Chronic pain affects roughly 1 in 5 American adults, according to a 2023 study from the National Institutes of Health, yet effective treatments remain scarce. Researchers have now found that melatonin, the popular over-the-counter sleep supplement, may offer some relief for people living with chronic pain.
The findings come from a systematic review and meta-analysis published in the journal Pain, which examined 23 randomized controlled trials involving more than 2,000 participants. Trials included people with chronic musculoskeletal pain as well as those recovering from surgery.
Participants took daily melatonin doses ranging from 3 to 10 milligrams. They were compared against groups that received a placebo or standard pain treatments, then measured for changes in pain levels and sleep quality.
The analysis found moderate evidence that melatonin provided significant pain relief for people with chronic pain. It also improved sleep quality. Those with post-operative pain, however, did not appear to benefit.
This is not the kind of finding that typically makes headlines. For the millions of people who cycle through prescription painkillers, physical therapy, and acupuncture with limited success, the idea that a cheap, widely available supplement might help is worth paying attention to. Melatonin’s safety profile, at least in the short term, is far better than most pharmaceutical alternatives.
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Doctors have long observed that poor sleep makes pain worse, and pain makes sleep worse. Melatonin appears to interrupt that loop.
“Research has clearly shown that getting good sleep is critical for pain relief,” said Jacob Teitelbaum, M.D., a board-certified internist in integrative medicine who specializes in sleep, chronic pain, and fatigue.
Sleep helps regulate inflammation, which is often a driver of chronic pain. When sleep is disrupted, inflammation can increase, making pain more intense.
“Pain and poor sleep feed each other,” said Jay Luthar, M.D., a triple board-certified physician 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.”
The supplement is best known as a sleep aid, but its anti-inflammatory properties may be doing some of the heavy lifting for pain patients. The exact mechanism is still being studied, but the dual action — improving sleep while reducing inflammation — gives melatonin an advantage over treatments that address only one side of the problem.
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Despite the promising results, doctors caution against treating melatonin as a cure-all.
“This is far from a green light to self-medicate with melatonin,” said Dr. Luthar. “When I work with patients who experience chronic pain and sleep issues, we take a broader 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.”
Melatonin is generally considered safe, but it does come with potential side effects. The most common include grogginess, headache, and nausea. The right dosage also varies from person to person.
Both doctors recommend speaking with a healthcare provider before starting melatonin, especially if chronic pain is the primary concern. A doctor may be able to identify the root cause of the pain and determine whether targeted treatment would be more effective.
The researchers noted that melatonin performed about as well as some prescription painkillers in the trials they reviewed. That suggests the supplement may offer comparable relief with a much better short-term safety profile. But more research is needed to understand long-term effects and optimal dosing for different types of pain. For now, the evidence points in a useful direction: a supplement millions already take for sleep may also help quiet the kind of persistent pain that standard medicine often struggles to treat.
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