As concerns grow over the side effects and dependency risks of common painkillers, scientists are looking to a familiar sleep aid for help.
A review by the University of Sydney found that melatonin successfully reduces chronic pain intensity and improves sleep for long-term conditions.
The link between melatonin, chronic pain, and sleep
Around 47% of people worldwide live with muscle, bone, and joint pain. Standard treatments such as opioids and everyday painkillers can stop working over time and carry heavy risks, including dependency and harsh side effects.
Sleep is also intertwined in the misery of chronic pain—they form a frustrating, two-way loop. Ongoing discomfort affects sleep, and tired bodies produce more inflammatory chemicals, which heighten pain sensitivity.
This cycle has led researchers to look at melatonin, the natural hormone that controls sleep, as well as a widely used over-the-counter supplement. It is cheap, safe, and already used to help people fall asleep faster.
“Melatonin is already in people’s homes, it’s inexpensive, and we know it’s safe,” said lead author Kangchao Wu, a PhD student at the University of Sydney. “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.”
Previous research on melatonin’s ability to alleviate pain has produced mixed results. Past reviews have used different types of pain together or failed to test melatonin directly against real painkillers.
To clear up the confusion, the new study gathered global data to measure how effective melatonin is at tackling pain and sleep.
How melatonin performs against chronic pain
The team analyzed data from 23 controlled clinical trials involving 2,028 adults from countries including the United States, Russia, Brazil, Egypt, and China. The studies tracked people taking oral pills or skin patches containing 1–10 mg of melatonin daily. Researchers compared melatonin against placebo pills, common anti-inflammatories, and strong surgical painkillers. They used 0-to-100 scales to track changes in pain levels and standard tracking questionnaires for sleep quality.
The data revealed a divide between long-term and short-term discomfort.
For chronic pain, melatonin delivered a clear, measurable benefit. Across all combined groups, pain scores dropped by an average of ~9 points, and when looking only at the highest-quality studies, melatonin outperformed placebo pills by over 10 points. This matched the relief provided by traditional anti-inflammatory drugs, while also delivering the bonus of better sleep.
However, the hormone was ineffective for acute surgical pain, showing no meaningful benefit. It also did nothing to improve sleep after surgery.
Taking higher doses did not lead to more relief, meaning no “optimal” dosage could be identified.
Melatonin did prove incredibly safe, with minor, temporary side effects such as mild nausea or headaches occurring at the same rate for placebo pills.
The future of melatonin in chronic pain management plans
The findings highlight melatonin as an accessible, affordable tool for tackling the twin problems of poor sleep and chronic pain.
“We’re taking a medication we already understand and applying it to a problem that affects a huge proportion of the global population,” said co-author Prof. Paulo Ferreira, the director of the Musculoskeletal Research Hub at the University of Sydney.
“For many patients, pain doesn’t exist in isolation and is closely tied to poor sleep. Melatonin appears to target both, which makes it particularly useful for people managing chronic pain,” added Wu.
The study highlighted clear limitations. Most reviewed trials were small, averaging 50–83 people, and there was no data tracking patients beyond three months. The team was also unable to identify whether melatonin is more effective for specific pain subtypes.
“The level of pain relief we observed is comparable to some conventional treatments, but this does not mean melatonin should replace them,” Wu emphasized. “Rather, it may offer a safer additional option within a broader pain management plan.”
Moving forward, larger, high-quality studies are needed to pinpoint exact dosing guidelines and track long-term safety.
“Our advice isn’t for melatonin to replace every pain medication,” Wu said. “Instead, after consultation with a doctor, it may be used as an adjunct to existing treatments, particularly for people who also experience sleep problems.”
Reference: Wu K, Ho TH, Beckenkamp PR, et al. Efficacy and effectiveness of melatonin for the management of musculoskeletal pain: a systematic review and meta-analysis of placebo and active controlled trials. Pain. 2026. doi: 10.1097/j.pain.0000000000004045
This article is a rework of a press release issued by the University of Sydney. Material has been edited for length and content.
