Self-Chosen Music as a Contributor to Music-Induced Analgesia Across Diverse Socio-Cultural Backgrounds: A Crossover Randomised Controlled Trial

Background: Music-induced analgesia (MIA) has been extensively studied, but the role of socio-cultural background, which shapes music preferences and perceptions, remains unexplored. This study investigates whether the effect of preferred music on pain endurance remains consistent across different socio-cultural backgrounds. Methods: In a crossover randomised controlled trial (n = 84), participants underwent three auditory interventions in a randomised sequence: self-chosen music, researcher-chosen (classical) music and a podcast (control). After 20 min, pain endurance was tested by increasing electric stimuli while participants continued listening. Additionally, pain threshold, perceived pain scores, heart rate variability (HRV) and emotions were measured. Results: Compared with the control condition, self-chosen music significantly increased pain endurance (β = 0.74, p = 0.003) and reduced pain intensity (β = −0.43, p < 0.001) and unpleasantness (β = −0.38, p = 0.007). Both self-chosen (β = 0.32, p = 0.034) and researcher-chosen music (β = 0.37, p = 0.018) increased the pain threshold compared to the control condition. These pain measurements were not influenced by participants' socio-cultural background (cultural capital, level of education). HRV analysis revealed more parasympathetic activity with the researcher-chosen music and higher heart rate with the self-chosen music than with the control intervention. Conclusions: Listening to self-chosen music was effective in MIA, irrespective of socio-cultural background or type of music. In contrast, researcher-chosen (classical) music was most effective in enhancing parasympathetic activity. This study highlights that self-selected music in line with personal preferences is effective for pain relief, encouraging personalised approaches in MIA. Significance Statement: This study revealed that self-chosen music significantly enhances pain endurance and reduces subjective pain scores, regardless of socio-cultural background and type of music. In contrast, researcher-chosen (classical) music increases parasympathetic activity, indicating a more ‘relaxed’ state. These findings suggest that different types of music may serve different functions, with self-chosen music being especially effective for pain relief. Encouraging patients to self-select their music could improve pain management outcomes, underscoring the importance of personalised approaches when using music for pain relief.