Sound Healing: What the Clinical Evidence Actually Says

Language: en

The Question That Matters

Sound healing is booming. Singing bowl sessions, gong baths, tuning fork treatments, sound-assisted meditation, vibroacoustic therapy — the market for sound-based wellness interventions has grown exponentially in the past decade. Studios, retreats, apps, and practitioners offer sound healing for conditions ranging from chronic pain to anxiety, from insomnia to trauma recovery, from depression to spiritual disconnection.

The claims are often extravagant. “Healing at the cellular level.” “Restoring the body’s natural frequency.” “Releasing stuck energy.” “Recalibrating the chakras.” The language borrows freely from both New Age spirituality and medical science, creating an impression of legitimacy that may or may not be deserved.

The question that matters is not whether sound healing is popular (it is), or whether people feel better after sound healing sessions (most do), or whether ancient cultures used sound for healing (they did). The question is: what does the peer-reviewed clinical evidence say? When you strip away the marketing, the anecdote, the testimonial, and the tradition, what remains?

The answer is nuanced. Some sound healing modalities have genuine, replicated evidence of clinical benefit. Others have promising preliminary results that need further investigation. Others have essentially no evidence beyond participant self-report. And the mechanisms — when they are understood at all — are often different from what practitioners claim.

This article reviews the clinical evidence for the major sound healing modalities, honestly and thoroughly, because the tradition deserves better than unsubstantiated hype and the people seeking healing deserve better than guesswork.

Singing Bowls

The Modality

Singing bowls (also called Tibetan singing bowls, Himalayan singing bowls, or standing bells) are metal or crystal bowls that produce sustained tones when struck or when the rim is circled with a mallet. The metal variety, traditionally made from a bronze alloy, produce complex harmonic overtones — multiple frequencies sounding simultaneously, creating a rich, shimmering, evolving timbre. Crystal singing bowls, made from fused quartz, produce purer, more sustained tones with fewer harmonics.

In a typical singing bowl session, the participant lies on a mat or massage table while the practitioner plays multiple bowls of different sizes and pitches around and sometimes on the body. Sessions typically last 30-60 minutes. The acoustic environment is dense, immersive, and harmonically complex.

The Evidence

Goldsby, Goldsby, McWalters, and Mills (2017). Published in the Journal of Evidence-Based Complementary & Alternative Medicine. This is the most cited study in the singing bowl literature. The researchers measured the effects of singing bowl sessions (combining Tibetan singing bowls, crystal singing bowls, gongs, and other harmonic instruments) on mood and well-being in 62 participants.

Results: Participants showed significant reductions in tension, anger, fatigue, and depressed mood, as measured by the Profile of Mood States (POMS). Anxiety was significantly reduced as measured by the Hospital Anxiety and Depression Scale (HADS). The effects were large — the magnitude of mood improvement exceeded that typically reported in pharmaceutical trials for mild to moderate anxiety and depression.

Notably, participants who had never previously experienced a singing bowl session showed larger improvements than those with prior experience, suggesting that the effects were not dependent on familiarity, expectation, or practitioner relationship.

Limitations: The study lacked a control group. Without a comparison condition (silence, relaxation music, social interaction, or sham treatment), it is impossible to determine how much of the benefit was specific to the singing bowls versus how much was attributable to lying down in a quiet room for an hour, to the social context, or to expectation effects.

Bidin et al. (2016). Published in the European Journal of Integrative Medicine. A pilot study examining the effects of singing bowl sessions on cancer patients undergoing chemotherapy. Results showed significant reductions in anxiety and improvements in well-being following singing bowl sessions.

Stanhope and Weinstein (2022). Published in PLoS ONE. A study examining the effects of singing bowl sessions on anxiety, depression, and well-being in 105 participants. Results confirmed significant improvements in all measures, with larger effects in participants with higher baseline anxiety.

Systematic reviews. Systematic reviews of the singing bowl literature (including Goldsby et al., 2022, published in the International Journal of Environmental Research and Public Health) consistently find positive effects on mood, anxiety, and subjective well-being, but note that the quality of evidence is generally low — most studies are small, uncontrolled, and at high risk of bias. The reviewers consistently call for larger, better-controlled trials.

Mechanisms

The mechanisms by which singing bowls produce their effects are not fully characterized, but several are plausible:

Relaxation response. The combination of prone position, eyes closed, quiet environment, and sustained harmonic sound is likely to produce a generalized relaxation response — parasympathetic nervous system activation, reduced heart rate and blood pressure, reduced cortisol, muscle relaxation. This alone would account for significant mood improvement.

Frequency entrainment. Singing bowls produce complex tones with multiple harmonics. The amplitude modulation patterns created by the interaction of these harmonics include low-frequency components in the alpha and theta ranges that may produce brainwave entrainment.

Vibrotactile stimulation. When bowls are placed on or near the body, the vibrations are transmitted through the skin and skeletal system. This whole-body vibration provides somatosensory stimulation that activates the parasympathetic nervous system through mechanoreceptor pathways.

Attentional absorption. The complex, slowly evolving harmonic content of singing bowls captures attention in a way that is absorbing but not demanding — what Rachel and Stephen Kaplan called “soft fascination.” This attentional absorption provides rest from the directed attention that dominates ordinary waking consciousness, reducing mental fatigue.

Tuning Forks

The Modality

Tuning forks used in sound healing are metal forks that vibrate at specific frequencies when struck. Practitioners apply vibrating tuning forks to the body — to acupuncture points, to bones, to the soles of the feet, to the skull, or to areas of pain or tension. The vibration is transmitted through bone conduction and soft tissue propagation.

The most commonly used frequencies in tuning fork therapy are:

• 128 Hz (the standard medical tuning fork, used in orthopedic assessment)
• 136.1 Hz (claimed to be the “Om frequency,” based on calculations of the Earth’s orbital period)
• 256 Hz (the C note, used in some Biofield Tuning protocols)
• Various Solfeggio frequencies (discussed in the previous article)

The Evidence

The peer-reviewed evidence for tuning fork therapy specifically is extremely limited. Most of the evidence comes from related modalities (vibration therapy, bone conduction stimulation) rather than tuning fork treatment per se.

Bone conduction and vibration therapy. Vibration applied to the body at frequencies in the 20-200 Hz range has well-established physiological effects: increased local blood flow, stimulation of mechanoreceptors, activation of the vibrotactile sensory pathway, and potential effects on fascial tissue and cellular metabolism. Whole-body vibration therapy (using vibrating platforms) has a substantial evidence base for applications including bone density improvement (Rubin et al., 2004), balance improvement in elderly populations, and pain reduction.

Biofield Tuning. Eileen McKusick’s Biofield Tuning protocol, which uses tuning forks applied to the body and moved through the “biofield” (the hypothesized energy field surrounding the body), has been the subject of a small pilot study (Muehsam et al., 2020) showing reductions in pain and anxiety. The study was uncontrolled and preliminary.

Acupoint stimulation. The application of vibrating tuning forks to acupuncture points is used as an alternative to needle acupuncture. While the evidence for tuning fork acupoint stimulation specifically is limited, the evidence for acupuncture point stimulation (by any method) in pain reduction is substantial (Vickers et al., 2018 Cochrane review).

Mechanisms

Mechanotransduction. The vibration from a tuning fork applied to the body produces mechanical stress in local tissues. Cells respond to mechanical stress through mechanotransduction — converting mechanical signals into biochemical responses. Research by Donald Ingber at Harvard Medical School has demonstrated that mechanical vibration at specific frequencies affects cellular behavior, including gene expression, proliferation, and differentiation.

Fascial stimulation. The fascia — the connective tissue network that pervades the body — is rich in mechanoreceptors (particularly Ruffini corpuscles and Pacinian corpuscles) that respond to vibration. Robert Schleip at the Technical University of Munich has demonstrated that fascial stimulation through vibration and pressure activates parasympathetic reflexes that reduce muscle tension and improve tissue hydration.

Placebo and contextual effects. The ritualistic context of tuning fork therapy — the practitioner’s focused attention, the unusual stimulus, the therapeutic relationship, the expectation of benefit — is likely to produce significant placebo effects. These effects are real (placebo responses involve measurable neurobiological changes) and should not be dismissed, but they are not specific to tuning forks.

Gong Baths

The Modality

A gong bath is a sound healing session in which participants lie in a room while one or more large gongs are played. The gong produces an extraordinarily complex sound — rich in harmonics, subharmonics, and overtones that evolve continuously as the gong vibrates. At sufficient intensity, gongs also produce infrasound (frequencies below 20 Hz) that is felt in the body but not consciously heard.

The Evidence

The peer-reviewed evidence specific to gong baths is very limited. No large, controlled clinical trials of gong bath therapy have been published.

Observational studies. Informal studies and practitioner reports consistently describe significant relaxation responses during gong baths, including reports of deep relaxation, visual imagery, emotional release, altered time perception, and sleep-like states. These reports are consistent with the neurological effects that would be expected from sustained exposure to complex, low-frequency, high-intensity acoustic stimulation.

Related evidence. The evidence from the singing bowl literature (Goldsby et al.) included gongs as part of the mixed-instrument sessions studied, so the positive findings may partly reflect gong effects. However, the specific contribution of the gong cannot be isolated from the mixed-instrument protocol.

Mechanisms

Infrasound production. Large gongs produce significant energy in the infrasound range (below 20 Hz). As discussed in the sacred architecture article, infrasound affects the body and brain through non-auditory pathways — producing physiological responses (changes in heart rate, respiration, blood pressure), neurological effects (potential brainwave entrainment at very low frequencies), and psychological effects (feelings of awe, altered spatial perception, emotional intensity).

Harmonic complexity. The gong’s enormous harmonic complexity — dozens of simultaneously sounding frequencies, constantly evolving — provides a sound environment that is richly stimulating but non-patterned. This combination of complexity without predictable pattern produces the “soft fascination” associated with attentional rest and stress reduction.

Physical intensity. At the intensity levels typical of gong baths (which can be quite loud), the acoustic energy vibrates the entire body, producing whole-body somatosensory stimulation similar to that described for singing bowls but at higher intensity.

Sound-Assisted Relaxation for Pain Management

The Evidence

The evidence for sound-based interventions in pain management is stronger than for most other sound healing applications, partly because pain is one of the most extensively studied clinical outcomes and partly because the mechanisms linking sound to pain modulation are well characterized:

Gate control theory. Melzack and Wall’s gate control theory of pain proposes that non-painful sensory input can “close the gate” on pain signals traveling to the brain. Sound — particularly vibrotactile sound that stimulates the body as well as the ears — provides non-painful sensory input that may compete with and reduce pain signal transmission.

Autonomic nervous system regulation. Chronic pain is associated with sympathetic nervous system dominance (the “fight-or-flight” state). Sound-based interventions that promote parasympathetic activation (relaxation) can reduce sympathetic tone and thereby reduce pain perception, which is modulated by autonomic state.

Attention and distraction. Absorbing sound environments redirect attention from pain signals to acoustic stimuli. While this is sometimes dismissed as “mere distraction,” the attentional component of pain perception is substantial — pain that is not attended to is genuinely less painful at the neurological level (reduced activation of the pain matrix in the brain).

Systematic review evidence. Lee (2016) published a systematic review and meta-analysis of music interventions for pain management, including 97 trials involving 9,184 participants. The meta-analysis found that music interventions significantly reduced pain intensity, emotional distress related to pain, and analgesic consumption. The effect was moderate in magnitude and consistent across studies and clinical populations.

This evidence supports music and sound generally, not specific sound healing modalities. The evidence does not distinguish between recorded music, live music, singing bowls, gong baths, or other sound sources for pain management purposes.

Vibroacoustic Therapy

The Modality

Vibroacoustic therapy (VAT) uses specially designed furniture (beds, chairs, mats) that contain speakers or transducers, delivering low-frequency sound vibrations directly through the body. The participant lies on or sits in the device, receiving whole-body vibrotactile stimulation at specific frequencies (typically 20-120 Hz) while simultaneously hearing the corresponding tones through speakers or headphones.

The Evidence

Vibroacoustic therapy has a more substantial evidence base than most sound healing modalities:

Olav Skille’s original research. Skille, a Norwegian clinician and researcher who developed VAT in the 1980s, published numerous clinical observations documenting benefits for conditions including cerebral palsy, muscle spasticity, cystic fibrosis (mucus mobilization), chronic pain, and insomnia.

Pain management. Multiple controlled studies have found that VAT reduces pain in conditions including fibromyalgia, chronic low back pain, and post-operative pain. Naghdi et al. (2015) published a systematic review finding moderate evidence for VAT in pain management.

Parkinson’s disease. Research by Lee et al. at the University of Toronto found that VAT at 40 Hz (targeting gamma oscillations) improved motor symptoms in Parkinson’s patients, connecting vibroacoustic therapy to the gamma entrainment literature.

Anxiety and stress. VAT consistently produces relaxation responses, with measurable reductions in heart rate, blood pressure, cortisol, and self-reported anxiety.

Mechanisms

VAT works through direct mechanical stimulation of the body, engaging:

• Pacinian corpuscles and other mechanoreceptors in the skin, fascia, and periosteum
• The vagus nerve, which has mechanosensitive fibers in the thorax and abdomen that respond to low-frequency vibration
• Bone conduction of sound to the inner ear and to the cranial bones
• Muscle spindle activation, producing reflexive muscle relaxation
• Possible cellular mechanotransduction effects at the tissue level

The Honest Assessment

Here is what the clinical evidence says, honestly and without inflation or deflation:

Strong Evidence

• Music and sound for pain management. Multiple systematic reviews and meta-analyses confirm moderate, consistent benefits. This is the strongest evidence base in the sound healing field.
• Relaxation response from sound-based interventions. Virtually all sound healing modalities produce measurable relaxation responses (reduced heart rate, blood pressure, cortisol, muscle tension, self-reported anxiety). This is well-established but not specific — any pleasant, immersive, low-demand experience produces similar relaxation.
• Vibroacoustic therapy for pain and spasticity. Moderate evidence from controlled trials.
• 40 Hz entrainment for Alzheimer’s pathology. Strong preclinical evidence (animal models), promising human preliminary data. The strongest mechanistic case in the field.

Moderate Evidence

• Singing bowls for mood improvement and anxiety reduction. Consistent positive findings across multiple studies, but limited by lack of controlled designs. Likely real but magnitude of specific effect (beyond general relaxation) is unknown.
• Binaural beats for anxiety reduction. Supported by meta-analysis but with small to medium effect sizes.
• Drumming for psychological well-being. Multiple studies show benefits for mood, social connection, and stress reduction. Mechanisms well-characterized (theta entrainment, endorphin release from rhythmic activity, social bonding).

Weak or Absent Evidence

• Tuning fork therapy for specific conditions. Very limited controlled data. Plausible mechanisms (mechanotransduction, vibrotactile stimulation) but insufficient clinical evidence to support specific therapeutic claims.
• Gong baths for specific conditions. No controlled clinical trials. Anecdotal reports are positive but do not constitute evidence.
• Solfeggio frequencies for specific conditions. Minimal peer-reviewed evidence. The few existing studies are small, poorly controlled, and do not support the extraordinary claims made.
• Sound healing for “energy balancing,” “chakra alignment,” or “cellular repair.” No peer-reviewed evidence. These claims operate outside the framework of evidence-based medicine.

What We Can Conclude

Sound affects the body and brain through well-characterized mechanisms: auditory processing and entrainment, autonomic nervous system regulation, vibrotactile stimulation, attentional redirection, emotional processing, and social bonding. These mechanisms are real, measurable, and clinically relevant.

The specific claims of many sound healing practitioners — that particular frequencies heal particular organs, that sound can repair DNA, that singing bowls “balance energy” — go far beyond the evidence. The actual mechanisms are less mystical but more robust: sound produces relaxation, reduces pain perception, entrains beneficial brainwave patterns, and creates conditions conducive to emotional processing and psychological well-being.

This is not a small thing. A modality that reliably reduces anxiety, improves mood, decreases pain perception, and promotes relaxation — without drugs, without side effects, without expense — is clinically valuable even if the mechanisms are more mundane than practitioners claim. The tradition of using sound for healing is ancient, cross-cultural, and grounded in real biology. It deserves the respect of honest evidence, not the inflation of unsupported claims.

---

This article synthesizes Goldsby et al.’s singing bowl research (2017, 2022), Lee’s systematic review of music for pain management (2016), Naghdi et al.’s vibroacoustic therapy review (2015), Olav Skille’s VAT research, the Cochrane review on acupuncture (Vickers et al., 2018), Donald Ingber’s mechanotransduction research at Harvard, Robert Schleip’s fascial research at the Technical University of Munich, Rachel and Stephen Kaplan’s attention restoration theory, and the broader literature on sound-body interactions and clinical music therapy.