Headache Medicine 2021, 12(1) p-ISSN 2178-7468, e-ISSN 2763-6178
12
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DOI: 10.48208/HeadacheMed.2021.3
Headache Medicine
© Copyright 2021
Review
Dichotomy of music in the approach of tension-type headache
Laura Santos Oliveira Natália de Fátima Gonçalves Amâncio
Medical School, University Center of Patos de Minas, Patos de Minas, Minas Gerais, Brazil
Abstract
Introduction
Headache is one of the most frequent diseases of the nervous system. Headache is considered
a public health problem, due to its high prevalence - since more than 90% of the population will
present this clinical condition throughout their lives according to the World Health Organization
(WHO) and for its negative impact on quality of life. In such a subtype of headache, music is seen
as an antithesis either for its relief action or not, with ndings in both extremes.
Objective
The objective of this paper is to identify the real effects of routine listening to music in patients with
tension-type headache, based on reports in the current literature. The present study consists of an
integrative literature review on the effects of routine listening to music in patients with tension-type
headache.
Methodology
After careful reading of the publications, six articles were not used due to the exclusion criteria.
Thus, 14 articles were selected for the nal analysis and construction of the bibliographic review
on the topic.
Results
After the analysis, in 50% of the studies, the intensity of the headache increased with listening
to music, and in 50% of the studies the intensity of the headache with listening to music de-
creased.
Conclusion
It can be concluded that music is related in an ambivalent way to cases of headache arising from
several etiologies. When administered at high frequencies, it can be a triggering factor, presenting
a higher incidence in those who listen to it in this way, if compared to those who listen to it in a
less intense way. But when used systematically, with frequency and delimited periods - such as
the music therapy mechanism - music reveals itself as a benecial element to reduce the frequency
and intensity of headache caused by different diseases.
Luana Santos Oliveira
laurasoliveira@unipam.edu.br
Edited by
Mario Fernando Prieto Peres
Marcelo Moraes Valença
Keywords:
Headache
Tension-type headache
Music
Music therapy
Severity
Alternative treatment.
Received: February 5, 2021
Accepted: March 30, 2021
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Dichotomy of music in the approach of tension headache
Introduction
H
eadache is characterized as one of the most frequent dis-
eases of the nervous system.
1
For many authors, headache
is considered a public health problem due to its high preva-
lence - since more than 90% of the population will present
this clinical condition throughout their lives according to the
World Health Organization (WHO)
2,3
and for its negative
impact on quality of life.
4
Tension-type headache is one of the most recurrent types,
given its triggers arising from daily stress.
5
Tension-type head-
ache affects two thirds of adult men and more than 80% of
women.
4
It can also be conceptualized as "constrictive head-
ache, usually bilateral, with mild to moderate intensity, not
aggravated by routine physical activities and with a variable
duration between 30 minutes and 7 days".
6
In this sense, music is seen as an antithesis in the sense of
its relief action or not, in such type of headache. Moreover,
music is closely related to people at different times, not only
as a social element, but also a professional one.
7
Because of
this, when music is heard with great frequency and intensity,
it can bring irreversible damage to hearing, besides causing
stress to the individual, with release of typical hormones such
as cortisol, which can cause and/or intensify the occurrence
of tension-type headaches.
7
Still at this juncture, many studies have been developed re-
garding music therapy, in a non-pharmacological approach
in the treatment of headaches. This mechanism is a com-
plementary therapy based on the integration of listening to,
producing, or composing music in the therapeutic process.
8
It has thus been found that "classical music therapy can re-
lieve the intensity of headache attack and reduce emotional
stress”.
9
Since, according to the same authors, the effects of
the intervention consist in the acceleration of cerebral blood
ow, reducing the pressure in these vessels, starting from
an interaction of hormones related to relaxation. Given the
relevance of the topic in the current situation, both by the
frequent incidence of headache, and the signicance and
scope of music at different times throughout life, the devel-
opment of this work is based focusing on the relationship of
the elements mentioned above. Thus, its development aims to
identify the real effects of routine music listening in patients
with tension-type headache, from reports in the current litera-
ture since the existing articles are not very enlightening when
gathering the thresholds of music for the disease in question.
Metodology
The present study consists of an integrative literature review
on the effects of routine listening to music in patients with
tension-type headache. The PICO (acronym for Patient, In-
tervention, Comparison and Outcome) strategy was used
to develop the research question of the integrative review.
Thus, the dened research question was "Can people with
tension-type headache have their symptoms changed by
routinely listening to music? In it, we have P= People with
tension-type headache; I= routine listening to music; and
O= altered pictures. After establishing the search keywords,
the descriptors "Tension Headache and Music"; "Tension
Headache and Altered Charts"; "Music and Positive and Neg-
ative Effects and Headache"; "Music and Headache" were
crossed in the following databases: Virtual Health Library
(VHL); National Library of Medicine (PubMed MEDLINE),
Scientic Electronic Library Online (SCIELO), and EbscoHost.
The search was conducted in the month of September 2020.
Studies published between 2010 and 2020 were considered.
The strategy for selection of articles followed the following
steps: search of the selected databases; reading of the titles of
all articles found and exclusion of those that did not address
the subject; critical reading of the abstracts of the articles
and full reading of the articles selected in the previous steps.
Eighteen articles were found, of which the published titles and
abstracts were read. Inclusion criteria were original articles
that addressed the research topic and allowed full access
to the study content; studies that did not meet the above
inclusion criteria were excluded. After careful reading of the
publications, six articles were not used due to the exclusion
criteria. Thus, 12 articles were selected for the nal analysis
and construction of the literature review on the theme.
Results and Discussion
In study 1 (Table 1), 36% of adolescents who were exposed
to listening to amplied music presented headache as an
extra-auditory symptom, while in adolescents not exposed,
25% presented this symptom. However, these were not young
people who had a clinical diagnosis of tension-type head-
ache.
10
In consonance, study 5 (Table 1) obtained similar
results, in which 74 (62.20%) of the amplied music listeners
reported having headache, while 13 (59.10%) of the non-us-
ers reported this symptom.
13
Still regarding studies in which
listening to music proved to be favorable to the occurrence
of headache, when analyzing two groups of young people/
adults regarding the use of headphones in two distinct inten-
sities - high and extended high - it was obtained that 29 of
182 participants who listened to music with high extended
intensity, reported feeling headaches, while 7 of 46 who
listened with high frequency reported this symptom.
14
In study
2 (Table 1), 78 young patients with tension-type headaches
were analyzed, who would receive the music therapy pro-
cedure over 8 weeks, being composed of two groups, one
14
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Dichotomy of music in the approach of tension headache
that would receive any music therapy and the other with a
pedagogical rhythm program and a "placebo control", the
results were similar, and both groups obtained a moderate
average reduction after treatment of 20% and a small portion
obtained a 50% reduction of the symptom.
11
In a more specic approach, it is revealed that classical mu-
sic can be used in the context of headaches resulting from
meningitis, which, despite not being the focus of this work,
has similar effects on the brain region of the patient.
9
Thus,
a patient was exposed to classical music for 12 minutes and
15 seconds for 3 sessions over 3 days, obtaining positive
results, relieving the intensity of pain, and reducing emotional
stress. In the same way, when analyzing what was raised by
Study 4 (Table 1), referring to the effects of classical music
therapy against headache in hypertensive patients, it was
shown to be advantageous, since all the groups that received
the intervention had the intensity of the symptom reduced.
12
After observing such studies, especially contemplating their
methodologies and results, one can see that there are two
distinct thresholds that correlate music to headache. The rst
would be the one in which music would be a trigger for
headaches, as elucidated in studies 1, 5 and 6 (Table 1).
However, it is relevant to emphasize that they were not focused
on participants diagnosed with tension-type headache, and
the big difference was the intensity in which the music was
listened to, being in all of them with high intensity.
10,13,14
The second one is about music as a non-pharmacological
alternative for patients who have headache due to some
pathology. Music therapy, in the analyzed studies, was used
as an alternative for the relief of headache in patients with
meningitis, with hypertension and in patients with primary
headache, in all three, by means of correct tests, it was shown
to be positive, regarding the reduction of headache intensity
and frequency. Again, it is important to emphasize that the
tests of the referred studies were not directed to patients with
tension-type headache, thus becoming a factor for analogies,
aiming at the physiological effect that music caused in both
studies, dilating the encephalic vessels, and making the blood
more uid in this region.
9,11,12
Conclusion
It can be concluded, from the content shown in this paper,
that music is related in an ambivalent way to cases of head-
ache arising from several etiologies. When administered at
high frequencies, it can be a triggering factor, presenting
a higher incidence in those who listen to it in this way, if
compared to those who listen to it in a less intense way.
But when used systematically, with frequency and delimited
periods - such as the music therapy mechanism - music reveals
itself as a benecial element to reduce the frequency and
intensity of headache caused by different diseases.
Therefore, it is important that new studies be developed, with
the objective of relating music - with different styles, intensi-
ties, and frequency - to people who suffer from tension-type
headache. Since the current literature has modest ndings
aiming at the effects of listening to music (this cultural and
social manifestation) in a routine way, to this type of head-
ache, which belongs to a vast portion of the national and
world population.
Financing: No
Conflict of interests: No
Laura Santos Oliveira
https://orcid.org/0000-0002-6555-8465
Natália de Fátima Gonçalves Amâncio
https://orcid.org/0000-0003-4006-8619
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Table 1 - Analysis of the effects of music on patients with headache found in publications from 2013-2020
Study Title Main Findings
1. Rodrigues
10
Hearing Evaluation in Adolescent Users of Amplied Music
Increased frequency and
incidence of headaches
2. Koenig et al.
11
Specic Music Therapy Techniques In The Treatment
Of Primary Headache Disorders In Adolescents: A Randomized
Attention-Placebo-Controlled Trial
Decrease in headache intensity
3.Purwandari, Yona
9
Classical Music Therapy As The Intervention To Relieve Headache In A Meningitis Patient Decrease in headache intensity
4. Siauta. Yusuf,
Suprajitno
12
Change Of Blood Pressure And Headache In People With Hypertension
Using Relaxation Of Handgrip And Classical Music In Dr. M.
Haulussy Hospital Ambon
Decrease in headache intensity
5. Ferreira
13
Relationship of Listening Habits with Auditory and Extra-Auditory Symptoms in Adolescent Users of Amplied Music
Increased frequency and
incidence of headaches.
6. Sulaiman, Husain,
Seluakumaran
14
Hearing Risk among Young Personal Listening Device Users: Effects at High-Frequency and Extended High
Frequency Audiogram Thresholds
Increased frequency and
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Source: Research data, 2020.
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música amplificada
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Journal of International Advanced Otology
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10.5152/iao.2015.699
