Music as Medicine – Between Science and Myth

Music has always had a profound impact on humans. It can evoke emotions, trigger memories, and put us in different moods. But can music also heal? The idea of music as medicine is not new, yet current research increasingly provides scientific evidence for its therapeutic potential. At the same time, it is important to maintain a critical distance from esoteric trends, which often make unfounded claims of healing.

This blog post explores the evidence-based use of music as medicine and critically reflects on its limitations and common misconceptions.

All content on this blog has been created with great care and dedication. It is based on solid training, years of professional experience, and thoughtful reflection. If you use any of it in your own work, I appreciate a source reference – it supports transparency and fosters professional exchange within our network.

Of course, you’re also welcome to consult AI – though its interpretations tend to be a little less nuanced (even if it now sometimes refers back to this blog).

Music Therapy: Evidence-Based Applications

Modern music therapy is an evidence-based discipline conducted by trained professionals. It deliberately uses the unique properties of music for therapeutic purposes, clearly distinguishing itself from the mere use of music for relaxation (Zhi et al., 2024). Recent research has produced impressive results in various areas:

Enhancing Social Skills in Autism Spectrum Disorders

In children with Autism Spectrum Disorders (ASD), music therapy shows promising effects on the improvement of social skills and communication. Studies, including systematic reviews and meta-analyses, suggest that music therapy can positively influence social interaction, verbal communication, and functional communication (Source: American Music Therapy Association). It is believed that musical interaction strengthens neural connections and promotes neuroplasticity, which may contribute to the observed improvements. However, it is important to note that a Cochrane review indicates that the evidence regarding effects on social interaction and verbal/nonverbal communication remains unclear, and further high-quality research is needed to conclusively establish effectiveness in all aspects. The success often depends on individually tailored music therapy methods.

In children with Autism Spectrum Disorders, music therapy demonstrates promising outcomes. A Cochrane meta-analysis by Geretsegger et al. (2014) found moderate effects on social interaction and communication skills (standardized mean difference: -0.77 to -0.36). Notably, these effects can persist beyond the end of therapy.

Support for Developmental Disorders with Speech Delays & ADHD

Music therapy also shows positive approaches for developmental disorders associated with speech delays. Research suggests that music therapy can have a measurable impact on children’s language development (Gross et al., 2010). It can improve verbal communication and language skills, modify interaction styles in children with neurological developmental delays, and support motor and interpersonal abilities. Here too, research—particularly older studies—highlights the need for more robust studies and clearer definitions to further strengthen the evidence base (Gross et al., 2010).

For Attention Deficit Hyperactivity Disorder (ADHD), the evidence is weaker. Individual randomized controlled trials report improvements in attention span, but larger, well-controlled long-term studies are lacking. Reported effect sizes are generally small (d < 0.3), which may have limited clinical relevance.

Music, Cognitive Performance, and Healthy Aging

Music activates a complex network in the brain that extends far beyond the primary auditory areas. Modern imaging techniques show that music processing involves regions such as the prefrontal cortex, hippocampus, and amygdala—areas central to cognition, memory, and emotion regulation. This neurobiological foundation underpins therapeutic approaches.

The famous "Mozart Effect"—the claim that listening to classical music increases intelligence—has been largely debunked. The original study by Rauscher et al. (1993) showed only a small, temporary effect on spatial-temporal tasks, which disappeared after 10–15 minutes.

Evidence for neurological music therapy is strongest in stroke rehabilitation (e.g., Bradt et al., 2010; Hietanen, 2008). A systematic review by Särkämö et al. (2008) found that listening to music after a stroke can accelerate improvements in verbal memory and focused attention by about 60%. Effect sizes were moderate to strong (d = 0.4–0.6).

For neurodegenerative diseases such as dementia, findings are mixed (McDermott et al., 2013). A meta-analysis by van der Steen et al. (2017) found small to moderate effects (d = 0.3–0.4) on mood and behavioral symptoms, but no consistent improvements in cognitive functions. The methodological quality of many studies is limited, making interpretation difficult.

Long-term effects of musical activity on specific cognitive functions are, however, well documented. A longitudinal study by Hanna-Pladdy and MacKay (2011) found that older adults with prior musical experience showed better executive functions and working memory performance. Effect sizes were moderate (d = 0.3–0.4), and the causal direction remains unclear. Neuroscience increasingly provides evidence for how music can positively influence the aging brain. Musical experiences in older adults contribute not only to well-being but are also associated with preserved brain volume and activation of neural networks involved in cognitive functions (Tichko et al., 2022). Learning a musical instrument, even later in life, can induce neuroplasticity and improve the brain’s structural integrity. For example, a six-month piano training program in healthy older adults showed improved structural integrity of white matter (Jünemann et al., 2022).

Although the evidence suggests a strong positive correlation between musical engagement and healthy brain aging, further long-term studies are needed to establish definitive causal relationships and to determine the optimal types and durations of musical interventions.

Preterm Infants: Between Hope and Reality

Research on music interventions for preterm infants is particularly emotionally charged, as parents desperately seek ways to support their vulnerable children. A comprehensive meta-analysis by Standley (2012) examined 13 studies with a total of 1,093 participants. The results showed moderate effects on physiological parameters such as heart rate and respiration, as well as on feeding behavior.

Of particular note are the findings regarding neurological development. A pilot study by Lordier et al. (2019) used fMRI imaging and found that preterm infants who listened to music in the incubator exhibited stronger connections in auditory and sensorimotor networks at 12 months of age. However, the sample size was small (n = 39), and independent replication is still pending.

It is important to critically note that many studies have methodological weaknesses. Control groups are often inadequately blinded, and some of the outcome measures used have questionable clinical relevance. Moreover, various meta-analyses show considerable heterogeneity across studies, reflecting inconsistent interventions and patient populations.

Stress and Pain Management

Another important area of application is stress and pain management. Systematic reviews and meta-analyses demonstrate that music therapy has a medium to large effect on stress-related outcomes. Listening to music can reduce stress both subjectively and physiologically (e.g., positive changes in cortisol levels) and positively influence immunological and endocrinological factors (e.g., Kreutz et al., 2012).

In pain management, music therapy has been shown to reduce pain intensity and anxiety during medical procedures, promote relaxation, and decrease the need for sedatives. Meta-analyses suggest that music can significantly lower opioid requirements and improve outcomes in surgical patients (e.g., Iyendo, 2016). The evidence indicates that music-based interventions can have positive effects on both the intensity of pain and the emotional burden associated with it. It is important to note, however, that effectiveness may vary depending on the type of pain and individual response.

Read more: There's a spark - the Neurochemistry of Music

The Dark Side: Esoteric Trends and Unfounded Healing Claims

While scientific music therapy is based on evidence and well-founded methods, there are also trends within the realm of “music as medicine” that rely on esoteric or pseudoscientific claims. These can discredit the legitimate field of music therapy and create false hope for patients.

Problematic Aspects:

• Unscientific Assumptions:

Some approaches in music therapy that draw on esoteric traditions are based on assumptions such as the “doctrine of correspondences” or mystical thinking, which have no scientific basis. While such holistic theories may seem appealing, they lack empirical verifiability.

• Lack of Boundaries:

The term “music therapy” is often misused, including by individuals who lack the proper training or qualifications. This blurs the line between professional, evidence-based therapy and unregulated practices, which can potentially be harmful.

• Pseudoscientific Claims:

Particularly in areas such as autism therapy, which are vulnerable to unconventional approaches, pseudoscientific claims related to music therapy can arise if practices are not rigorously supported by science. It is crucial to distinguish between interventions with proven effectiveness and those based solely on anecdotal evidence or unverified theories.

• Discrediting the Field:

Unfounded healing claims or the blending of music therapy with esoteric practices can undermine the reputation of the entire field as a legitimate, scientifically recognized treatment. This makes it more difficult to secure acceptance and funding for evidence-based music therapy.

Concrete Examples of Esoteric and Pseudoscientific Claims:

• 432 Hz Healing Music:

A widespread pseudoscientific claim is that music tuned to 432 Hz (instead of the standard 440 Hz) possesses special healing properties, aligns with cosmic frequencies, or has a deeper positive effect on body and mind. These claims often lack a scientific basis and are rooted more in numerological or spiritual interpretations than in empirical evidence.

• “Water Crystal Music” and Cell Resonance:

Some esoteric approaches, such as “water crystal music,” claim that playing certain sounds or music can positively influence the structure of water or even the cells of the human body, supposedly improving health or emotional well-being. These ideas, popularized by figures like Masaru Emoto, lack rigorous scientific validation and are considered pseudoscientific, as they rely on anecdotal observations rather than reproducible experimental evidence. These concepts ignore fundamental principles of physics and biochemistry and have never been validated in peer-reviewed studies.

• Solfeggio frequencies:

Similar to 432 Hz, certain frequencies (such as 528 Hz, often promoted as the "love frequency") are claimed to have healing properties. Proponents assert that these frequencies can repair DNA, balance chakras, or induce spiritual transformation. However, scientific studies supporting these specific claims are lacking.

• Vibrational healing and energy work:

ESome esoteric approaches claim that music, sounds, or specific frequencies can directly manipulate a person’s energy fields, chakras, or subtle bodies to promote healing. While sounds can have physiological effects (e.g., through bone conduction or auditory processing), claims about direct energy manipulation for healing often fall outside the realm of evidence-based medicine.

• “Quantum healing” and quantum-medical explanations:

Some proponents claim that music or sound frequencies can influence health at a quantum level, often invoking concepts from quantum physics to justify healing effects. These explanations are not supported by scientific evidence and misapply physical principles. Terms like “quantum resonance” or “bioenergetic frequencies” sound scientific but have nothing to do with actual quantum physics. They are used merely to give esoteric practices a pseudoscientific veneer.

• Unfounded healing claims for diseases:

The idea that a certain frequency or piece of music has universal healing effects contradicts everything we know about individual differences in music perception. Music preferences, cultural background, and personal associations play a crucial role in the emotional impact of music. Some individuals or groups claim that specific types of music or sound therapy can cure particular diseases, including serious conditions like cancer, without providing robust scientific evidence from clinical studies. Such claims are especially dangerous, as they can lead people to forgo conventional, evidence-based treatments.

• Generalized “positive energy” or “spiritual alignment”:

While music can undoubtedly evoke positive emotions and contribute to well-being, some esoteric perspectives attribute healing to vague concepts such as “positive energy transfer” or “spiritual alignment” through music, without defining measurable mechanisms or outcomes. This contrasts with scientific music therapy, which focuses on observable changes in physiological, psychological, and social domains.

• Binaural Beats as a Panacea::

While binaural beats can indeed have measurable effects on brain waves, they are often promoted as a cure-all for everything from weight loss to boosting IQ. Many of these claims go far beyond the effects that have actually been demonstrated.

Resonance and Healing: Between Physics and Fantasy

The concept of "resonance" is used in music medicine both in a scientifically grounded way and misused pseudoscientifically. A nuanced consideration is therefore essential.

Scientifically proven resonance effects

Vibroacoustic therapy: Low-frequency vibrations between 20–120 Hz, especially around 40 Hz, show measurable physiological effects in controlled studies. These mechanical vibrations can indeed influence cell membranes and tissue structures. The frequencies partially correspond to brain wave activity and provide "deep physical cellular stimulation."

The underlying mechanisms are partially understood: acoustic technologies can generate precise forces within suitable length and frequency ranges, thereby influencing cellular functions. Mechanotransduction—the conversion of mechanical stimuli into biochemical signals—is an established mechanism in cell biology.

Cellular sound perception: New research suggests that cells in the human body may be capable of perceiving sound—a capability previously attributed only to specialized sensory organs. Amino acid vibrations occur within a frequency spectrum of 0 to 25,000 Hz, providing a theoretical basis for direct cellular sound effects.

Mechanistic limitations: It is important to note, however, that experimental setups vary widely—from pure tones to broadband signals, from 20 to 100 dB sound pressure levels, and exposure times ranging from seconds to three days. This variability makes it difficult to identify specific “healing frequencies.”

The boundary to pseudoscience

Specific “healing frequencies”: While low-frequency vibrations can demonstrably have physiological effects (both positive and negative, see research on soundscapes), the claim of specific “healing frequencies” for particular organs or diseases is scientifically unfounded. Studies with cell cultures and audible sound show that the tested frequencies were mostly between 40 and 840 Hz, but with large variations in overtones and other frequency components.

Bioresonance therapy: Devices with frequency ranges from 1 Hz to 800 kHz, which supposedly “invert electromagnetic vibrations of allergens” and send them back to the body, lack any scientific basis. The claimed mechanisms contradict fundamental principles of physics and biochemistry.

Cellular “natural frequencies”: The idea that “in homeostasis, electromagnetic fields around the body, organs, cells, bones, tissues, and fluids have a healthy vibration frequency” is a poetic metaphor rather than a scientifically proven fact. Living systems are far too complex for such simplistic resonance models.

Important distinction

It is of utmost importance to distinguish between scientifically grounded music therapy, conducted by qualified professionals and supported by research evidence, and practices that incorporate music but lack empirical support or rely on esoteric and spiritual interpretations. The critique is not aimed at the profound effects of music itself, but at claims that go beyond demonstrable effects and are not backed by scientific evidence.

Critical Evaluation Criteria

Serious resonance research differs from pseudoscience through the following characteristics:

• Mechanistic precision: Genuine research describes specific biophysical mechanisms (e.g., mechanotransduction), not vague "energy fields."

• Dose dependency: Legitimate effects show clear dose–response relationships regarding frequency, amplitude, and exposure duration.

• Reproducibility: Effects must be replicable in independent laboratories.

• Specificity vs. universality: Real biological effects are often tissue- or cell-type-specific, not universal.

Warning signs of pseudoscience:

• Claims about "universal healing frequencies."

• Use of physical terms without correct definitions.

• Promises of miraculous cures without controlled studies.

• Mixing various scientific disciplines without a coherent theory.

Critical evaluation of effect sizes

When interpreting music therapy studies, a critical evaluation of effect sizes is essential. According to Cohen's conventions, effect sizes of d = 0.2 are considered small, d = 0.5 moderate, and d = 0.8 large. Many music therapy interventions show effects in the small to moderate range, which can indeed be clinically relevant, but are far from the “miracle cures” sometimes claimed.

Moreover, it should be considered that music therapy often involves considerable time and personnel effort. An honest cost-benefit analysis must take these factors into account and compare music therapy with other, possibly more effective interventions.

Music therapy research faces particular methodological challenges. Double-blind studies are practically impossible, as both therapist and patient know whether a music intervention is taking place. This can lead to expectation effects and systematic biases.

Many studies suffer from small sample sizes, insufficient randomization, and lack of long-term follow-up. The heterogeneity of interventions makes it difficult to compare the results of different studies and draw general conclusions.

Conclusion: Music as Medicine – A Potential with Responsibility

Music undoubtedly has enormous potential as a therapeutic tool. Over the past decades, scientific music therapy has made impressive progress and demonstrated its effectiveness across a wide range of applications – from promoting social skills in autism, supporting language development delays, managing stress and pain, to aiding healthy aging. These successes are based on rigorous research, evidence-based methods, and the work of qualified music therapists.

Particularly noteworthy are the neuroscientific findings showing how music can positively influence the aging or damaged brain. These developments highlight the importance of an interdisciplinary approach that connects music therapy, neuroscience, and audiology.

The scientific evidence for the therapeutic effects of music is indeed present, but it must be considered more nuancedly than popular science presentations often suggest. Especially in neurological rehabilitation, certain developmental disorders, and as an adjunct treatment for preterm infants, music therapy shows measurable, albeit moderate, effects.

At the same time, it is crucial to distinguish music therapy interventions from the numerous pseudoscientific claims that populate the field. Credible music-based medicine relies on controlled studies, not on esoteric speculations about healing frequencies or quantum resonance.

The future of music medicine lies in a scientifically grounded, evidence-based approach that sets realistic expectations and clearly differentiates between established effects and unproven claims. Only in this way can the therapeutic potential of music be fully realized, without giving patients false hope or deterring them from more effective treatments.

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Sources:

• Zhi, L., Hou, D., Hong, Y., Ke, M., Zhang, Q., Wang, Y., & Long, J. (2024). Research on music therapy from 2013 to 2022: a bibliometric and visualized study. Frontiers in Psychiatry, 15, 1323794. https://pmc.ncbi.nlm.nih.gov/articles/PMC11366619/

• Iyendo, T.O. Exploring the effect of sound and music on health in hospital settings: A narrative review. Int J Nurs Stud. 2016, 63, 82–100.

• Kreutz, G.; Murcia, C.Q.; Bongard, S. Psychoneuroendocrine research on music and health: An overview. Music Health Wellbeing. 2012, 457–476.

• Groß, W., Linden, U., & Ostermann, T. (2010). Effects of music therapy in the treatment of children with delayed speech development—results of a pilot study. BMC Complementary and Alternative Medicine, 10(1), 39. https://pmc.ncbi.nlm.nih.gov/articles/PMC2921108/

• De Witte, M., Pinho, A. S., Stams, G. J., Moonen, X., & van Hooren, S. (2022). Music therapy for stress reduction: a systematic review and meta-analysis. Health Psychology Review, 16(2), 223-247. https://www.tandfonline.com/doi/full/10.1080/17437199.2020.1846580

• Levin, J. (2008). Esoteric healing traditions: A conceptual overview. Explore, 4(1), 4-10.

• Tichko, P., Kim, J. C., Large, E., & Loui, P. (2022). Integrating music-based interventions with Gamma-frequency stimulation: implications for healthy ageing. European Journal of Neuroscience, 56(12), 6563-6577. https://onlinelibrary.wiley.com/doi/abs/10.1111/ejn.15059

• Jünemann, K., Marie, D., Worschech, F., Scholz, D. S., Grouiller, F., Kliegel, M., ... & Sinke, C. (2022). Six months of piano training in healthy elderly stabilizes white matter microstructure in the fornix, compared to an active control group. Frontiers in aging neuroscience, 14, 817889.

• Särkämö, T., Tervaniemi, M., Laitinen, S., Forsblom, A., Soinila, S., Mikkonen, M., ... & Hietanen, M. (2008). Music listening enhances cognitive recovery and mood after middle cerebral artery stroke. Brain, 131(3), 866-876. doi: 10.1093/brain/awn013

• Geretsegger, M., Elefant, C., Mössler, K. A., & Gold, C. (2014). Music therapy for people with autism spectrum disorder. Cochrane Database of Systematic Reviews, (6). doi: 10.1002/14651858.CD004381.pub3

• van der Steen, J. T., Smaling, H. J., van der Wouden, J. C., Bruinsma, M. S., Scholten, R. J., & Vink, A. C. (2018). Music‐based therapeutic interventions for people with dementia. Cochrane Database of Systematic Reviews, (7). doi: 10.1002/14651858.CD003477.pub4

• McDermott, O., Crellin, N., Ridder, H. M., & Orrell, M. (2013). Music therapy in dementia: a narrative synthesis systematic review. International Journal of Geriatric Psychiatry, 28(8), 781-794.

• Standley, J. M. (2012). Music therapy research in the NICU: an updated meta-analysis. Neonatal Network, 31(5), 311-316. doi: 10.1891/0730-0832.31.5.311

• Lordier, L., Meskaldji, D. E., Grouiller, F., Pittet, M. P., Vollenweider, A., Vasung, L., ... & Hüppi, P. S. (2019). Music in premature infants enhances high-level cognitive brain networks. Proceedings of the National Academy of Sciences, 116(24), 12103-12108. doi: 10.1073/pnas.1817536116

• Rauscher, F. H., Shaw, G. L., & Ky, K. N. (1993). Music and spatial task performance. Nature, 365(6447), 611. doi: 10.1038/365611a0

• Hanna-Pladdy, B., & MacKay, A. (2011). The relation between instrumental musical activity and cognitive aging. Neuropsychology, 25(3), 378-386. doi: 10.1037/a0021895

• Bartel, L., & Mosabbir, A. (2021). Possible mechanisms for the effects of sound vibration on human health. Healthcare, 9(5), 597. doi: 10.3390/healthcare9050597

• Bradt, J., Magee, W. L., Dileo, C., Wheeler, B. L., & McGilloway, E. (2010). Music therapy for acquired brain injury. Cochrane Database of Systematic Reviews, (7). doi: 10.1002/14651858.CD006787.pub2

• Fusar-Poli, L., Bieleninik, Ł., Brondino, N., Chen, X. J., & Gold, C. (2018). The effect of music therapy on cognitive functions in patients with dementia: a systematic review and meta-analysis. Aging & Mental Health, 22(9), 1103-1112.

• Gold, C., Wigram, T., & Elefant, C. (2006). Music therapy for autistic spectrum disorder. Cochrane Database of Systematic Reviews, (2). doi: 10.1002/14651858.CD004381.pub2

• Godwin, J. (2023). Sacred and Profane in Music Therapy. Religions, 14(10), 1229.

  https://www.mdpi.com/2077-1444/14/10/1229