Research Article
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The Effects of Music Listening on Pain, Anxiety, and Quality of Life in Patients with Chronic Low Back Pain

Year 2025, Volume: 15 Issue: 2, 333 - 339, 30.06.2025
https://doi.org/10.33808/clinexphealthsci.1552871

Abstract

Objective: The aim of this study was to investigate the effects of music listening on pain, anxiety and quality of life in Chronic Low Back Pain (CLBP) patients.
Methods: This randomized controlled trial included 60 patients aged 30-50 with CLBP. Participants were randomly assigned to either a control group receiving standard physiotherapy or a music group receiving the same physiotherapy accompanied by music listening. Pain intensity, anxiety levels, and quality of life were assessed using the Visual Analogue Scale (VAS), Beck Anxiety Inventory (BAI), and SF-36, respectively, at baseline and after a 4-week intervention.
Results: Both groups showed significant reductions in pain and anxiety post-intervention, with more pronounced improvements in the music group (p<.05). The music group also demonstrated significant enhancements in physical function, emotional role, and pain perception on the SF-36 (p<.05), while other subscales showed no significant changes (p>.05).
Conclusion: listening, as an adjunct to conventional physiotherapy, effectively reduces pain and anxiety while improving certain aspects of quality of life in CLBP patients. These findings support the inclusion of music therapy as a complementary approach in the management of chronic pain.

Ethical Statement

This study was approved by the ethics committee of KTO Karatay University Faculty of Medicine, non-drug and non-medical device research. (Approval date: 22.12.2023 Number: 2023/042).

References

  • GBD 2021 Low Back Pain Collaborators. Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023;5(6):316-329. https://doi.org/10.1016/S2665-9913(23)00098-X
  • Knezevic NN, Candido KD, Vlaeyen, JW, Zundert JV, Cohen SP. Low back pain: Epidemiology, mechanisms, and treatment. The Lancet. 2021;398(10294):78-92. https://doi.org/10.1016/S0140-6736(21)00733-9.
  • Urits I, Burshtein A, Sharma M, Testa L, Gold PA, Orhurhu V, Kaye AD. Low back pain, a comprehensive review: Pathophysiology, diagnosis, and treatment. Curr Pain and Headache Rep. 2019; 23(3):23. https://doi.org/10.1007/s11916-019-0757-1
  • George SZ, Fritz JM, Silfies SP, Schneider MJ, Beneciuk J M, Lentz TA,Vining R. Interventions for the management of acute and chronic low back pain: revision 2021: clinical practice guidelines linked to the international classification of functioning, disability and health from the academy of orthopaedic physical therapy of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2021;51(11):1-60. https://www.jospt.org/doi/10.2519/jospt.2021.0304
  • Foster NE, Anema JR, Cherkin D, Chou R, Cohen SP, Gross DP, Woolf, A. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet. 2018; 391(10137): 2368-2383. https://doi.org/10.1016/S0140-6736(18)30489-6
  • Owen PJ, Miller CT, Mundell NL, Verswijveren SJ, Tagliaferri SD, Brisby H, Belavy, DL. Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. Br J Sports Med. 2020;54(21):1279-1287. 10.1136/bjsports-2019-100886
  • McDowell CP, Dishman RK, Gordon BR, Herring MP. Physical activity and anxiety: A systematic review and meta-analysis of prospective cohort studies. Am J Prev Med. 2019; 57(4): 545–556. https://doi.org/10.1016/j.amepre.2019.05.012
  • Peluso MA, Guerra de Andrade LH. Physical activity and mental health: The association between exercise and mood. Clinics (Sao Paulo). 2005;60(1):61-70. https://doi.org/10.1590/S1807-59322005000100012
  • Thaut MH. Music as therapy in early history. Prog Brain Res. 2015; 217:143-158. https://doi.org/10.1016/bs.pbr.2014.11.025
  • Thoma MV, La Marca R, Brönnimann R, Finkel L, Ehlert U, Nater UM. The effect of music on the human stress response. PloS one. 2013;8(8):e70156. https://doi.org/10.1371/journal.pone.0070156
  • Mitrovic P, Stefanovic B, Paladin A, Radovanovic M, Radovanovic N, Rajic D. Music therapy in patients with hypertension and early post-infarction angina; 15-year experience of the MUSIC study. Eur Heart J. 2018;39(1):564-153. https://doi.org/10.1093/eurheartj/ehy564.153
  • Raglio A. A novel music-based therapeutic approach: The therapeutic music listening. Front Hum Neurosci. 2023; 14(17):1-7. https://doi.org/ 10.3389/fnhum.2023.1204593.
  • Oksuz H, Atılgan E. The effect of relaxation training with electromyography feedback on pain, disability and depression in chronic neck pain. Health Academy Kastanomu.2019; 4(2):98-103. https://doi.org/10.25279/sak.486777.
  • Pauwels EK, Volterrani D, Mariani G, Kostkiewics M. Mozart, music and medicine. Med Princ Pract. 2014;23(5):403-412. https://doi.org/10.1159/000364873
  • Knight WEJ, Rickard NS. Relaxing music prevents stress-induced increases in subjective anxiety, systolic blood pressure, and heart rate in healthy males and females. J Music Ther. 2001;38(4):254–272. https://doi.org/10.1093/jmt/38.4.254.
  • Koumantakis GA, Watson PJ, Oldham JA. Trunk musclestabilization training plus general exercise versus generalexercise only: Randomized controlled trial of patients withrecurrent low back pain. Physical Therapy. 2005; 85(3): 209–225. https://doi.org/10.1093/ptj/85.3.209.
  • Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol. 1988;56(6):893-897. https://doi.org/10.1037//0022-006x.56.6.893.
  • Boonstra AM, Schiphorst Preuper HR, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res. 2008;31(2):165-169. https://doi.org/10.1097/MRR.0b013e3282fc0f93.
  • Brazier JE, Harper R, Jones NM, O'Cathain A, Thomas KJ, Usherwood T, Westlake L. Validating the SF-36 health survey questionnaire: New outcome measure for primary care. Br Med J. 1992;305(6846):160-164. https://doi.org/10.1136/bmj.305.6846.160.
  • Kim SK, Min A, Jeon C, Kim T, Cho S, Lee SC, Lee CK. Clinical outcomes and cost-effectiveness of massage chair therapy versus basic physiotherapy in lower back pain patients: A randomized controlled trial. Medicine (Baltimore). 2020; 99(12):e19514. https://doi.org/10.1097/MD.0000000000019514.
  • Mitchell LA, MacDonald RAR, Brodie EE. A comparison of the effects of preferred music, arithmetic and humour on cold pressor pain. Eur J Pain. 2006;10(4):343-51. https://doi.org/10.1016/j.ejpain.2005.03.005
  • Garza-Villarreal EA, Wilson AD, Vase L, Brattico E, Barrios FA, Jensen TS, Romero-Romo JI, Vuust P. Music reduces pain and increases functional mobility in fibromyalgia. Front Psychol. 2014;5(90):1-10. https://doi.org/10.3389/fpsyg.2014.00090
  • Roy M, Peretz I, Rainville P. Emotional valence contributes to music-induced analgesia. Pain. 2008;134(1-2):140-147. https:// doi.org/10.1016/j.pain.2007.04.003
  • Salimpoor VN, Benovoy M, Larcher K, Dagher A, Zatorre RJ. Anatomically distinct dopamine release during anticipation and experience of peak emotion to music. Nature Neurosci. 2011; 14(2):257-262. https://doi.org/10.1038/nn.2726
  • Levitin DJ, Tirovolas AK. Current advances in the cognitive neuroscience of music. Ann N Y Acad Sci. 2009;1156(1): 211-231. https://doi.org/10.1111/j.1749-6632.2009.04417.x
  • Chanda ML, Levitin DJ. The neurochemistry of music. Trends Cogn Sci. 2013;17(4):173-193. https://doi.org/10.1016/j.tics.2013.02.007
  • Cepeda MS, Carr DB, Lau J, Alvarez H. Music for pain relief. Cochrane Database Syst Rev. 2013; 19(2):1-39. https://doi.org/10.1002/14651858.CD004843.pub3
  • Khalfa S, Dalla Bella S, Roy M, Peretz I, Lupien SJ. Effects of relaxing music on salivary cortisol level after psychological stress. Ann N Y Acad Sci. 2003; 999(1): 374-376. https://doi.org/10.1196/annals.1284.045
  • Nilsson U. The Anxiety- and pain-reducing effects of music ınterventions: A systematic review. AORN J. 2008;87(4):780-807. https://doi.org/10.1016/j.aorn.2007.09.013
  • Bradt J, Dileo C. Music interventions for mechanically ventilated patients. Cochrane Database Syst Rev. 2014;12(1):1-67. https://doi.org/10.1002/14651858.CD006902.pub
  • Jaušovec N, Habe K. The Mozart effect: An electroencephalographic analysis employing the methods of ınduced event-related desynchronization/ synchronization and event-related coherence. Brain Topogr. 2003;16(2):73-84. https://doi.org/10.1023/B:BRAT.0000006331.10425.4b
  • Lee JH. The effects of music on pain: A meta-analysis. J Music Ther. 2016;53(4):430-477. https://doi.org/10.1093/jmt/thw012
  • Chan MF, Wong ZY, Thayala N V. The effectiveness of music listening in reducing depressive symptoms in adults: A systematic review. Complement Ther Med. 2011;19(6):332-348. https://doi.org/10.1016/j.ctim.2011.08.003
  • Pelletier CL. The effect of music on decreasing arousal due to stress: A meta-analysis. J Music Ther. 2004;41(3):192-214. https://doi.org/10.1093/jmt/41.3.192
  • De Niet G, Tiemens B, Lendemeijer B, Hutschemaekers G. Music-assisted relaxation to improve sleep quality: Meta-analysis. J Adv Nurs. 2009;65(7):1356-1364. https://doi.org/10.1111/j.1365-2648.2009.04982.x
  • Bradt J, Magee WL, Dileo C, Wheeler B, McGilloway E. Music therapy for acquired brain injury. Cochrane Database Syst Rev. 2007; 7(7):1-44. https://doi.org/10.1002/14651858.CD006787
  • Siedliecki SL, Good M. Effect of music on power, pain, depression and disability. J Adv Nurs. 2006;54(5):553-562. https://doi.org/10.1111/j.1365-2648.2006.03860.x
Year 2025, Volume: 15 Issue: 2, 333 - 339, 30.06.2025
https://doi.org/10.33808/clinexphealthsci.1552871

Abstract

References

  • GBD 2021 Low Back Pain Collaborators. Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023;5(6):316-329. https://doi.org/10.1016/S2665-9913(23)00098-X
  • Knezevic NN, Candido KD, Vlaeyen, JW, Zundert JV, Cohen SP. Low back pain: Epidemiology, mechanisms, and treatment. The Lancet. 2021;398(10294):78-92. https://doi.org/10.1016/S0140-6736(21)00733-9.
  • Urits I, Burshtein A, Sharma M, Testa L, Gold PA, Orhurhu V, Kaye AD. Low back pain, a comprehensive review: Pathophysiology, diagnosis, and treatment. Curr Pain and Headache Rep. 2019; 23(3):23. https://doi.org/10.1007/s11916-019-0757-1
  • George SZ, Fritz JM, Silfies SP, Schneider MJ, Beneciuk J M, Lentz TA,Vining R. Interventions for the management of acute and chronic low back pain: revision 2021: clinical practice guidelines linked to the international classification of functioning, disability and health from the academy of orthopaedic physical therapy of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2021;51(11):1-60. https://www.jospt.org/doi/10.2519/jospt.2021.0304
  • Foster NE, Anema JR, Cherkin D, Chou R, Cohen SP, Gross DP, Woolf, A. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet. 2018; 391(10137): 2368-2383. https://doi.org/10.1016/S0140-6736(18)30489-6
  • Owen PJ, Miller CT, Mundell NL, Verswijveren SJ, Tagliaferri SD, Brisby H, Belavy, DL. Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. Br J Sports Med. 2020;54(21):1279-1287. 10.1136/bjsports-2019-100886
  • McDowell CP, Dishman RK, Gordon BR, Herring MP. Physical activity and anxiety: A systematic review and meta-analysis of prospective cohort studies. Am J Prev Med. 2019; 57(4): 545–556. https://doi.org/10.1016/j.amepre.2019.05.012
  • Peluso MA, Guerra de Andrade LH. Physical activity and mental health: The association between exercise and mood. Clinics (Sao Paulo). 2005;60(1):61-70. https://doi.org/10.1590/S1807-59322005000100012
  • Thaut MH. Music as therapy in early history. Prog Brain Res. 2015; 217:143-158. https://doi.org/10.1016/bs.pbr.2014.11.025
  • Thoma MV, La Marca R, Brönnimann R, Finkel L, Ehlert U, Nater UM. The effect of music on the human stress response. PloS one. 2013;8(8):e70156. https://doi.org/10.1371/journal.pone.0070156
  • Mitrovic P, Stefanovic B, Paladin A, Radovanovic M, Radovanovic N, Rajic D. Music therapy in patients with hypertension and early post-infarction angina; 15-year experience of the MUSIC study. Eur Heart J. 2018;39(1):564-153. https://doi.org/10.1093/eurheartj/ehy564.153
  • Raglio A. A novel music-based therapeutic approach: The therapeutic music listening. Front Hum Neurosci. 2023; 14(17):1-7. https://doi.org/ 10.3389/fnhum.2023.1204593.
  • Oksuz H, Atılgan E. The effect of relaxation training with electromyography feedback on pain, disability and depression in chronic neck pain. Health Academy Kastanomu.2019; 4(2):98-103. https://doi.org/10.25279/sak.486777.
  • Pauwels EK, Volterrani D, Mariani G, Kostkiewics M. Mozart, music and medicine. Med Princ Pract. 2014;23(5):403-412. https://doi.org/10.1159/000364873
  • Knight WEJ, Rickard NS. Relaxing music prevents stress-induced increases in subjective anxiety, systolic blood pressure, and heart rate in healthy males and females. J Music Ther. 2001;38(4):254–272. https://doi.org/10.1093/jmt/38.4.254.
  • Koumantakis GA, Watson PJ, Oldham JA. Trunk musclestabilization training plus general exercise versus generalexercise only: Randomized controlled trial of patients withrecurrent low back pain. Physical Therapy. 2005; 85(3): 209–225. https://doi.org/10.1093/ptj/85.3.209.
  • Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol. 1988;56(6):893-897. https://doi.org/10.1037//0022-006x.56.6.893.
  • Boonstra AM, Schiphorst Preuper HR, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res. 2008;31(2):165-169. https://doi.org/10.1097/MRR.0b013e3282fc0f93.
  • Brazier JE, Harper R, Jones NM, O'Cathain A, Thomas KJ, Usherwood T, Westlake L. Validating the SF-36 health survey questionnaire: New outcome measure for primary care. Br Med J. 1992;305(6846):160-164. https://doi.org/10.1136/bmj.305.6846.160.
  • Kim SK, Min A, Jeon C, Kim T, Cho S, Lee SC, Lee CK. Clinical outcomes and cost-effectiveness of massage chair therapy versus basic physiotherapy in lower back pain patients: A randomized controlled trial. Medicine (Baltimore). 2020; 99(12):e19514. https://doi.org/10.1097/MD.0000000000019514.
  • Mitchell LA, MacDonald RAR, Brodie EE. A comparison of the effects of preferred music, arithmetic and humour on cold pressor pain. Eur J Pain. 2006;10(4):343-51. https://doi.org/10.1016/j.ejpain.2005.03.005
  • Garza-Villarreal EA, Wilson AD, Vase L, Brattico E, Barrios FA, Jensen TS, Romero-Romo JI, Vuust P. Music reduces pain and increases functional mobility in fibromyalgia. Front Psychol. 2014;5(90):1-10. https://doi.org/10.3389/fpsyg.2014.00090
  • Roy M, Peretz I, Rainville P. Emotional valence contributes to music-induced analgesia. Pain. 2008;134(1-2):140-147. https:// doi.org/10.1016/j.pain.2007.04.003
  • Salimpoor VN, Benovoy M, Larcher K, Dagher A, Zatorre RJ. Anatomically distinct dopamine release during anticipation and experience of peak emotion to music. Nature Neurosci. 2011; 14(2):257-262. https://doi.org/10.1038/nn.2726
  • Levitin DJ, Tirovolas AK. Current advances in the cognitive neuroscience of music. Ann N Y Acad Sci. 2009;1156(1): 211-231. https://doi.org/10.1111/j.1749-6632.2009.04417.x
  • Chanda ML, Levitin DJ. The neurochemistry of music. Trends Cogn Sci. 2013;17(4):173-193. https://doi.org/10.1016/j.tics.2013.02.007
  • Cepeda MS, Carr DB, Lau J, Alvarez H. Music for pain relief. Cochrane Database Syst Rev. 2013; 19(2):1-39. https://doi.org/10.1002/14651858.CD004843.pub3
  • Khalfa S, Dalla Bella S, Roy M, Peretz I, Lupien SJ. Effects of relaxing music on salivary cortisol level after psychological stress. Ann N Y Acad Sci. 2003; 999(1): 374-376. https://doi.org/10.1196/annals.1284.045
  • Nilsson U. The Anxiety- and pain-reducing effects of music ınterventions: A systematic review. AORN J. 2008;87(4):780-807. https://doi.org/10.1016/j.aorn.2007.09.013
  • Bradt J, Dileo C. Music interventions for mechanically ventilated patients. Cochrane Database Syst Rev. 2014;12(1):1-67. https://doi.org/10.1002/14651858.CD006902.pub
  • Jaušovec N, Habe K. The Mozart effect: An electroencephalographic analysis employing the methods of ınduced event-related desynchronization/ synchronization and event-related coherence. Brain Topogr. 2003;16(2):73-84. https://doi.org/10.1023/B:BRAT.0000006331.10425.4b
  • Lee JH. The effects of music on pain: A meta-analysis. J Music Ther. 2016;53(4):430-477. https://doi.org/10.1093/jmt/thw012
  • Chan MF, Wong ZY, Thayala N V. The effectiveness of music listening in reducing depressive symptoms in adults: A systematic review. Complement Ther Med. 2011;19(6):332-348. https://doi.org/10.1016/j.ctim.2011.08.003
  • Pelletier CL. The effect of music on decreasing arousal due to stress: A meta-analysis. J Music Ther. 2004;41(3):192-214. https://doi.org/10.1093/jmt/41.3.192
  • De Niet G, Tiemens B, Lendemeijer B, Hutschemaekers G. Music-assisted relaxation to improve sleep quality: Meta-analysis. J Adv Nurs. 2009;65(7):1356-1364. https://doi.org/10.1111/j.1365-2648.2009.04982.x
  • Bradt J, Magee WL, Dileo C, Wheeler B, McGilloway E. Music therapy for acquired brain injury. Cochrane Database Syst Rev. 2007; 7(7):1-44. https://doi.org/10.1002/14651858.CD006787
  • Siedliecki SL, Good M. Effect of music on power, pain, depression and disability. J Adv Nurs. 2006;54(5):553-562. https://doi.org/10.1111/j.1365-2648.2006.03860.x
There are 37 citations in total.

Details

Primary Language English
Subjects Pain
Journal Section Articles
Authors

Mustafa Savaş Torlak 0000-0002-8084-6203

Bayram Sönmez Ünüvar 0000-0003-2095-3645

Osman Tüfekci 0000-0001-5140-3377

Hasan Gerçek 0000-0001-7459-4452

Burcu Dursun 0000-0003-0645-3820

Early Pub Date June 27, 2025
Publication Date June 30, 2025
Submission Date September 19, 2024
Acceptance Date June 20, 2025
Published in Issue Year 2025 Volume: 15 Issue: 2

Cite

APA Torlak, M. S., Ünüvar, B. S., Tüfekci, O., Gerçek, H., et al. (2025). The Effects of Music Listening on Pain, Anxiety, and Quality of Life in Patients with Chronic Low Back Pain. Clinical and Experimental Health Sciences, 15(2), 333-339. https://doi.org/10.33808/clinexphealthsci.1552871
AMA Torlak MS, Ünüvar BS, Tüfekci O, Gerçek H, Dursun B. The Effects of Music Listening on Pain, Anxiety, and Quality of Life in Patients with Chronic Low Back Pain. Clinical and Experimental Health Sciences. June 2025;15(2):333-339. doi:10.33808/clinexphealthsci.1552871
Chicago Torlak, Mustafa Savaş, Bayram Sönmez Ünüvar, Osman Tüfekci, Hasan Gerçek, and Burcu Dursun. “The Effects of Music Listening on Pain, Anxiety, and Quality of Life in Patients With Chronic Low Back Pain”. Clinical and Experimental Health Sciences 15, no. 2 (June 2025): 333-39. https://doi.org/10.33808/clinexphealthsci.1552871.
EndNote Torlak MS, Ünüvar BS, Tüfekci O, Gerçek H, Dursun B (June 1, 2025) The Effects of Music Listening on Pain, Anxiety, and Quality of Life in Patients with Chronic Low Back Pain. Clinical and Experimental Health Sciences 15 2 333–339.
IEEE M. S. Torlak, B. S. Ünüvar, O. Tüfekci, H. Gerçek, and B. Dursun, “The Effects of Music Listening on Pain, Anxiety, and Quality of Life in Patients with Chronic Low Back Pain”, Clinical and Experimental Health Sciences, vol. 15, no. 2, pp. 333–339, 2025, doi: 10.33808/clinexphealthsci.1552871.
ISNAD Torlak, Mustafa Savaş et al. “The Effects of Music Listening on Pain, Anxiety, and Quality of Life in Patients With Chronic Low Back Pain”. Clinical and Experimental Health Sciences 15/2 (June 2025), 333-339. https://doi.org/10.33808/clinexphealthsci.1552871.
JAMA Torlak MS, Ünüvar BS, Tüfekci O, Gerçek H, Dursun B. The Effects of Music Listening on Pain, Anxiety, and Quality of Life in Patients with Chronic Low Back Pain. Clinical and Experimental Health Sciences. 2025;15:333–339.
MLA Torlak, Mustafa Savaş et al. “The Effects of Music Listening on Pain, Anxiety, and Quality of Life in Patients With Chronic Low Back Pain”. Clinical and Experimental Health Sciences, vol. 15, no. 2, 2025, pp. 333-9, doi:10.33808/clinexphealthsci.1552871.
Vancouver Torlak MS, Ünüvar BS, Tüfekci O, Gerçek H, Dursun B. The Effects of Music Listening on Pain, Anxiety, and Quality of Life in Patients with Chronic Low Back Pain. Clinical and Experimental Health Sciences. 2025;15(2):333-9.

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