About this trial
Low back pain is one of the conditions causing more disability worldwide. The use of pain medications is substantial in patients with chronic LBP. But the efficacy of commonly used analgesics is modest. More than half of patients with chronic LBP also has sleep problems. In recent years, some preliminary studies have shown a promising effect of melatonin for the treatment of pain.
The objective of this study is to investigate the efficacy of melatonin, relative to placebo, in patients with chronic LBP.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
age 18-65
understand and write Dutch
LBP for 3 months or longer
LBP must be present on 'most days' or 'every day' within the past 3 months
Disqualifiers
LBP resulting from a specific cause such as malignancy, fracture, lumbar radiculopathy and spinal stenosis
Radiating pain into the leg that goes further (down) than the knee
Inflammatory/autoimmune arthritis
Severe physical or psychiatric co-morbidities
Trial design
Parallel
Treatments tested in this trial
Melatonin 10 mg
Drug10 mg melatonin daily for a period of 6 weeks
Placebo
DrugDaily placebo for a period of 6 weeks
Treatment groups
Trial outcomes
Primary outcomes
Change in low back pain intensity
Change in low back pain intensity (average pain intensity past 7 days), measured on a 0-10 Numeric Rating Scale (NRS) where 0 means no pain and 10 means worst pain imaginable, from baseline to 6 weeks
Secondary outcomes
Back pain-related disability (RMDQ)
Back pain-related disability is measured using the Roland Morris Disability Questionnaire (RMDQ). The RMDQ outcome ranges from 0-24, where a higher score means more disability.
Global perceived effect score
Using Global perceived effect (GPE) questionnaire (7-point scale), where a score of 1 means highly satisfied/ great recovery and a score of 7 means highly dissatisfied / poor recovery.
Physical and mental health measured using the PROMIS Global Health
Physical and mental health measured using the PROMIS Global Health questionnaire. A 10 items questionnaire, items are scored from 1-5 where a score of 5 is the best outcome and a score of 1 is the worst outcome.
Health related quality of life measured using the EQ-5D-5L
Measured using the EQ-5D-5L (questionnaire). The EQ-5D-5L consists of the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS). The descriptive system comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state. The EQ VAS (0-100) records the patient's self-rated health on a vertical visual analogue scale where the endpoints are labelled 'The best health you can imagine' and 'The worst health you can imagine'.
Other outcomes
Activity patterns measured using a GENEActiv activity tracker
A GENEActiv activity tracker is worn for a period of 7 days during the 6-week treatment period by a subgroup of 60 participants. This device can measure activity and sleep. This measure is use as an explorative objective and only descriptive statistics of the data will be given. GENEActiv software is used to analyse the data.
Sleep reports measured using a GENEActiv activity tracker
A GENEActiv activity tracker is worn for a period of 7 days during the 6-week treatment period by a subgroup of 60 participants. This device can measure activity and sleep. A sleep report is created using the GENEActiv software. This measure is used as an explorative measure, only descriptive statistics are done.
Sponsors and contacts
Click on the lead sponsor to view all of their trials.
Bart Koes
Lead sponsor
Erasmus Medical Center
Sponsor institution