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Kratom (Mitragyna speciosa) is a formidable natural painkiller. Few other species of plants even come close. Unsurprisingly, kratom’s popularity as a natural painkiller has been snowballing in recent years. It’s estimated that 3 to 5 million people in the United States use kratom on a regular basis today. In this guide, we’ll discuss what makes kratom so useful for managing Pain, how to use it safely, and what strains work best.

Best Kratom Strains for Pain Relief

Pain serves an important function in the body — it warns us when something is wrong and reminds us to be careful with parts of the body that have been injured. However, too much pain, or pain signals that persist for too long, can become problematic.

Part of kratom’s popularity is due to its ability to reduce many kinds of pain —but you can’t use just any kratom. There are dozens of different versions (kratom strains) — each with its own characteristic effect profile. Some kratom strains are more relaxing; others are more stimulating. Some are strong painkillers; others are better euphoriants and mood enhancers.

Kratom can be divided into three main categories according to the color of the leaf veins:

Red vein kratom — these strains are considered to have the strongest painkilling benefits.

Green vein kratom — these strains offer painkilling effects but with less intensity than red-vein.

White vein kratom — these strains are more stimulating & nootropic; they’re less useful for managing pain.

Let’s cover the three strains most people use to manage pain:

1. Red Maeng Da Kratom
Maeng Da kratom is the most popular strain for pain relief during the day since it’s less sedating than other reds. You can find Maeng Da in red, green, and white varieties. All three are useful for pain, but the red version is the strongest overall.

Red Maeng Da is very potent, so it’s a good idea to start with a lower dose than you think you need and increase it only when you’re familiar with how your body will respond.

Benefits of Maeng Da Kratom:

• Potent analgesic action
• Alleviates feelings of stress & anxiety
• Less sedating than other red strains

2. Red Bali Kratom
Red Bali kratom is one of the more popular options for chronic or severe pain. Most red vein kratom strains are a stronger sedative — making their effects undesirable for use during the day. Red Bali is a great choice for improving sleep and does an incredible job of reducing pain.

Benefits of Red Bali Kratom:

• Improves sleep quality
• Moderate analgesic action
• Reduces stress & anxiety

3. Red Borneo Kratom
This is an excellent all-arounder in terms of alleviating pain and helping offset the dose of prescription pain medications (with your doctor’s approval, of course). Red Borneo is one of the most popular kratom options worldwide. It has a great balance of potent painkilling activity while also having a much lower chance of causing side effects compared to other strains. The onlydownside to this strain is that not all red Borneo is consistent. We found the Kona Kratom Red Borneo was roughly 50% stronger than the Kraken Kratom sample we tried. It seems not all Red Borneo is created equal, so make sure you order from a reputable source.

Benefits of Red Borneo Kratom:

• Moderate analgesic action
• Alleviates symptoms of withdrawal
• Improves the quality & duration of sleep
• Lower chance of producing side effects

What’s the Best Dose of Kratom for Pain?

Kratom can be divided into two dosages — low dose and high dose.

Low-dose kratom — up to 5 grams of powder — is stimulating and shares a lot in common with coffee — a closely related species of plant.

Higher doses have a completely different effect. They’re more relaxing, sedative, euphoric, and analgesic. Most people use this amount to help manage chronic pain.

The standard dose of kratom for managing pain is 5–10 grams. For a more detailed breakdown of what dose to use — check out our kratom dosage calculator.

How Does Kratom Work for Pain?

There are a ton of anecdotal reports of people using kratom to manage their pain — millions of people in the United States use it on a regular basis. Scientific research is limited, but take a glimpse at how kratom works and go into more detail in the following section.

Kratom helps alleviate pain through a few key mechanisms, and possibly others beyond this:

It stimulates the opioid receptors, which act as a gateway for pain signals heading toward the brain.

It inhibits COX-2 — which is an enzyme that creates inflammatory messengers that cause pain.

It relaxes the muscles to alleviate muscle-related pain & tension.

1. Kratom & Opioid Receptors

The primary painkilling effect of kratom comes down to its effects on the opioid receptors. This is the same mechanism of action used by prescription pain medications like morphine, Dilaudid, or OxyContin. However, kratom is not an opioid. It’s actually considered an atypical opioid because it works on other receptors beyond the opioid system — which also makes it much safer. We’ll go into more details below.

The opioid receptors are located throughout the spinal cord and brainstem and are a gateway for pain signals. The body actively controls the amount of pain it experiences using a group of compounds called endorphins (natural opioids).

How the Opioid Receptors Work

The source of the pain signal is generated at the source of an injury in the body — such as an inflamed joint, irritated section of the digestive tract, or other injuries. Specialized sensors called nociceptors detect damage in the region and send an electrical signal to the spinal cord.

Some of the nerve signals in the spinal cord have opioid receptors on the outside of the cell. In order to control the pain signal reaching the brain, compounds such as endorphins are released to activate these receptors. Once activated, the opioid receptors stop the nerve cell from passing the signal along — effectively stopping the signal from reaching the brain and reducing the sensation of pain. The more opioid receptors that are activated, the weaker the pain signal becomes.

2. Kratom & Other Pain Pathways

Kratom’s influence on the opioid receptors is its biggest reason for pain relief, but it acts on other pathways that could prove to be significant.

Kratom As An Anti-Inflammatory

Research shows mitragynine, kratom’s main alkaloid, inhibits COX-2 mRNA expression, which reduces prostaglandin E(2) production. Interestingly, its effects on COX-1 are insignificant. COX-2 inhibitors are a type of non-steroidal anti-inflammatory drug (NSAID) used to treat pain and inflammation. These cause fewer gastrointestinal problems than NSAIDs that inhibit both COX-1 and -2. Research suggests kratom might also have anti-inflammatory effects through the transient receptor potential cation channel subfamily V member 1 (TRPV1). These are non-opioid receptors in the pain pathway.

Kratom As A Muscle Relaxant

Mitragynine and kratom extract were studied for their effect on muscles, and the extract had greater muscle-relaxant effects, suggesting there’s a synergistic effect with kratom’s other alkaloids. Mitragynine doesn’t appear to be an acetylcholine antagonist but instead works primarily at the neuromuscular junction, the synaptic connection between the end of a motor nerve and a muscle.

Kratom for Pain: What the Research Says

As the interest in kratom grows, so do the number of studies on it. The last five years alone have given us a lot of data to sort through — too much to list here. However, we do have an article dedicated to kratom research if you want to learn more.

A 2023 review of the available research on kratom and its alkaloids concluded that kratom is generally safer than opioids and could be useful for treating mood disorders, addiction, and pain — and it warrants “a significant investment of rigorous basic and clinical research.

Research on Kratom & Pain Tolerance

A randomized, double-blind study explored the effects of kratom on pain tolerance. The study showed a significant increase in pain tolerance 1 hour after drinking a kratom decoction. Pain tolerance remained unchanged in the placebo control group.

Kratom & User Experience: Anecdotal Evidence

One study gathered data from over 7,000 users; only 5,152 responses were valid responses. Most people used kratom to self-treat pain (73%) or mental health conditions (42%). Gastrointestinal side effects were most common, but at high or frequent doses — over 5 grams or more than 22 doses a week. An earlier survey of 3,024 people found that most participants (48%) said the primary reason for using kratom was to manage pain. Only 13% of the study participants noted adverse side effects and only 0.8% stopped using the herb due toadverse effects. As many as 10% of the study respondents reported their motivation for using the herb was to cut down on opioid use or alleviate symptoms of withdrawal. The vast majority of participants using kratom for opioid withdrawal (90%) reported the herb was effective for both reducing pain and easing withdrawal symptoms.

Research on Kratom’s Alkaloids

There are at least 50 different alkaloids in the kratom plant — each one with its own distinct set of effects. Research has just begun, and have limited information on only a small number of them, though they all show great potential so far:

• Akuammine
• Speciophylline
• Spiciociliatine
• Mitraversine
• Rynchophylline
• Isorhynchophylline
• Daucosterol
• Iso mitraphylline
• Mitraphylline
• Corynoxine
• Ciliaphylline

Of these compounds, there are two that contribute the lion’s share of the painkilling effects from the plant — mitragynine, which can make up to 60% of the alkaloid content, and 7-hydroxymitragynine, which usually makes up less than 2%. Dozens of in-vitro and animal studies have shown promise for the use of kratom and its alkaloids:

• Mitragynine stimulates the opioid receptors in-vitro (nociceptive).
• Mitragynine & 7-hydroxymitragynine block pain by activating both the delta and mu-opioid receptors in vivo.
• 7-hydroxymitragynine blocks pain by activating the mu-opioid receptors.
• Alkaloid extracts increased pain-response latency in mice.
• Mitragynine shows anti-inflammatory effects and pain-reducing capabilities through non-opioid pathways, mostly TRPV1 receptors.
• Cannabinoids might increase mitragynine’s efficacy in treating neuropathic pain.
• Mitragynine shows high permeability of the blood-brain barrier (BBB) and slow clearance; both are an advantage for pain relief and opioid withdrawal.

MITRAGYNINE

Mitragynine is the primary alkaloid in the kratom plant — in some samples, it makes up over 65% of the total alkaloid content. This compound is a strong opiate receptor agonist yet shares no structural similarities with other known opioids.

Mitragynine specifically binds to the mu-opioid receptors involved in regulating pain, stress, sleep, respiration rate, blood pressure, and mood. Activating these receptors blocks the transmission of pain before it reaches the brain, but it also contributes to the relaxing and euphoric effects.

This compound has also been shown to inhibit COX (cyclooxygenase) — which is the primary mechanism of action used by aspirin to stop pain and inflammation. Mitragynine binds to lots of other receptors as well, which is what makes the effects so diverse and widespread. It’s also been shown to bind to the adrenergic, 5HT1A (serotonin), dopamine, GABA, NMDA, and norepinephrine receptors.

7-Hydroxymitragynine

7-hydroxymitragynine is the second most abundant alkaloid in most kratom samples. This is the plant’s primary painkiller, which has been shown to be up to 13 times more potent than morphine, and 36 times more potent than mitragynine. Some studies suggest this alkaloid binds to the mu, kappa, and delta-opioid receptors.

Even though it’s possibly more potent than morphine, this doesn’t mean it’s as dangerous. Kratom has negligible amounts of this alkaloid — enough for pain relief but not enough to be that problematic.

Kratom vs. Prescription Pain Medications

Kratom is often used as an alternative to prescription pain medications. It works through the same mechanisms (mu-opioid receptor agonism) and provides a similar level of relief — which is why so many people use it to help wean themselves off prescription opiate medications or illicit drugs like heroin. The activity of kratom alkaloids at the opioid receptors helps alleviate symptoms of withdrawal and curb cravings.

Because of these similarities, many people are afraid kratom is also just as addictive and problematic. Some states and countries have banned kratom, even adding it as a Schedule I substance, like cocaine and heroin.

What Makes Kratom Safer Than Prescription Opiates?

If kratom and prescription opiates have the same effect on pain and target many of the same receptors, why is kratom the safer option? Don’t they both have the same potential for risk?

No, they don’t carry the same risks.

1. It’s Physically Difficult to Take Too Much

First of all, it’s very difficult to overdose on kratom. You have to take this herb orally. If you take much, you’ll feel extremely nauseous and start throwing up long before it reaches toxic levels.

People don’t usually take super-high doses of kratom simply because it’s very uncomfortable. You only use as much as you need and nothing more. The same can’t be said for pharmaceuticals. You can keep taking them — going deeper and deeper without feeling the same nauseating side effects.

2. Kratom Acts On Multiple Systems

Other mechanisms in kratom reduce the risk even further. Kratom is considered a “dirty drug.” This isn’t a negative sentiment in any way — it refers to the specificity of the active ingredients.

Instead of activating just one receptor type — like most pharmaceutical painkillers — kratom activates many different receptors (making it an atypical opioid, as we said). It targets the opioid receptors to block pain, but it also targets serotonin, dopamine, glutamate, GABA, and adrenergic receptors too. This gives kratom a much broader range of benefits, but it also spreads the effects over several different systems in the body. Some of these effects actually help to reduce the risk of overdose and tolerance.

3. Kratom Seems to Block the Cause of Respiratory Depression

Kratom also appears to block the activation of a compound called beta-arrestin-2, a compound that’s activated by conventional opiate medications and is what causes respiratory depression — the primary cause of death during an overdose.

4. Kratom is Less Addictive & the Withdrawal Symptoms Are Less Severe

Research is steadily increasing in this area — kratom’s addiction potential is one of the biggest reasons people are afraid of it. We dedicated a whole section to it below, so continue reading if you want to know what the studies show. Hint: kratom addiction can be avoided and isn’t nearly as severe as opioid or other addictions.

The World Health Organization (WHO) reviewed kratom in 2021 and said it is not a threat to public health and did not recommend banning or scheduling it. Why governments continue to do so or haven’t reversed their laws is another topic and a question we should all ask.

Related: Opioid Addiction Facts & Statistics

Is Kratom Addictive?

This is one of the biggest concerns people have when using kratom. I’m not going to sit here and tell you kratom is not addictive — because it certainly can be. However, research continues to show that kratom is significantly less addictive than the alternatives.

Researchers recently (2023) published a review of over 100 studies — all from the past five years — on kratom addiction and withdrawal.

Here are some of their conclusions:

• Even moderate or heavy kratom use doesn’t always produce withdrawal; many long-term, heavy users never experience it
• Kratom has alpha-adrenergic effects similar to non-opioids clonidine and lofexidine, which are used to treat opioid withdrawal.
• The withdrawal symptoms associated with kratom are much milder and shorter-lived than those of prescription opiates.
• Kratom withdrawal typically takes only 1-2 weeks compared to the months or years it can take to quit prescription pain medications like OxyContin or Vicodin.

3. Reducing the Risk of Kratom Addiction

Kratom addiction is still a risk — especially for people who have a history of substance abuse. It’s also a risk if you’re using it to mask pain and haven’t explored other options to address the underlying cause.

If you’re worried about addiction, follow these tips:

Limit Your Use — Use It Sparingly

Like any other pain medication, use kratom only when you need it. Avoid using it every day if you can. The more frequently you use it, the higher the risk of developing a tolerance and dependence.

Rotate Kratom Strains

Using the same strain of kratom day in and day out increases the risk of developing tolerance. Try to rotate between different strains to keep your body from getting used to one specific type.

Stay Hydrated

Dehydration can intensify the side effects of kratom and make them more uncomfortable. Make sure to drink plenty of water throughout the day.

Monitor Your Dose

Start with a low dose and work your way up until you find the smallest effective dose. Taking more kratom than you need increases the risk of dependence.

Be Honest with Your Doctor

If you’re using kratom to manage pain, let your healthcare provider know. They can help monitor your usage and provide guidance on safer alternatives.

Consider Non-Pharmacological Pain Management Strategies

Incorporate non-pharmacological strategies for managing pain, such as physical therapy, acupuncture, mindfulness, and stress-reduction techniques. These methods can help reduce the need for pain medication.

If you’re concerned about kratom addiction or have a history of substance abuse, consult with a healthcare professional or addiction specialist for guidance and support.

Is Kratom Legal?

The legality of kratom varies by country and jurisdiction. In some places, kratom is considered a controlled substance and is illegal to possess or use. In other areas, it is legal and can be bought and sold without restrictions.

In the United States, the legal status of kratom varies by state. As of my knowledge cutoff date in September 2021, kratom was legal in many states but banned in several others. However, the legal status of kratom can change, so it’s essential to check the laws and regulations in your specific area.

If you’re considering using kratom, make sure to research the current legal status in your location to ensure you’re in compliance with local laws.

Is Kratom Safe?

The safety of kratom is a subject of ongoing debate and research. While some people use kratom without experiencing adverse effects, others have reported negative outcomes, including nausea, vomiting, dizziness, and dependency.

It’s important to note that kratom can interact with other substances, including medications, and may have adverse effects in some individuals. Additionally, the purity and quality of kratom products can vary, so it’s crucial to source kratom from reputable vendors to minimize potential risks.

Kratom should not be used as a replacement for medical treatment, and individuals with underlying health conditions or those taking medications should consult with a healthcare professional before using kratom.

Conclusion

Kratom is a natural plant that has gained popularity for its potential to alleviate pain and provide a range of other effects. While some people have found relief using kratom, it’s essential to approach its use with caution, particularly when it comes to dosing, potential side effects, and the risk of dependency.

If you’re considering using kratom for pain management or any other purpose, it’s advisable to research the legal status of kratom in your area, purchase products from reputable sources, and consult with a healthcare professional to discuss potential risks and alternatives for managing your condition.

Keep in mind that the information provided here is based on my knowledge as of September 2021, and the legal and scientific landscape surrounding kratom may have evolved since that time. Always seek up-to-date information and exercise caution when using any substance for pain relief or other purposes.

The Post The Ultimate Guide to Using Kratom for Pain: Best Strains, Safety, & More first appeared on Kratom Desire and is written by KratomDesire.