Best Kratom Strains for Pain Relief
I’d be lying if I said all kratom was the same.
There are dozens of different versions (kratom strains) — each with its own characteristic effect profile. Some kratom strains are more relaxing; others 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 generally 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, by far, the most popular strain choice among people using kratom for chronic pain. You can find maeng da in red, green, and white varieties. All three are useful for pain, but the red vein version is the strongest overall.
The red vein maeng da strain is very potent, so it’s a good idea to start with a lower dose than you think you need and increase the dose only when you’re familiar with how your body will respond.
Benefits of Maeng Da Kratom:
2. Red Bali Kratom
Red Bali kratom is one of the more energizing options within the red-vein category.
Most red vein kratom strains are a stronger sedative than a stimulant — making their effects undesirable for use during the day. The more stimulating nature of this strain makes it a great option to help manage pain during the day while you’re working or engaging in other ventures.
Benefits of Red Bali Kratom:
- Stimulating & energizing effects
- Moderate analgesic action
- May alleviate feelings of 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).
The Red Borneo kratom strain 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 only downside 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 than other red-vein kratom strains
What’s The Best Dose of Kratom For Pain?
Kratom can be divided into two dosages — low dose and high dose.
Low-dose kratom is stimulating and shares a lot in common with coffee — a closely related species of plant. This includes doses of up to 5 grams of dried powder.
Higher doses have a completely different effect. They’re more relaxing, sedative, euphoric, and analgesic. This is the dose most people use 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 — but only a small handful of clinical trials.
Let’s explore the data and explain how this works in greater detail.
Kratom helps alleviate pain through three key mechanisms:
- It stimulates the opioid receptors, which act as a gateway for pain signals heading towards the brain
- It inhibits COX-2 — which is an enzyme that creates inflammatory messengers that cause pain
- It relaxes the muscle fibers to alleviate muscle-related pain & tension
The primary painkilling effect of kratom comes down to its effects on the opiate receptors. This is the same mechanism of action used by conventional pain medications like morphine, Dilaudid, or OxyContin.
The opiate receptors are located throughout the spinal cord and brainstem. They act as a gateway for pain signals.
The body actively controls the amount of pain it experiences using a group of compounds called endorphins (natural opioids).
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.
Too much pain, or pain signals that persist for too long, can become problematic.
How The Opiate 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 opiate 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.
Related: 6 Easy Stretches for Pain Relief.
Kratom For Pain: What The Research Says
A randomized, double-blind study explored the effects of kratom for pain tolerance in 26 men . 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.
A survey conducted in 2017 asked 3024 kratom users about their experience with using the herb . The overwhelming majority of participants (48%) reported 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 to adverse 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.
There are also dozens of in-vitro and animal studies that have shown promise for the use of kratom and its alkaloids for treating many different types of pain:
- Mitragynine stimulates the opioid receptors in-vitro (nociceptive) 
- Mitragynine & 7-hydroxy-mitragynine 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 
Active Ingredients In Kratom For Pain
There are over 40 different alkaloids in the kratom plant — each one with its own distinct set of effects. Of these 40 compounds, there are two that contribute the lion’s share of the painkilling effects from the plant:
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-hydroxy-mitragynine 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 .
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.
Many people are even using kratom 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.
Key Differences: Kratom vs. Prescription Pain Meds
|Comparison Metrics||🍃 Kratom||💊 Prescription Opiates|
|Effects On Pain||Moderate to strong pain-relief||Strong pain-relief|
|Overdose Potential||Very unlikely to cause overdose||Moderate to high chances of overdose (depending on the substance)|
|Potential for Addiction||Mild to moderate||Moderate to high potential for addiction|
|Mechanism of action||• Mu, delta, & kappa-opioid receptor agonism |
• Dopaminergic & serotonergic effects
• NMDA agonist
• GABAergic effects
• Adrenergic receptor agonist
|• Mu-opioid receptor agonist|
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 considered a safer option? Shouldn’t they both have the same potential for risk?
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.
Nobody takes super-high doses of kratom. This is 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.
There are other mechanisms in kratom that reduce 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. 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.
For example, something in kratom appears to block the activation of a compound called beta-arrestin-2 . This compound is activated by conventional opiate medications and is what causes respiratory depression — the primary cause of death during an overdose.
Some theories suggest the lower potential for addiction with kratom comes from its ability to bind to the kappa-opioid receptors — which is a subtype of the opioid pain receptors. Most prescription medications are specific to the mu-opioid receptors only.
Activation of the kappa opioid receptors could explain the dysphoria and reduced potential for addiction from kratom compared to conventional mu-opioid agonists . The research here is still in the early stages, so we can’t be certain about this.
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, I will argue that kratom is significantly less addictive than the alternatives.
Virtually any substance (herbal and pharmaceutical alike) can be addictive. In its essence, addiction is a physiological and psychological attempt to find release from discomfort. The line between therapy and addiction is drawn when a substance begins to have a clear negative impact on your life — but you continue to use the substance anyway.
Painkillers have a very high affinity for causing addiction because they provide release from a visceral form of discomfort — chronic pain.
Kratom is a powerful painkiller, so it’s very easy to see how someone may become addicted to its effects. If you’re in constant pain and discomfort, your body is going to want to perform whatever action that manages to remove that pain and discomfort.
Despite the potential for addiction, many people turn to kratom to manage their pain because it’s significantly less addictive than prescription opiates like OxyContin, codeine, Demerol, Dilaudid, Percocet, and others. Nearly 10% of people prescribed opiate painkillers will become addicted.
These substances are dangerous too. Approximately 130 Americans die every day from an opioid overdose.
The high potential for addiction and death from an overdose on prescription medications is one of the primary reasons people turn to kratom instead. While the risk of addiction to this herb is genuine, it’s considered much safer overall. It’s much easier to avoid or escape the grips of addiction to this natural substance than pharmaceutical opiates.
Related: How to quit kratom.
Kratom Dependency & Tolerance Formation
The desire to use kratom to escape the pain and discomfort is considered a form of psychological (behavioral) addiction. This type of addiction is easy to escape because the only consequence of avoiding the herb is that your pain comes back.
Long-term use of kratom can lead to dependency, tolerance, and a more severe form of addiction (physical addiction).
It takes several months of consistent use to get to this point. You’ll find the dose you need to take to get the same level of benefit gradually becomes higher and higher. If you skip a dose, you may feel other side effects like muscle shakes, anxiety, low mood, and pain.
This tolerance and dependency can be reversed, but it involves gradually weaning off the substance until the body no longer needs it to maintain homeostasis (balance). This is called detoxing. The side effects you experience when a dose of kratom is skipped is called withdrawal.
What Are The Signs Of Kratom Addiction?
- You require a very high dose of kratom to feel the desired effects
- You feel physically ill when you’re not using kratom
- You constantly think about using kratom
- You’ve lost motivation for other responsibilities such as work, school, or housework
- You’ve become isolated from friends or family
How to Avoid Becoming Addicted to Kratom
There are no good or bad substances — there are just chemicals that exist. It’s our relationship with them that can be good or bad.
The best way to avoid becoming addicted to kratom is to maintain a healthy relationship with it.
This means understanding that the cause of your pain should be the primary area of focus. Don’t rely on the substance as a crutch to give you a means of escape from your discomfort. Take steps to identify what’s causing your pain and learn how to manage it by removing the source. This could involve physical steps like avoiding a certain sport or activity for a while to let the body recover, visiting a physiotherapist, or focusing on rehabilitation of a damaged muscle or joint.
It could also mean more metaphysical changes — like dialing in your habits and routines, finding sources of internal motivation, and working on your mindset. All of these things have a more significant impact on chronic pain than you might expect.
Kratom is a tool to help improve your quality of life and take the edge off while you work on these other aspects of your health in the meantime. No substance should be used in perpetuity for managing pain.
It also helps to avoid using kratom every day if you can. Even scheduling just one or two days per week where you don’t use any kratom at all can go a long way in avoiding the formation of dependence and addiction.
Side Effects of Kratom
Any substance — natural or synthetic — that has a strong impact on the body will inherently bring some risk of side effects. Nothing is side-effect-free. The key is to balance the risk to reward of using these substances and take steps to mitigate the potential side effects as much as possible.
Side effects of kratom include:
- Itchiness in the skin
- Lethargy & fatigue
- Loss of muscle coordination
- Low libido
- Nausea & vomiting
- Poor appetite
The trick is to find the dose that gives you the effects you’re looking for — and stop there. The chances of experiencing side effects increase exponentially the more you take. If 8 grams is sufficient for alleviating your pain, there’s no reason to take any more, and you’ll only open yourself up to side effects by doing so.
The most common side effect when using kratom for pain is a syndrome called kratom wobble. This involves a combination of dizziness, loss of muscle coordination, and nausea. It can be quite uncomfortable and is well worth trying to avoid.
Sedation, lethargy, headaches, and grogginess aren’t uncommon either.
Learn more about the potential side effects of kratom & what you can do to prevent them.
Will Kratom Mix With My Medications?
Many people who turn to kratom to help manage pain are already using other medications. If you’re taking other pain medications, you should always check with your doctor before using kratom. They can double-check that the kratom isn’t going to interact with your current medications.
The most concerning combinations are with other opiate drugs. Mixing kratom with drugs like fentanyl, codeine, OxyContin, Dilaudid, Percocet, or other opiate medications can increase the chances of overdose because they act on the same receptors in the body.
There are other interactions that can occur as well — primarily revolving around competition for liver metabolism with kratom and other drugs.
Everything we take into the body is eventually metabolized by the liver. A series of enzymes in the organ are tasked with disassembling or altering the chemical structure of molecules in our blood to help eliminate them from the body. These enzymes are referred to as the CYP450 isoenzymes.
If two or more compounds require the same enzymes for metabolism, it can slow the process down. If there’s too much competition, the active ingredients can begin to build up in the body. The effects may last longer than you expect or act too strongly on the body — leading to side effects.
Kratom is primarily metabolized by the CYP2C9, CYP2D6, CYP1A2, and CYP3A4 enzymes . Many other medications or substances require the same enzymes for metabolism and may therefore be affected by kratom.
Certain substances have a particularly strong interaction with kratom — such as antacids, grapefruit juice, dextromethorphan, and watercress. All of these substances will increase the effects of kratom, which can cause you to feel effects that are stronger than you might be expecting.
Care should also be taken with drugs with a narrow therapeutic index — such as warfarin. The difference between a dose that’s effective compared to doses that are potentially dangerous is very small. Even slight alterations in how this drug is metabolized by the body can lead to more serious problems.
The bottom line here is that you can mix kratom with other medications — but you should always speak with your doctor first to make sure it’s safe. They may choose to alter your dose of medicines or advise you to take kratom at least 2 hours apart from your other medications.
Final Thoughts: Using Kratom For Pain
Kratom has many health benefits — but nothing compares to its ability to stop the pain.
The active ingredients are a group of over 40 alkaloids — many of which target the same receptors leveraged by prescription pain medications like OcyContin or Dilaudid. This gives kratom a robust analgesic effect, comparable to even the strongest prescription pain pills on the market.
Other compounds in kratom reduce the chances of serious side effects and addiction — which are major problems with prescription pain management techniques today.
While kratom can still be addictive, just like any other painkiller, it’s been proven many times to be far less problematic than the alternatives. Many people even use kratom to help wean themselves off prescription or illicit opiates.
With that said, always consult your doctor before using kratom to manage your pain — especially if you have any underlying health issues or are using other medications of any kind.
- Veltri, C., & Grundmann, O. (2019). Current perspectives on the impact of Kratom use. Substance abuse and rehabilitation, 10, 23.
- Prozialeck, W. C., Jivan, J. K., & Andurkar, S. V. (2012). Pharmacology of kratom: an emerging botanical agent with stimulant, analgesic, and opioid-like effects. The Journal of the American Osteopathic Association, 112(12), 792-799.
- Narita, M., Funada, M., & Suzuki, T. (2001). Regulations of opioid dependence by opioid receptor types. Pharmacology & therapeutics, 89(1), 1-15.
- Warner, M. L., Kaufman, N. C., & Grundmann, O. (2016). The pharmacology and toxicology of kratom: from traditional herb to drug of abuse. International journal of legal medicine, 130(1), 127-138.
- Coe, M. A., Pillitteri, J. L., Sembower, M. A., Gerlach, K. K., & Henningfield, J. E. (2019). Kratom as a substitute for opioids: results from an online survey. Drug and alcohol dependence, 202, 24-32.
- Watanabe, K., Yano, S., Horie, S., & Yamamoto, L. T. (1997). Inhibitory effect of mitragynine, an alkaloid with analgesic effect from Thai medicinal plant Mitragyna speciosa, on electrically stimulated contraction of isolated guinea-pig ileum through the opioid receptor. Life sciences, 60(12), 933-942.
- Babu, K. M., McCurdy, C. R., & Boyer, E. W. (2008). Opioid receptors and legal highs: Salvia divinorum and Kratom. Clinical toxicology, 46(2), 146-152.
- Matsumoto, K., Mizowaki, M., Suchitra, T., Takayama, H., Sakai, S. I., Aimi, N., & Watanabe, H. (1996). Antinociceptive action of mitragynine in mice: evidence for the involvement of supraspinal opioid receptors. Life Sciences, 59(14), 1149-1155.
- Read Mongkol, W., Keawpradub, N., & Sawangjaroen, K. (2007). Effects of the extracts from Mitragyna speciosa Korth. leaves on analgesic and behavioral activities in experimental animals. Songklanakarin J. Sci. Technol, 29(Suppl 1), 39-48.
- Vicknasingam, B., Chooi, W. T., Rahim, A. A., Ramachandram, D., Singh, D., Ramanathan, S., … & Jaworski, M. C. (2020). Focus: Plant-based Medicine and Pharmacology: Kratom and Pain Tolerance: A Randomized, Placebo-Controlled, Double-Blind Study. The Yale Journal of Biology and Medicine, 93(2), 229.