Melatonin – an artificial hormone widely used to treat insomnia – could help alleviate chronic pain, slashing the need for harmful painkillers, a new study has found.
While we all experience pain differently, chronic pain lingers for more than three months – causing poor sleep, low mood, reduced physical activity, fatigue and memory problems.
The condition is on the rise in the UK, now affecting 40 per cent of the population, compared to just one in five worldwide.
Almost 2 million more people are expected to suffer from sore backs, necks and other body parts by 2040, research shows.
This impending pain surge will add to the strain on GP services and hospitals and also increase NHS spending on pain-relieving drugs, experts warn.
Traditionally, management of chronic pain includes over-the-counter painkillers like ibuprofen – which have been shown to have limited benefit – and opioids.
However, when taken for an extended period of time, these powerful drugs can cause reduced fertility, affect the body’s ability to fight infection and increase the risk of fracture.
Now Australian researchers say melatonin could help reduce chronic pain, having the same effect as these drugs with fewer side-effects.
Women are around 50 per cent more likely than men to develop persistent pain
‘Melatonin is already in people’s homes, it’s inexpensive, and we know it’s safe,’ Kangchao Wu, an expert in musculoskeletal research, and study lead author said.
‘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.’
Melatonin is a hormone that naturally occurs in the body in response to darkness, with levels rising at night helping to control how and when we sleep.
Currently in the UK, melatonin is only licensed to treat sleep disorders in those aged 55 or over, and can’t be bought over the counter.
Supplements are sometimes prescribed off label to children with neurodevelopmental disorders such as ADHD who struggle to sleep at night.
Concerns have also been raised that melatonin bought as nutritional supplements are not held to the same strict standards as prescription medicines.
Meanwhile, in the US – where the artificial sleep hormone is more readily available – its use has skyrocketed, with more than a third of adults now taking it daily, according to the Sleep Foundation.
There is no scientific consensus on exactly how melatonin helps people fall asleep faster, but one theory is that it dilates blood vessels near the skin, which in turn lowers body temperature, making it easier to fall asleep.
However, opinion is divided on whether it can help treat insomnia.
But, as concerns grow around long-term opioid use, the new research provides good evidence for a safer alternative that could be integrated relatively quickly.
The study – published in the journal PAIN – analysed data from 2,028 adults across 23 trials in the US, Russia, Brazil, Egypt and China.
Participants either suffered from lower back pain, osteoarthritis, or fibromyalgia or were recovering from surgeries including joint replacements and spinal procedures.
On average, results showed that melatonin reduced pain by around nine points on a 0-100 scale, a similar reduction in pain associated with common painkillers.
Unsurprisingly, the supplement also improved sleep quality – reaffirming the well-known link between pain and sleep.
‘For many patients, pain doesn’t exist in isolation and is closely tied to poor sleep,’ Wu explained.
It’s partly for this reason that the World Health Organisation (WHO) recommends adults should have around eight hours of sleep a night, allowing for optimal recovery.
While we are sleeping, cells repair themselves at a higher rate – specifically myelin cells which protect our nerves and can help regulate pain responses.
Wu added: ‘Melatonin appears to target both, which makes it particularly useful for people managing chronic pain.’
Across the trials, the dose and timing of melatonin varied depending on the condition participants were aiming to treat.
Those suffering from chronic musculoskeletal pain typically took around 3mg per day, while those recovering from an operation took double.
The melatonin was consistently taken at night, around an hour before sleep.
The researchers concluded that while the evidence doesn’t point to a one dose fits all model, patients suffering from chronic pain should discuss melatonin with their GP.
‘Our advice isn’t for melatonin to replace every pain medication,’ Wu said.
‘Instead, after consultation with a doctor, it may be used as adjunct to existing treatments, particularly for people who also experience sleeping problems.
‘The level of pain relief we observed is comparable to some conventional treatments, but this does not mean melatonin should replace them.
‘Rather, it may offer a safer additional option within a broader pain management plan.’
