As evening descends, our body’s pineal gland releases melatonin, a hormone that signals it’s time to sleep. In many countries, including Germany, melatonin is available as a dietary supplement or in higher doses as a prescription medication intended to aid sleep. However, emerging research is suggesting that melatonin may have an additional and surprising benefit: pain relief.
Reduced Pain, Improved Sleep
Studies indicate that melatonin may play a role in treating chronic pain. According to Kangchao Wu from the University of Sydney, Australia, a comprehensive evaluation of 23 randomized controlled trials—encompassing data from 2,028 individuals—revealed promising results. Participants included those suffering from chronic back pain, osteoarthritis, and fibromyalgia, as well as individuals recovering from surgeries involving joints or the spine.
The outcome was noteworthy: on a pain scale of 0 to 100, the intake of melatonin reduced pain levels by an average of nine points. This effect is comparable to that of widely used painkillers such as paracetamol, mild opioids, and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. Furthermore, participants frequently reported an improvement in sleep quality. “Many patients experience pain not in isolation but closely associated with poor sleep,” explains Wu. “Melatonin seems to influence both aspects, making it particularly beneficial for those living with chronic pain.”
Uncertainty Around Effective Dosage
Despite the positive outcomes, the optimal dosage of melatonin remains unclear. The studies varied significantly, with dosages ranging from one to ten milligrams, typically taken before bed. Researchers found little evidence of a dose-response relationship; lower dosages performed just as well, if not better, than higher ones. Therefore, Wu and his team cannot recommend a definitive “optimal dose” based on existing results.
Common side effects reported include nausea, dizziness, and headaches. The Federal Institute for Risk Assessment (BfR) warns that melatonin-containing supplements can lead to unwanted drops in blood pressure and body temperature, affect blood sugar levels, and disturb the sleep-wake cycle.
A Potential Complement to Existing Pain Medications
In comparison to conventional pain medications, melatonin is generally well-tolerated. Researchers believe it could potentially lessen the need for higher-risk pain relievers or those with dependency potential. “We do not recommend that melatonin should replace other pain medications,” Wu clarifies. “Rather, it may be used in conjunction with existing treatments, especially for individuals who also suffer from sleep issues.”
The research team advises against self-treatment. While melatonin is usually safe, it can have unexpected effects in individuals with pre-existing conditions or may interact with other medications. For instance, estrogen-based medications like birth control pills can slow the breakdown of melatonin in the body.
In conclusion, the emerging evidence surrounding melatonin’s potential to alleviate chronic pain is both intriguing and encouraging. While it is not a panacea, its ability to address both pain and sleep issues could make it a valuable adjunct therapy for many patients. Users should always consult healthcare professionals before starting any new treatment regime, especially when it involves combining multiple medications.
Source: Kangchao Wu (University of Sydney, Australia) et al., PAIN, doi: 10.1097/j.pain.0000000000004045
