In the brain, dopamine acts as a neurotransmitter and is released from nerve cells to send signals to other nerves – think of it as a neural messenger. Dopamine (DA, which is contracted from 3,4-dihydroxyphenethylamine) is an organic chemical of the catecholamine and phenethylamine families that has many important functions in the brain and body. Dopamine is already known to play a pivotal role in thinking, memory, and movement. Low levels of dopamine are known to be a contributory factor in many different diseases such as Parkinson’s disease, fibromyaliga, burning mouth syndrome and diabetic neuropathy, as well as restless legs syndrome and even attention deficit hyperactivity disorder (ADHD). All of these are directly linked to decreased dopamine activity.

It’s noticeable that many of these diseases and syndromes include debilitating pain or painful conditions as part of their symptomology. Studies have shown that what is known as dopaminergic neurotransmission plays a central role in modulating pain perception and exhibiting an analgesic effect within certain parts of the brain including the insula, thalamus, basal ganglia, and anterior cingulate cortex. Researchers from the University of Texas published a study in 2015 in the Journal of Neuroscience providing evidence that dopamine may play a key role in the maintenance of chronic pain. The researchers traced the pain signalling pathway between the brain and spinal cord and found that dopamine-containing cells (known as A11) influenced chronic pain. Interestingly, the study found that these dopamine-containing cells have no effect on acute pain, yet seem to have a significant effect on how chronic pain may affect a sufferer. Conversely, pain is a form of inflammation in the body, and studies have shown that inflammation causes inhibition of dopamine levels in the body. Therefore, dopamine is central to pain management.

With the above in mind, we turn to music. We all know the power of music that we love in the strong emotions it can inspire, never mind the wonderful ‘rush’ and those ‘tingling’ sensations it can give us. That rush and all that tingling are not perchance nor do they have a minimal impact on our body. Blood & Zatorre (2001) found that listening to pleasurable music had the exact same neurological effect as did other pleasurable activities, such as food and sex, both of which have been shown in other studies to significantly increase dopamine activity in the brain. When pleasurable music is heard, dopamine is released into the striatum, which is an ancient part of the brain and which is known to respond to naturally rewarding stimuli like food and sex (and can also be artificially targeted by drugs like cocaine and amphetamines).

Chanda & Levitin (2013) from McGill University in Montreal did a fascinating review of what they call ‘the neurochemistry of music’. They consider this form of neurochemical research to possibly “be the next great frontier” with regard to the severity of symptoms and quality of life, of which pain is often a huge factor. The authors make the pertinent observation that, “the promise of music-based treatments is that they are non-invasive, have minimal or no side-effects, are inexpensive, convenient, and completely ‘natural’”.

A seminal work on how music can affect dopamine levels is that titled ‘Anatomically distinct dopamine release during anticipation and experience of peak emotion to music’by Salimpoor et al. (2011). These researchers used functional magnetic resonance imaging to calculate the release of dopamine by subjects listening to music they liked, particularly at the so-called ‘peak’ of this experience. Their results concluded that intense pleasure caused by listening to music can lead to dopamine release in the striatal system of the brain, thereby validating the findings of Blood & Zatorre from a decade earlier. The study clearly demonstrated that there was a direct link between dopamine peaks and emotional arousal by listening to music a person loves. Scientific American commented that, “Such induced dopamine release could explain why people put a high value on some music. And why music can manipulate our emotion”.

The correlation is clear and easy to make: if dopamine has a marked effect on alleviating pain and music is known to release dopamine in the brain, then music must be an effective means by which to cope with pain. Barbara Crowe declared that, “(Music therapy) can make the difference between withdrawal and awareness, between isolation and interaction, between chronic pain and comfort — between demoralization and dignity”. Music can make our imagination and our hearts soar – it’s high time that it also be given its rightful place in the understanding and management of pain.