Opinion
Neuroscience finds musicians feel pain differently from the rest of us
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It’s well known that learning to play an instrument can offer benefits beyond just musical ability. Indeed, research shows it’s a great activity for the brain – it can enhance our fine motor skills,language acquisition, speech, and memory – and it can even help to keep our brains younger.
After years of working with musicians and witnessing how they persist in musical training despite the pain caused by performing thousands of repetitive movements, I started wondering: if musical training can reshape the brain in so many ways, can it also change the way musicians feel pain, too? This is the question that my colleagues and I set out to answer in our new study.
Scientists already know that pain activates several reactions in our bodies and brains, changing our attention and thoughts, as well as our way of moving and behaving. If you touch a hot pan, for example, pain makes you pull back your hand before you get seriously burned.
Pain also changes our brain activity. Indeed, pain usually reduces activity in the motor cortex, the area of the brain that controls muscles, which helps stop you from overusing an injured body part.
These reactions help to prevent further harm when you’re injured. In this way, pain is a protective signal that helps us in the short term. But if pain continues for a longer time and your brain keeps sending these “don’t move” signals for too long, things can go wrong.
For example, if you sprain your ankle and stop using it for weeks, it can reduce your mobility and disrupt the brain activity in regions related to pain control. And this can increase your suffering and pain levels in the long term.
Research has also found that persistent pain can shrink what’s known as our brain’s “body map” – this is where our brain sends commands for which muscles to move and when – and this shrinking is linked with worse pain.
But while it’s clear that some people experience more pain when their brain maps shrink, not everyone is affected the same way. Some people can better handle pain, and their brains are less sensitive to it. Scientists still don’t fully understand why this happens.
Musicians and pain
In our study, we wanted to look at whether musical training and all the brain changes it creates could influence how musicians feel and deal with pain. To do this, we deliberately induced hand pain over several days in both musicians and non-musicians to see if there was any difference in how they responded to the pain.
To safely mimic muscle pain, we used a compound called nerve growth factor. It’s a protein that normally keeps nerves healthy, but when injected into hand muscles, it makes them ache for several days, especially if you’re moving your hand. But it’s safe, temporary, and doesn’t cause any damage.
Then we used a technique called transcranial magnetic stimulation (TMS) to measure brain activity. TMS sends tiny magnetic pulses into the brain. And we used these signals to create a map of how the brain controls the hand, which we did for each person who took part in the study.
We built these hand maps before the pain injection, and then measured them again two days later and eight days later, to see if pain changed how the brain was working.
Yiistocking/Shutterstock.com
A striking difference
When we compared the brains of the musicians and the non-musicians, the differences were striking. Even before we induced pain, the musicians showed a more finely tuned hand map in the brain, and the more hours they had spent practising, the more refined this map was found to be.
After pain was induced, the musicians reported experiencing less discomfort overall. And while the hand map in non-musicians’ brains shrank after just two days of pain, the maps in musicians’ brains remained unchanged – amazingly, the more hours they had trained, the less pain they felt.
This was a small study of just 40 people, but the results clearly showed that the musicians’ brains responded differently to pain. Their training seems to have given them a kind of buffer against the usual negative effects, both in how much pain they felt and in how their brain’s motor areas reacted.
Of course, this doesn’t mean music is a cure for chronic pain. But it does show us that long-term training and experience can shape how we perceive pain. This is exciting because it might help us understand why some people are more resilient to pain than others, along with how we can design new treatments for those living with pain.
Our team is now conducting further research on pain to determine if musical training may also protect us from altered attention and cognition during chronic pain. And off the back of this, we hope to be able to design new therapies that “retrain” the brain in people who suffer from persistent pain.
For me, this is the most exciting part: the idea that as a musician, what I learn and practise every day doesn’t just make me better at a skill, but that it can literally rewire my brain in ways that change how I experience the world, even something as fundamental as pain.
This article was commissioned by Videnskab.dk as part of a partnership collaboration with The Conversation. You can read the Danish version of this article, here.
Opinion
Paracetamol use during pregnancy not linked to autism, our study of 2.5 million children shows
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United States President Donald Trump recently claimed that using the common painkiller acetaminophen (also known as paracetamol and by the brand name Tylenol in the US) during pregnancy is fuelling the rise in autism diagnoses. He then went on to suggest pregnant women should “tough it out” rather than use the common painkiller if they experience fever or pain.
This announcement has caused alarm and confusion worldwide. But despite Trump’s claim, there is no strong scientific evidence to back it up. Our study of nearly 2.5 million births in Sweden published in 2024 shows no evidence that acetaminophen use during pregnancy increases a child’s risk of autism. This is the largest study conducted on the subject to date.
To understand whether acetaminophen really poses a risk in pregnancy, we turned to Sweden’s national health registers, which are among the most comprehensive in the world. Our study followed nearly 2.5 million children born between 1995 and 2019, tracking them for up to 26 years.
Using prescription records and interviews that midwives conducted during prenatal visits, we could see which mothers reported using acetaminophen (about 7.5% of pregnancies) and which did not.
We also made sure to account for any variables that may have affected the results of our statistical analysis – including controlling for health factors, such as fever or pain, which would have influenced whether or not a mother used acetaminophen during her pregnancy. This was to ensure a more fair comparison between the two groups.
We then looked at the children’s neurodevelopmental outcomes – specifically whether they were diagnosed with autism, ADHD or an intellectual disability.
The real strength of our study came from being able to compare siblings. This allowed us to compare children born to the same mother, where acetaminophen had been used during one child’s pregnancy but not the other. We compared over 45,000 sibling pairs, where at least one sibling had an autism diagnosis.
This sibling design is powerful because siblings share much of their genetics and family environment. This allows us to tease apart whether the drug itself – rather than underlying family traits or health conditions – is responsible for any apparent risks for neurodevelopmental outcomes.
Acetaminophen use
When we first looked at the entire population, we saw a pattern that echoed earlier studies: children whose mothers reported using acetaminophen during pregnancy were slightly more likely to be diagnosed with autism, ADHD or an intellectual disability.
But once we ran the sibling comparisons, that association completely disappeared. In other words, when we compared sets of siblings where one was exposed in the womb to acetaminophen and one was not, there was no difference in their likelihood of later being diagnosed with autism, ADHD or an intellectual disability.
Dragana Gordic/ Shutterstock
Our study is not the only one to put this question to the test. Researchers in Japan recently published a study using a similar sibling-comparison design, and their results closely matched ours.
Importantly, they replicated our findings in a population with a different genetic background and where patterns of acetaminophen use during pregnancy are quite different. Nearly 40% of mothers in Japan reported using the drug during pregnancy. In comparison, less than 10% of Swedish mothers had used it.
Despite these differences, the conclusion was the same. When siblings are compared, there is no evidence that acetaminophen use during pregnancy increases the risk of autism or ADHD.
These findings mark an important shift from earlier studies, which relied on more limited data, used smaller cohorts and didn’t account for genetic differences. They also did not fully account for why some mothers used pain relief during pregnancy while others didn’t.
For example, mothers who take acetaminophen are more likely to also have migraines, chronic pain, fever or serious infections. These are conditions that are themselves genetically linked to autism or ADHD, as well as a child’s likelihood of later being diagnosed with one of these conditions.
These types of “confounding factors” can create associations that look convincing on the surface, but may not reflect a true cause-and-effect relationship.
That brings us to the real question on many people’s minds: what does this mean if you’re pregnant and dealing with pain or fever?
It’s important to recognise that untreated illness during pregnancy can be dangerous. A high fever in pregnancy, for example, is known to increase the risk of complications for both mother and baby. “Toughing it out,” as the president suggested, is not a risk-free option.
That’s why professional medical organisations such as the American College of Obstetricians and Gynecologists and the UK’s Medicines and Healthcare products Regulatory Agency continue to recommend acetaminophen (paracetamol) as the safest fever reducer and pain reliever during pregnancy when used at the lowest effective dose and only when necessary. This has been the guidance for decades.
Read more:
Paracetamol, pregnancy and autism: what the science really shows
Of course, if someone finds themselves needing to take acetaminophen regularly over a longer period of time, that’s a decision best made in consultation with their doctor or midwife. But the idea that acetaminophen use during pregnancy causes autism simply isn’t supported by the best available science.
The greater danger is that alarmist messaging will discourage pregnant women from treating pain or fever – putting both themselves and their babies at risk.
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Only a few days ago, it still seemed possible that voters would have a choice of up to six candidates in next month’s presidential election. But when nominations closed at noon on Wednesday, only three names had made it on to the ballot paper. That reflected the narrowing that had taken place over the previous four days.
First, Sinn Féin announced that it would be supporting Catherine Connolly rather than putting forward a candidate of its own. That was followed by businessman Gareth Sheridan’s failure to secure the requisite support from local authorities.
There was a flurry of excitement in the final hours before nominations closed, as Maria Steen edged ever closer to the 20 signatures from members of the Oireachtas which the Constitution requires. But the conservative campaigner ultimately fell two names short.
As a result, the electorate now finds itself presented with the smallest field of candidates since the presidential election of 1990.
That is regrettable. A broader, more varied choice would surely have led to a more vigorous and wide-ranging debate, which in turn would have stimulated public interest and potentially increased voter turnout.
Steen’s supporters have been quick to blame her failure to secure a nomination on the main political parties, whom they accuse of shutting down democratic choice.
The charge is unfounded; between them, Connolly, Jim Gavin and Heather Humphreys command the support of nearly every party in the Oireachtas – almost 85 per cent of its members. The suggestion that parties with candidates in the field should ease the path of potential opponents reached absurd levels on Tuesday when it was suggested that Connolly herself might sign Steen’s nomination papers.
It should not shock anyone that political parties pursue their own electoral advantage in order to achieve the objectives they were set out up to accomplish. That, after all, is the proposition they presented to their voters.
Where Ireland differs from most of its international counterparts is in the number of Independents it elects. As a result, there were more than enough Independent TDs and Senators available to ensure Steen’s nomination. They chose not to do so, presumably for a variety of different reasons. That is why she did not succeed.
The fact that she came so close is largely due to the efforts of Peadar Tóibín, leader of Aontú, one of the smallest parties in the Oireachtas. In the end, he fell short, in part because the campaign itself began too late and ran out of time.
But there are lessons here for those who believe Irish political discourse is too narrow and that some voices are excluded. The remedy to that lies not in the kindness of opponents but in effective, organised and sustained political work.
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Ireland is the second largest producer of textile waste per head in Europe, second only to Belgium. We each consume 53kg of textiles each year – more than double the European average. To put the figure in context, a T-shirt weighs between 100 and 250 grams, and a winter duvet can weigh 3 kg.
It’s a lot of clothes, bedding and curtains to throw out and most of it goes in the bin, with only a third being recycled via clothes banks and charity shops. Given the dubious distinction of being one of the worst offenders when it comes to textile waste you might assume that we would quickly and wholeheartedly embrace new rules to reduce textile waste adopted by the European Parliament earlier this month.
Under the new directive, producers who make textiles available in the EU will have to cover the cost of their collection, sorting and recycling. The rules will apply to all producers, including online sellers, irrespective of whether they are established in an EU country or outside it.
The measures will be implemented through a producer responsibility scheme similar to the Re-turn system for drink bottles and cans set up by packaging and drinks companies.
Member states have 30 months from the directive’s entry into force to establish a scheme. There is, of course, no reason why it cannot be done sooner and every reason why it should be.
But if the Re-turn scheme is any guide, the Government will be in no rush when it finds itself caught between industry lobbying and fears the measure may push up prices.
The Single Use Plastic directive came into effect in 2019 but the Irish deposit-based scheme for recycling drink bottles and cans launched in February 2024. Many other European countries brought them in 20 years ago.
Despite initial teething problems, the Re-turn scheme has been supported by the public and has helped the industry meet its EU-mandated recycling targets. There is no reason to believe consumers will not support a textile recycling scheme sooner rather than later.
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