Effects of Preferred Music on Pain Tolerance During an Experimental Cold Pressor Test: A Pilot Study

Background Preferred music has shown promise as a non-pharmacologic strategy for modulating pain, yet its effects in controlled laboratory environments relevant to rehabilitation practice remain underexplored. This pilot study examined whether listening to self-selected preferred music influences pain perception during an experimental cold pressor task. Methods  Twenty healthy adults (mean age: 35.4 years) completed six cold pressor cycles in a repeated-measures design: two pre-music trials, two preferred-music trials, and two post-music trials. During each trial, participants immersed their non-dominant hand in 0°C water until the first pain perception. Outcomes included time-to-pain perception (seconds) and pain intensity (10-cm Visual Analogue Scale). Friedman's test with Wilcoxon post-hoc comparisons analyzed non-normally distributed time-to-pain data, while repeated-measures ANOVA evaluated normally distributed pain intensity scores. Results Preferred music significantly increased pain tolerance. Mean time-to-pain perception rose from 33.8 s (pre-music) to 56.2 s during preferred-music trials, decreasing to 45.4 s post-music. The overall effect of the condition was significant (χ²(2) = 15.6, p < .001). Post-hoc tests showed significantly greater tolerance during preferred-music trials compared with both pre-music (p = 0.001) and post-music (p = 0.001) conditions, with 17 of 20 participants demonstrating increased tolerance. Pain intensity ratings did not differ significantly across conditions (F(2, 38) = 0.561, p > 0.05). Conclusion Preferred music meaningfully delayed pain onset during the cold pressor test (CPT) but did not alter perceived pain intensity. These findings support preferred music as a simple, low-cost strategy that may enhance pain tolerance and patient engagement during rehabilitation activities. Larger, clinically focused studies are needed to clarify mechanisms, the durability of effects, and real-world therapeutic applications.