A large-scale review of clinical trials published in this week’s Pain magazine 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 is a natural hormone produced by the pineal gland and is often used as an over-the-counter remedy for sleep issues. However, clinical guidelines typically do not recommend it as a frontline treatment for insomnia.

A systematic review conducted in 2013 found that melatonin effectively decreased sleep latency and enhanced total sleep duration compared to placebo in insomnia patients.

This supplement appears to have a strong safety profile, with existing reviews showing that high doses or prolonged use do not lead to drug dependence or severe adverse effects.

“Melatonin is already easily accessible, affordable, and recognized as safe,” stated Kanchao Wu, a medical student at the University of Sydney.

“Interestingly, melatonin may also assist in managing chronic pain, potentially reducing reliance on higher-risk medications.”

“We are applying an established medication to address a widespread issue affecting many individuals globally,” noted Professor Paulo Ferreira from the University of Sydney and Edith Cowan University.

In this study, data from 23 randomized controlled trials involving 2,028 participants were analyzed.

Participants included individuals with conditions such as lower back pain, osteoarthritis, fibromyalgia, and those recovering from surgeries like joint replacements and spinal operations.

Researchers found that melatonin decreased pain intensity by nearly 9 points on a 100-point scale in patients with chronic musculoskeletal pain, comparable to the efficacy of common nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.

Furthermore, researchers observed that melatonin significantly enhanced sleep quality in individuals with chronic musculoskeletal issues. This improvement may help explain some of the pain relief, given the established connection between sleep deprivation and heightened pain sensitivity.

The supplement was reported to be safe across the reviewed trials, with the most commonly documented side effects being mild, transitory symptoms such as nausea, dizziness, and headaches, comparable to placebo occurrences in some studies.

“Pain often coexists with sleep deprivation,” Wu highlighted.

“Melatonin seems to address both aspects, making it particularly beneficial for chronic pain sufferers.”

Doses of melatonin in trials varied based on conditions and environments.

For chronic musculoskeletal pain, the typical dosage ranged from 3 to 10 mg, with 3 mg being the most frequently used.

For postoperative pain management, dosages ranged from 1 to 10 mg, with 5 to 6 mg being the most common.

Melatonin was generally taken at bedtime or up to an hour prior to sleep.

The researchers found no evidence supporting a clear dose-response relationship, indicating that a single optimal dose cannot be identified based on the current evidence.

They advise that patients consult with healthcare providers before considering melatonin, particularly if taking other medications or managing underlying health conditions.

“Our recommendation is not to have melatonin replace all pain medications,” Wu said.

“Instead, after consulting a doctor, it can serve as an adjunctive treatment, especially for individuals struggling with sleep issues.”

“While the observed pain relief levels are similar to traditional treatments, it doesn’t imply melatonin should displace those options; rather, it may present a safer alternative in a comprehensive pain management strategy.”

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Kanchao Wu et al. Efficacy and Effectiveness of Melatonin in the Management of 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