Melatonin vs Chronic Pain?

We’ve previously wrote about about melatonin:

❝Melatonin is a hormone normally made in our pineal gland. It helps regulate our circadian rhythm, by making us sleepy.

It has other roles too—it has a part to play in regulating immune function, something that also waxes and wanes as a typical day goes by.

Additionally, since melatonin and cortisol are antagonistic to each other, a sudden increase in either will decrease the other. Our brain takes advantage of this, by giving us a cortisol spike in the morning to help us wake up.

As a supplement, it’s generally enjoyed with the intention of inducing healthy, natural, restorative sleep.❞

Read in full: Melatonin: A Safe, Natural Sleep Aid? ← our research review article that does cover the pros and cons, and yes, there are indeed downsides too, including some contraindications e.g. melatonin helps regulate immune function, so that’s something to bear in mind if you’re on immunosuppressants or otherwise have an autoimmune disorder. It can also interfere with blood pressure medications and blood thinners, and may make epilepsy meds less effective.

We’ve also written about how it can help with specific chronic diseases, such as: Melatonin vs Lupus!

…so, what’s this about melatonin vs chronic pain?

The sleep-pain relationship

This one came to our attention because of a rather eye-catching headline: Melatonin may ease chronic pain, study finds

Which is a fascinating headline to come from a study of 254 adults (mean average age 60.8 years; 87% women) with chronic musculoskeletal (MSK) pain, and whose results were as follows:

❝Sleep disturbances were reported by 73 % of participants, with insomnia most common. Forty percent had previously used melatonin, primarily for sleep, yet 57 % of users were uncertain about its analgesic effects. Willingness to use melatonin was expressed by 79 % of users and 83 % of non-users for pain management. General concerns included side effects, drug interactions, efficacy, and cost.❞

Yes, it was a survey-based study, and the main pain-related finding was “I don’t know”.

Further, if we break down the responses of those with chronic pain and using melatonin, more participants regarded it as “not effective at all” than regarded it as “moderately effective or very effective” (i.e. even if we stack those latter categories on top of each other, they still don’t add up to as many as the responses for “not effective at all”:

Source: Patients’ attitudes toward melatonin for musculoskeletal pain: Insights for rehabilitation practice

However, as anyone with chronic pain will know, chronic pain and poor sleep adversely affect each other (i.e. each being bad makes the other worse), and therefore it is reasonable to infer that the inverse is true—reducing pain can improve sleep, and improving sleep can reduce pain.

And, of course, if you literally just need a break… If you’re asleep, you’re not consciously* in pain and thus not suffering.

^{*Unconsciously, your nerves are still doing their thing and so your body still “knows” that you are in pain and responds accordingly. This is also the main reason that strong painkillers are given to a patient who is about to undergo surgery under general anaesthesia—they won’t be experiencing the pain, the body will still think it’s being eaten by a tiger or something and respond accordingly in terms of heart rate, inflammatory responses, etc.}

So while it’s fair to say “no, the study didn’t at all establish that melatonin can help vs chronic pain”, and nor was that even the question being examined in the study, it doesn’t mean that getting better sleep can’t help you manage chronic pain better, and so there may be an indirect help.

See also:

Want to learn more?

We’ve written quite a bit about pain management, including:

• Before You Reach For That Tylenol…
• How To Stop Pain Spreading
• How To Dial Down Your Pain
• Managing Chronic Pain (Realistically!)
• Get The Right Help For Your Pain
• The 7 Approaches To Pain Management
• Science-Based Alternative Pain Relief (When Painkillers Aren’t Helping, These Things Might)

Take care!