Kratom for Pain Relief: How It Works, Why It’s So Popular, & Safety Concerns

Kratom might have what it takes to knock out your pain; just make sure you know how to use it.

By Dan Simms Last Updated: June 21, 2023
Last Updated: June 21, 2023
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One of the most common uses of kratom is pain relief, and the herb has gained massive popularity in the U.S. in the past few years as an alternative to opioids.

In this guide, we’ll discuss how well kratom relieves pain, its common side effects, why it works, and tips on using the herb safely.

How Does Kratom Relieve Pain?

Kratom is used by countless people in place of more addictive opioids, but many users don’t really understand how the substance works.

A few of kratom’s alkaloids — specifically 7-hydroxymitragynine — help reduce the perception of pain.

1. Kratom Binds to Opioid Receptors

Perhaps the most obvious way kratom affects our perception of pain is by binding to opioid receptors. Opioid receptors have a domain over the signals that travel through our central nervous system and get processed by our brains as pain.

Kratom is known to bind to three types of opioid receptors: alpha-opioid receptors, mu-opioid receptors, and delta-opioid receptors [1, 2].

These opioid receptors are located on nerve cells. When chemicals — like opioids or kratom’s alkaloids — bind to them, they restrict the signals that can travel through the nerve and also affect some neurotransmitters.

Changes in the nerve’s firing capacity and the inter-neuronal chemistry cause what we perceive as pain relief. In essence, the pain signals traveling through your body are interrupted by the alkaloids before your brain can process them as pain.

2. Kratom Creates a Surge of Dopamine

A bump in dopamine is just one of the chemical changes created when kratom’s alkaloids bind to those opioid receptors. Specifically, alkaloids binding to mu-opioid receptors produce greater volumes of dopamine in the brain’s ventral tegmental area (VTA) [3].

Dopamine is the primary neurotransmitter involved in our body’s pleasure-based reward system. When dopamine levels increase — whether that occurs because of something you do (like exercise) or a compound you consume (like kratom) — the brain processes a positive event. As a result, we feel good.

An increase in dopamine doesn’t directly affect pain signals, but it does have an impact on our perception of it.

3. Kratom Is An Agonist of GABA Receptors

Kratom’s alkaloids also have an agonistic effect on GABA receptors [4].

GABA is a neurotransmitter that’s linked to sedation of the central nervous system. It’s the primary neurotransmitter that is affected by benzodiazepines and depressants. When kratom’s alkaloids bind to GABA receptors, neurotransmitter levels increase and lead to a slowing of the CNS.

Ultimately, higher levels of GABA mean fewer signals travel through the CNS as a whole. Fewer signals, in general, mean fewer pain signals, so a bump in GABA can lead to some pain relief.

The GABA-ergic effects of kratom’s alkaloids lead to sedation and drowsiness, which can help users fall asleep when they otherwise might not be able to because of pain. GABA also relaxes muscles, so kratom can reduce muscle and joint-related pain [2].

Is Kratom An Opiate?

Kratom’s effect on brain chemistry and its interactions with opioid receptors usually get people wondering if kratom is actually an opioid.

Technically, kratom is an atypical opioid — it has opioid and non-opioid mechanisms and comes with fewer side effects [5].

Kratom is a stimulant, and opioids are all central nervous system depressants. Because kratom acts on more than just opioid receptors, it has a wider range of effects.

Even though kratom provides pain relief to most users, the extent of the relief is less significant than you’d expect from an opioid.

Finally, opioids have a high risk of addiction, misuse, and abuse. In contrast, kratom has a relatively low risk of addiction and dependency — partly because it’s less potent and partly because of how it works. Only around 6% of lifetime kratom users report severe withdrawal symptoms when quitting [6].

The active ingredients in kratom are a group of anout 67 alkaloids. Roughly 18 of these alkaloids make up the vast majority of the total alkaloid content and account for most of its effects.

Kratom’s Active Ingredients

Is Kratom Good for Pain Relief?

Kratom is a good option for mild to moderate pain relief and can be suitable for some users to treat and manage severe pain.

To put this into context, user reports indicate that kratom is significantly more powerful than ibuprofen or acetaminophen. Research shows one of kratom’s main alkaloids, 7-hydroxymitragynine, is more potent than morphine when it’s isolated [1]. As a whole, it’s not nearly as potent as opioids.

It’s hard to quantify how well kratom treats pain, but most users find comfort when dosing correctly. It’s certainly a better option than prescription painkillers.

Considering the dangers of prescription pain relievers, kratom can certainly be worth trying out; just talk to your doctor first.

Which Kratom Strains Are Best for Relieving Pain?

Virtually all strains of kratom contain the alkaloid 7-hydroxymitragynine, the primary constituent in the plant that provides relief from pain. However, strains that contain higher volumes of this compound are better suited for the job.

Green-vein strains have a moderate levels of this alkaloid too but this can vary significantly.

White vein kratom has the lowest concentrations of this alkaloid and tend to be the least popular option for pain management.

Green-vein strains have a moderate levels of this alkaloid too but this can vary significantly.

White vein kratom has the lowest concentrations of this alkaloid and tend to be the least popular option for pain management.

Here are some of the most popular strains for people looking to use kratom specifically for pain relief:

1. Red Maeng Da Kratom

Of all the strains used for treating pain, Red Maeng Da is the most popular and reportedly the most successful. Many users agree that its analgesic effects are superior to what you get from most other strains. Plus, the levels of mitragynine are high as well, making it a great strain for daytime pain relief since it doesn’t make you drowsy. However, higher doses meant for severe pain will still provide sedation.

2. Red Borneo Kratom

Unlike Red Maeng Da, Red Borneo is a popular nighttime strain for pain relief. It’s considered above-average for reducing pain, and it’s also one of the most sedative and anxiety-relieving strains. Many users take this to help reduce the perception of pain after a long day, especially if it would otherwise keep them awake.

3. Red Bali Kratom

Red Bali falls into a similar boat as Red Borneo — it’s highly sedative, making it a better option for nighttime relief. In larger doses, Red Bali is one of the few strains that can rival Red Maeng Da in terms of pain reduction. This is also a great option for bringing down stress and anxious feelings.

4. Green Maeng Da Kratom

Green Maeng Da is one of the most popular strains because it provides above-average levels of pain relief but offers the stimulation and increased focus you’d expect from a white-vein strain. Green Maeng Da is a great option for minimizing pain during school or work.

5. Green Malay Kratom

Green Malay is a go-to strain for users looking for significant energy boosts — akin to drinking a few cups of coffee — alongside relief from mild, moderate, and even severe pain. Green Malay mimics the potency of red strains in terms of pain relief and white strains in terms of stimulation for most users.

How Much Kratom Should You Take to Relieve Pain?

Kratom is a unique substance because it is heavily dose-dependent. Taking a small amount and a large amount of a single strain can yield wildly different effects. As such, it’s important to get your dosing right if you want to use the herb as a natural pain reliever.

In general, moderate to large doses are more appropriate for alleviating pain.

Use the below guidelines to get an idea of where your dose should fall:

  • 3 to 4 grams — For mild pain
  • 4 to 6 grams — For moderate to severe pain
  • 6 to 8 grams — For severe pain

The dose you take should be determined by the level of pain you’re experiencing, although it’s a good idea, as with any psychoactive substance, to “start low and go slow.”

We recommend taking just 3 g of kratom powder to see if that helps. Wait a day before redosing, and increase by 0.5 g or 1 g if the previous dose didn’t relieve your pain.

Try to avoid taking unnecessarily large doses, and don’t increase your dose if the effects become less intense over time. Long-term kratom use can cause you to build a tolerance, which increases the likelihood of addiction and dependency.

Kratom has some side effects, all of which become more prominent with larger and more frequent doses.

Is It Safe to Use Kratom for Pain Relief?

Whether or not kratom is safe — and to what extent — is still somewhat up for debate. The herb has been used to treat pain for hundreds of years in Southeast Asia, where kratom grows naturally. However, research on the plant has only recently begun as its popularity grows in countries like the United States.

There are some concerns with using kratom for prolonged periods, although very limited research — and anecdotal evidence — shows so far that it is generally safe to use when used responsibly [7]. To prevent addiction and other side effects, limit your consumption daily, weekly, and monthly.

Wrapping Up: Why Kratom Is Such a Popular Pain Reliever

Kratom is a popular solution for relieving pain because it’s widely available, currently legal in most areas, and mimics the pain-reducing effects of opioids. Additionally, it’s considered far safer than taking prescription painkillers, and it has a lower risk of addiction, according to most experts.

If you’re looking to use kratom for pain relief, it’s best to take a red or green strain that has a high concentration of the alkaloid 7-hydroxymitragynine. Some common recommendations include Red Maeng Da, Red Borneo, Red Bali, Green Maeng Da, and Green Malay kratom.


References

  1. Matsumoto, K., Horie, S., Ishikawa, H., Takayama, H., Aimi, N., Ponglux, D., & Watanabe, K. (2004). Antinociceptive effect of 7-hydroxymitragynine in mice: Discovery of an orally active opioid analgesic from the Thai medicinal herb Mitragyna speciosa. Life Sciences, 74(17), 2143–2155. https://doi.org/10.1016/j.lfs.2003.09.054
  2. Suhaimi, F. W., Yusoff, N. H. M., Hassan, R., Mansor, S. M., Navaratnam, V., Müller, C. P., & Hassan, Z. (2016). Neurobiology of Kratom and its main alkaloid mitragynine. Brain Research Bulletin, 126, 29–40. https://doi.org/10.1016/j.brainresbull.2016.03.015
  3. Kosten, T. R., & George, T. P. (2002). The neurobiology of opioid dependence: Implications for treatment. Science & Practice Perspectives, 1(1), 13–20. https://doi.org/10.1151/spp021113
  4. Ismail, I., Wahab, S., Sidi, H., Das, S., Lin, L. J., & Razali, R. (2018). Kratom and Future Treatment for the Opioid Addiction and Chronic Pain: Periculo Beneficium? Current Drug Targets, 20(2), 166–172. https://doi.org/10.2174/1389450118666170425154120
  5. Raffa, R. B., Pergolizzi, J. V., Taylor, R., Ossipov, M. H., & NEMA Research Group. (2018). Nature’s first “atypical opioids”: Kratom and mitragynines. Journal of Clinical Pharmacy and Therapeutics, 43(3), 437–441. https://doi.org/10.1111/jcpt.12676
  6. Eggleston, W., Stoppacher, R., Suen, K., Marraffa, J. M., & Nelson, L. S. (2019). Kratom Use and Toxicities in the United States. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 39(7), 775–777. https://doi.org/10.1002/phar.2280
  7. Swogger, M. T., Smith, K. E., Garcia-Romeu, A., Grundmann, O., Veltri, C. A., Henningfield, J. E., & Busch, L. Y. (2022). Understanding Kratom Use: A Guide for Healthcare Providers. Frontiers in Pharmacology, 13, 801855. https://doi.org/10.3389/fphar.2022.801855