Melatonin, a hormone naturally produced by the body and widely used to treat insomnia, may also be effective in alleviating chronic pain, according to a new study. The research suggests that melatonin could offer a safer alternative to conventional painkillers, which carry risks with prolonged use.
Chronic pain, defined as pain lasting more than three months, affects a significant portion of the population, leading to issues such as poor sleep, low mood, reduced physical activity, and fatigue. In the UK, approximately 40% of the population experiences chronic pain, a figure that is projected to rise, placing additional strain on healthcare services and increasing reliance on pain-relieving drugs.
Traditional pain management often involves over-the-counter options like ibuprofen or prescription opioids. However, long-term use of these medications can lead to adverse effects including reduced fertility, compromised immune function, and an increased risk of fractures.
The study, published in the journal PAIN, analyzed data from 2,028 adults across 23 trials conducted in the US, Russia, Brazil, Egypt, and China. Participants suffered from conditions such as lower back pain, osteoarthritis, and fibromyalgia, or were recovering from surgeries including joint replacements and spinal procedures. The findings indicated that melatonin reduced pain by an average of nine points on a 0-100 scale, a level of relief comparable to that provided by common painkillers. The supplement also improved sleep quality, reinforcing the known connection between pain and sleep.
Kangchao Wu, an expert in musculoskeletal research and lead author of the study, highlighted that melatonin is already accessible, inexpensive, and considered safe. "What’s exciting is that melatonin may also help manage chronic pain, opening the door to reducing reliance on medications that come with more risks," Wu stated.
Melatonin's natural role in the body is to regulate sleep-wake cycles, with levels increasing in response to darkness. In the UK, its use is currently licensed only for sleep disorders in individuals aged 55 and over, and it cannot be purchased over the counter. While sometimes prescribed off-label for children with neurodevelopmental disorders experiencing sleep difficulties, concerns exist regarding the regulatory standards of melatonin sold as nutritional supplements compared to prescription medicines.
In contrast, melatonin is more readily available in the US, where its use has surged, with over a third of adults reportedly taking it daily. Theories on how melatonin aids sleep suggest it may lower body temperature by dilating blood vessels near the skin. However, its efficacy for treating insomnia remains a topic of ongoing discussion.
For individuals experiencing chronic pain, the research provides evidence for a potentially safer adjunct treatment. Wu noted that pain often coexists with poor sleep, and melatonin appears to address both aspects. During sleep, the body repairs cells, including myelin cells that protect nerves and may play a role in pain regulation.
Dosage and timing varied across the trials, with participants suffering from chronic musculoskeletal pain typically taking around 3mg daily, while those recovering from surgery took double that amount, usually an hour before bedtime. The researchers emphasized that melatonin should not necessarily replace existing pain medications but could serve as an additional, safer option within a comprehensive pain management plan, particularly for patients who also struggle with sleep issues. They advise that patients discuss the potential use of melatonin with their general practitioner.