Sleep is a great healer. Pain keeps you up, and being up makes pain worse—a cycle millions of people with chronic pain know well. Some researchers now think melatonin might help break it .

A new analysis of 23 clinical trials involving more than 2,000 patients found that melatonin—best known as a jet-lag and bedtime aid—reduced pain in people with chronic musculoskeletal conditions such as arthritis and low back pain.

The findings raise the question: Could this familiar sleep supplement have a supporting role in pain care?

What the Study Found

Researchers pooled results from studies of two groups: people with chronic pain lasting at least three months, and people recovering from musculoskeletal surgery such as joint replacement and spine surgeries.

The results showed melatonin eased pain in the chronic pain group in the highest-quality studies. It did not meaningfully help pain after surgery.

The researchers converted the results into a common 100-point scale for this meta-analysis. Across all chronic pain studies, melatonin lowered pain scores by about 9 points on average.

Nine points may not seem significant, but consider that a 2020 Cochrane review found that common first-line pain relievers such as ibuprofen reduced pain by about 7.7 points on the same scale.

Although this isn’t a direct comparison, it suggests melatonin may provide a similar degree of pain relief.

“We find that melatonin can relieve people’s pain intensity with the effect comparable to some conventional analgesic medications,” Kangchao Wu, a doctoral student at the University of Sydney’s Musculoskeletal Research Hub and the study’s lead author, told The Epoch Times.

Even so, melatonin’s pain point reduction falls below the threshold doctors generally consider clinically meaningful. The evidence is not yet strong enough to change clinical practice. Larger, high-quality human trials must follow.

Why Sleep and Pain Are Linked

Poor sleep and pain feed each other; each one makes the other worse.

The numbers in common musculoskeletal conditions show how common this overlap is: about 70 percent of people with osteoarthritis and up to 95 percent of people with fibromyalgia report sleep problems. Research shows that people who struggle to fall or stay asleep are more likely to develop chronic pain years later.

Here’s why: Pain triggers the body’s stress response, raising cortisol and keeping the brain alert, which cuts into deep, restorative sleep. Poor sleep then feeds the cycle; it increases inflammation and weakens the brain’s natural ability to suppress pain, making painful sensations feel more intense. Even just a few nights of restricted or interrupted sleep have been shown to increase pain sensitivity and reduce pain tolerance.

Melatonin may help break the cycle in several ways, according to Serena Poon, a certified nutritionist and longevity wellness advisor not involved in the study. Melatonin:

• Restores normal sleep patterns, stopping the pain-wake cycle

• Has antioxidant and anti-inflammatory effects, and inflammation is closely tied to chronic pain

• May directly calm an overactive nervous system, which in chronic pain conditions can amplify ordinary sensations into pain.

• May improve mood and reduce anxiety, which indirectly makes pain easier to manage.

Melatonin Needs Time to Take Effect

The clearest divide in the study was between chronic pain and post-surgical pain: Melatonin was not very helpful after surgery.

“Chronic musculoskeletal pain and acute postoperative pain are ... different experiences,” Poon said.

After surgery, the body immediately responds to tissue injury with acute inflammation and strong pain signals, she said. “That type of pain often requires fast-acting and relatively potent analgesic support, and melatonin’s effect may simply be too gradual or modest.” As a result, most postoperative studies gave melatonin only once or for only up to a week, which may not have been enough time for it to work.

Chronic musculoskeletal pain is different. Rather than fading as tissues heal, it is often sustained by ongoing inflammation, oxidative stress, poor sleep, and changes in the nervous system that make pain persist long after the original injury. “Melatonin may be better suited to this chronic environment because its potential benefits are regulatory rather than immediately anesthetic,” Poon said.

“We believe melatonin needs a longer period of administration to take effect,” Wu said. “Its anti-inflammatory properties may also need more time to work.”

Should You Try It?

Although melatonin appears promising for chronic musculoskeletal pain, it isn’t a one-size-fits-all solution. Before trying it for chronic pain, keep these points in mind:

• Talk to your doctor first if you’re pregnant or breastfeeding, elderly and at risk of falls, have epilepsy, or take other medications—melatonin can interact with some drugs.

• It’s not a fast fix. Unlike a painkiller, melatonin seems to work gradually, over weeks, not hours.

• More isn’t better. Researchers found no link between higher doses and stronger pain relief.

• Keep it short-term for now. Most of the studies used doses of about 2 to 3 mg per day for under three months. Long-term safety hasn’t been well studied.

Side effects across the studies were generally mild: nausea, dizziness, headache, and drowsiness.

The findings are encouraging but modest, Dr. Alberto Ramos, a professor of clinical neurology and research director of the sleep disorders program at the University of Miami Miller School of Medicine, told The Epoch Times. Improving sleep, he said, doesn’t fix the underlying joint or spine problem—melatonin should be one piece of a broader treatment plan, not a stand-in for medical care.

“For patients with chronic musculoskeletal pain who also have sleep disturbances, melatonin could be considered as an adjunct treatment,” Wu said. “If they don’t have pre-existing sleep problems, I'd recommend talking to their doctor first.”

The value here isn’t a new miracle drug, Poon said, but an accessible tool that can support both sleep and pain as part of a bigger plan that still includes good sleep hygiene, a healthy diet, regular movement, stress management, and physical therapy and medical care.