Melatonin May Help Alleviate Chronic Musculoskeletal Pain, New Study Indicates

The analysis indicated that melatonin can lead to modest improvements in musculoskeletal pain. However, researchers advise that it should not replace conventional treatments.

Melatonin is a hormone produced by the pineal gland and is often taken as a supplement for sleep disorders, despite clinical guidelines not recommending it as a primary treatment for insomnia. A previous systematic review in 2013 found that melatonin effectively reduced sleep latency and increased total sleep duration compared to placebo in individuals with insomnia.

Research suggests melatonin has a favorable safety profile, as high doses or prolonged usage do not typically result in drug dependence or significant adverse events. According to Kangchao Wu, a Ph.D. student at the University of Sydney, "Melatonin is already in people’s homes, it’s inexpensive, and we know it’s safe. What’s exciting is that melatonin may also help manage chronic pain, reducing reliance on higher-risk medications."

Professor Paulo Ferreira, a researcher at the University of Sydney and Edith Cowan University, noted, "We’re taking a medication we already understand and applying it to a problem that affects a huge proportion of the global population."

The study analyzed data from 23 randomized controlled trials involving 2,028 participants, encompassing various conditions such as low back pain, osteoarthritis, fibromyalgia, and individuals recovering from surgeries like joint replacements and spinal procedures.

The findings revealed that melatonin decreased pain intensity in those with chronic musculoskeletal pain by nearly nine points on a 100-point scale, a reduction comparable to that seen with common nonsteroidal anti-inflammatory drugs like ibuprofen. Additionally, melatonin significantly enhanced sleep quality among participants, which may further contribute to pain relief given the established connection between poor sleep and increased pain sensitivity.

The trials generally reported that melatonin was safe, with mild and transient side effects such as nausea, dizziness, and headache occurring at rates similar to placebo. Wu mentioned, "For many patients, pain doesn’t exist in isolation and is closely tied to poor sleep. Melatonin appears to target both, making it particularly beneficial for individuals managing chronic pain."

Dosages of melatonin across the studies varied based on specific conditions, typically ranging from 3 to 10 mg for chronic musculoskeletal pain, with 3 mg being the most frequently used dose. For postoperative pain, doses were generally between 1 to 10 mg, with 5 to 6 mg being most common. Melatonin was usually administered at bedtime or up to one hour before sleep. Researchers did not identify a clear dose-response relationship, indicating that no single optimal dose can be established from existing evidence.

They emphasize that individuals considering melatonin should consult their healthcare provider, especially if they are on other medications or have pre-existing health conditions. Wu stated, "Our advice isn’t for melatonin to replace every pain medication. Instead, in consultation with a doctor, it may be used as an adjunct to existing treatments, particularly for those also experiencing sleep difficulties."

The observed pain relief is comparable to some conventional treatments, but researchers stress that melatonin should not supplant these therapies. Instead, it could serve as a safer complementary option within a wider pain management strategy.