therapist in Los Angeles. "This alters both pain perception and experience—as well as the isolation and anxiety that often accompany pain."

The concept of using recorded music for pain management dates back to the late 19th century, predating local anesthetics in dental procedures. Today's researchers focus on optimizing conditions for music's effectiveness.

A study from Erasmus University Rotterdam involving 548 participants examined how different musical genres—classical, rock, pop, urban, and electronic—affected participants' ability to withstand acute pain during cold temperature exposure.

While all music provided benefits, no single genre proved superior. "The more participants listened to their preferred genre, the greater their pain endurance," explains co-author Dr. Emy van der Valk Bouman. "Many assumed classical music would offer greater benefits, but evidence increasingly suggests that personal preference determines effectiveness."

The precise mechanisms remain unclear, though familiar music may activate stronger memories and emotions, she suggests.

The act of choosing itself carries therapeutic power, according to Claire Howlin, director of Trinity College Dublin's Music and Health Psychology Lab, whose research indicates that patient selection of music improves pain tolerance.

"For individuals with chronic conditions, music selection offers a rare element of control—providing agency," she notes.

Active, focused listening also appears significant.

Hanley co-authored preliminary research suggesting daily attentive music listening may reduce chronic pain. "Music activates diverse brain regions," he explains, "providing positive emotional benefits that divert attention from pain."

Many healthcare professionals now describe music as a simple intervention without adverse effects.

Cecily Gardner, a jazz vocalist from Culver City, California, utilized music during her recovery from serious illness and has performed for friends experiencing pain. "Music reduces stress, builds community," she reflects, "and transports you to a better psychological space."