Efficacy and effectiveness of melatonin for the management of musculoskeletal pain: a systematic review and meta-analysis of placebo and active controlled trials

Abstract

Melatonin may provide benefits for managing musculoskeletal (MSK) pain, and this review evaluated its efficacy and effectiveness on pain intensity and sleep quality. We searched 6 databases from inception to April 2025 and included randomized controlled trials in people with chronic or postoperative MSK pain reporting pain or sleep outcomes. Comparators included placebo or active controls (eg, analgesics). Random-effects meta-analyses were performed using mean differences with 95% confidence intervals. Subgroup analyses were conducted by comparator type. Sensitivity analyses included only low-risk studies. Certainty of evidence was assessed using GRADE. Twenty-three studies (2028 participant..