Melatonin shows promise as add-on treatment for chronic musculoskeletal pain
A University of Sydney review found melatonin reduced pain and improved sleep in trials, though researchers say patients should consult doctors before using it.
By Priya Raghavan · Science Reporter
3 min read
Melatonin may help reduce chronic musculoskeletal pain while also improving sleep, according to a University of Sydney study published in the journal PAIN. The finding matters because the researchers say it could give patients and doctors another low-cost option at a time of concern over long-term use of opioids and other pain medicines.
The study reviewed 23 randomized controlled trials involving 2,028 adults in countries including the United States, Russia, Brazil, Egypt and China, according to the University of Sydney. Participants included people with low back pain, osteoarthritis and fibromyalgia, as well as patients recovering from operations such as joint replacements and spinal procedures.
Across the studies, melatonin was associated with an average pain reduction of about 9 points on a 0-to-100 scale, the researchers reported. In the trials judged most rigorous, the reduction was closer to 10 points, a level the team described as broadly comparable with commonly used pain treatments such as opioids, nonsteroidal anti-inflammatory drugs and paracetamol.
Sleep and pain findings
Lead author Kangchao Wu, a Ph.D. student at the Charles Perkins Center’s Musculoskeletal Research Hub and the School of Health Sciences, said melatonin is already widely used, inexpensive and has an established safety profile. Wu said the study suggests it may help with chronic pain management and could reduce reliance on medicines with greater risks.
The review also found that melatonin improved sleep quality, according to the University of Sydney. Wu said pain is often linked with poor sleep, and that melatonin’s possible effect on both problems may make it useful for some people with chronic pain.
The researchers said doses and timing varied by condition and clinical setting. For chronic musculoskeletal pain, trial doses were generally between 3 milligrams and 10 milligrams, with 3 milligrams per day used most often. For postoperative pain, doses ranged from 1 milligram to 10 milligrams, most commonly 5 milligrams to 6 milligrams.
Participants usually took melatonin at bedtime or within an hour before sleep, the researchers reported. The review did not find a clear dose-response pattern, so the team said the current evidence does not support naming one best dose.
Safety and access
The University of Sydney said melatonin is generally well tolerated, with mild short-term side effects and no evidence of dependence. The most common side effects reported in the review were nausea, dizziness and headaches, while overall rates were similar to placebo and no serious adverse events were reported.
The researchers said melatonin is generally considered safe for short-term use of less than three months. In Australia, they said, it is often priced below A$1.50 per tablet but is not sold as a standard over-the-counter supplement.
Most melatonin products in Australia require a prescription, according to the University of Sydney. Low-dose melatonin of 2 milligrams or less can be supplied by a pharmacist without a prescription for short-term insomnia treatment in adults aged 55 and older.
Wu said the findings should not be read as advice to replace all pain medication with melatonin. The researchers said patients should speak with a doctor before using it, particularly if they take other medicines or have underlying health conditions, and described melatonin as a possible add-on within a broader pain management plan.
This story draws on original reporting from Medical Xpress.