Chronic pain is startlingly common—according to a 2023 study from the National Institutes of Health (NIH), 21% of American adults live with it—and yet, it remains notoriously difficult to treat. So it’s particularly welcome news that scientists have found that some who struggle with chronic pain may find relief with melatonin, a popular, safe, and affordable supplement marketed as a sleep aid.
The study, published in Pain, was a systematic review and meta-analysis of 23 randomized controlled trials, which enrolled a total of over 2,000 participants with either chronic or post-surgical musculoskeletal pain. Researchers compared participants given a daily melatonin supplement (which ranged from 3 to 10 milligrams per day) to participants who either took a placebo or participated in active pain treatments, and measured pain and sleep outcomes. Ultimately, they found moderate evidence that melatonin provided participants with chronic pain with significant pain relief and other benefits, including improved sleep quality. (Those with post-operative pain, on the other hand, did not seem to benefit.)
Experts believe that melatonin may work because of a connection between chronic pain, inflammation, and sleep quality. Below, doctors explain why—and if melatonin supplementation may be worth exploring with your healthcare provider.
Meet the Experts: Jacob Teitelbaum M.D., a board-certified internist in integrative medicine who specializes in sleep, chronic pain, and fatigue; and Jay Luthar, M.D., triple board-certified physician, founder and medical director at Lutanen Health, and instructor at Harvard Medical School.
Why melatonin may help relieve chronic pain
“Research has clearly shown that getting good sleep is critical for pain relief,” says Jacob Teitelbaum M.D., a board-certified internist in integrative medicine who specializes in sleep, chronic pain, and fatigue.
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Sleep is important for daily functioning, but for those with chronic pain, it can also help manage inflammation. Conversely, not getting enough can worsen pain-causing inflammation.
“Pain and poor sleep feed each other,” adds Jay Luthar, M.D., triple board-certified physician, founder and medical director at Lutanen Health, and instructor at Harvard Medical School. “When you’re in pain, you sleep worse, and when you sleep worse, pain feels worse. Melatonin likely helps by breaking that cycle, plus it has modest anti-inflammatory effects on its own.”
So, should everyone with chronic pain try melatonin? Not necessarily. Everyone’s health circumstances are different, and even though melatonin is considered safe for most, it’s best to consult with your doctor before introducing any new medication or supplement.
“This is far from a green light to self-medicate with melatonin,” says Dr. Luthar. “When I work with patients who experience chronic pain and sleep issues, we take a more comprehensive look at advanced biomarkers, stress levels, lifestyle, and patient preferences to determine a treatment plan that works for the full picture, not just one symptom.”
The bottom line
Although more research is needed, both Dr. Teitelbaum and Dr. Luthar find it encouraging that the researchers found melatonin performed about as well as some prescription painkillers—suggesting the supplement may offer similar levels of relief, but with a much better short-term safety profile.
Of course, that’s not to say melatonin doesn’t come with potential side effects of its own, including grogginess, headache, and nausea. If you are interested in adding a melatonin supplement to your routine, ask your healthcare provider what dosage and frequency to start with. And if chronic pain is your primary concern, Dr. Luthar adds, be sure to discuss that with your doctor as well, as they may be able to pinpoint what’s causing the pain in the first place and if it would benefit from more targeted treatment.
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