Sleep supplements, widely used to treat insomnia, may help reduce dependence on the most common and potentially harmful painkillers, new research from the University of Sydney suggests.
Published in painThe study found that melatonin can reduce chronic musculoskeletal pain with a similar range of effectiveness as drugs such as opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and paracetamol.
Musculoskeletal pain affects up to 47% of people worldwide, and our findings point to a low-cost, widely available option that could change the way chronic pain is managed.
Melatonin for chronic pain
“We know that melatonin is already in people’s homes, it’s cheap, and it’s safe,” said first author and doctoral student Kanchao Wu of the Charles Perkins Center and Faculty of Health Sciences’ Musculoskeletal Research Hub.
“Interestingly, melatonin may also help manage chronic pain, potentially paving the way to reducing dependence on drugs that carry greater risks.”
This study highlights the growing potential for drug repurposing, where existing treatments are used in new ways to provide faster and more accessible health benefits.
We are taking medicine that we already understand and applying it to problems that affect large parts of the world’s population. ”
Professor Paulo Ferreira, Co-author and Director of the Musculoskeletal Research Hub
The study analyzed data from 2,028 adults across 23 randomized controlled trials conducted in countries including the United States, Russia, Brazil, Egypt and China. Participants included people with conditions such as lower back pain, osteoarthritis and fibromyalgia, as well as people recovering from surgeries such as joint replacements and spine surgeries.
The study found that, on average, melatonin reduced pain by about 9 points on a scale of 0 to 100, and the most rigorous tests showed a reduction of nearly 10 points, on par with widely used painkillers.
The supplement also improved sleep quality and strengthened the established relationship between pain and sleep.
“For many patients, pain does not exist in isolation, but is closely related to sleep deprivation,” Wu said.
“Melatonin appears to target both, making it particularly useful for people managing chronic pain.”
Across trials, melatonin dosage and timing varied depending on condition and environment. For chronic musculoskeletal pain, doses typically range from 3 to 10 mg, with 3 mg per day being most commonly used. For postoperative pain, doses range from 1 to 10 mg, with 5 to 6 mg being the most common. Melatonin was usually taken at bedtime or up to 1 hour before sleep.
The researchers found no evidence of a clear dose-response relationship. This means that a single ‘optimal’ dose cannot be recommended based on current evidence.
Melatonin safety, side effects and access in Australia
Melatonin is typically inexpensive in Australia at less than $1.50 per tablet, is generally well tolerated, has mild, short-term side effects, and has no evidence of dependence.
The most commonly reported side effects found in this study were nausea, dizziness, and headache. Overall rates were similar to placebo, and no serious adverse events were reported. Melatonin is generally considered safe for short-term use of less than 3 months.
Melatonin is not available as a standard over-the-counter supplement in Australia. Although most products require a prescription, low-dose melatonin (2 mg or less) is supplied by pharmacists without a prescription for the short-term treatment of insomnia in adults over 55 years of age.
Researchers stress that patients should discuss melatonin with their doctor before using it, especially if they are taking other medications or have underlying health conditions.
“Our advice is not that melatonin should replace any pain medication,” Wu said. “Alternatively, in consultation with your doctor, it can be used as an adjunct to existing treatments, especially for people with sleep disorders.”
As concerns grow over the long-term use of opioids and other pain medications, the findings highlight a safer alternative that can be incorporated into treatment relatively quickly.
The researchers say further large-scale studies will strengthen the evidence base, but stress that the current findings are strong enough to support careful study.
“Although the levels of pain relief we observed are comparable to conventional treatments, this does not mean melatonin should replace those treatments,” Wu said. “Rather, it may provide an additional, safer option within a broader pain management plan.”
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Reference magazines:
Wu, K. Others. (2026) Efficacy and efficacy of melatonin for the management of musculoskeletal pain: a systematic review and meta-analysis of placebo- and active-controlled trials. pain. DOI: 10.1097/j.pain.0000000000004045. https://journals.lww.com/pain/fulltext/9900/efficacy_and_Effectiveness_of_melatonin_for_the.1225.aspx
