A large-scale review of clinical trials published in this week’s issue of Pain indicates that melatonin, a widely used sleep supplement, may offer significant relief for individuals suffering from chronic musculoskeletal conditions, including lower back pain, osteoarthritis, and fibromyalgia.
Melatonin exhibits a modest effect on musculoskeletal pain, but researchers advise it should not replace standard medical treatments.
Melatonin is a natural hormone secreted by the pineal gland and is frequently taken as an over-the-counter supplement for sleep disorders. However, clinical guidelines typically do not endorse melatonin as a primary treatment for insomnia.
A systematic review published in 2013 demonstrated that melatonin significantly reduced sleep latency and increased total sleep duration compared to placebo among insomnia patients.
Studies have shown that melatonin possesses a favorable safety profile; high doses or prolonged use do not lead to drug dependence or severe adverse effects.
“Melatonin is accessible, inexpensive, and well-established as a safe treatment option,” stated University of Sydney student Kanchao Wu.
“Remarkably, melatonin may also assist in managing chronic pain, which could help reduce reliance on more harmful medications.”
“We’re leveraging a familiar medication to tackle a widespread issue affecting a significant portion of the global population,” commented Professor Paulo Ferreira, a researcher at the University of Sydney and Edith Cowan University.
This investigation analyzed data from 23 randomized controlled trials involving 2,028 participants.
Individuals studied included those with conditions like lower back pain, osteoarthritis, and fibromyalgia, as well as patients recovering from surgeries such as joint replacements and spinal procedures.
Research indicated that melatonin reduced pain intensity by nearly 9 points on a 100-point scale in patients with chronic musculoskeletal pain, a reduction comparable to popular nonsteroidal anti-inflammatory drugs such as ibuprofen.
Additionally, melatonin was found to significantly enhance sleep quality in individuals suffering from chronic musculoskeletal conditions. Considering the established connection between sleep deprivation and increased pain sensitivity, this effect may elucidate some of the observed pain relief.
The supplement displayed a consistent safety profile across all reviewed studies. Mild and transient side effects, including nausea, dizziness, and headache, were reported as frequently as with placebo in certain studies.
“For numerous patients, pain intertwines with sleep deprivation,” Wu explained.
“Melatonin seems to address both issues, making it particularly beneficial for individuals dealing with chronic pain.”
Across various trials, the dosage and timing of melatonin varied by condition and context.
For chronic musculoskeletal pain, dosages typically range from 3 to 10 mg, with 3 mg daily being the most common. For postoperative pain, doses range from 1 to 10 mg, with 5 to 6 mg being frequently used.
Melatonin is often consumed at bedtime or up to one hour before sleep.
The researchers did not find evidence supporting a clear dose-response relationship, indicating that a definitive ‘best’ dose cannot be recommended based on current data.
It is crucial for patients to consult with their healthcare provider before using melatonin, especially if they are on other medications or have underlying health issues.
“Our recommendation is that melatonin should not serve as a complete replacement for pain medications,” Wu stated.
“Instead, after consulting your doctor, it can complement existing treatments, particularly for those with sleep disorders.”
“While the levels of pain relief we observed are comparable to standard treatments, this doesn’t imply that melatonin should replace them.”
“Rather, it could provide an additional, safer option as part of a comprehensive pain management strategy.”
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Kanchao Wu et al. Efficacy and effectiveness of melatonin in managing musculoskeletal pain: a systematic review and meta-analysis of placebo and active-controlled trials. Pain, published online June 30, 2026. doi: 10.1097/j.pain.0000000000004045
Source: www.sci.news