Hydrocodone is a prescription painkiller from the opiate family. It works by attaching to opiate receptors in the brain, resulting in a decrease in pain perception. Hydrocodone is prescribed to relieve mild to moderate pain associated with conditions including arthritis, back pain and physical injury. There are a number of herbal alternatives to hydrocodone. Some produce painkilling effects closely comparable to the drug.
Kratom (Mitragyna speciosa) is hydrocodone's closest herbal relative. It has been used in Asian countries for centuries for its ability to decrease pain and fatigue, allowing workers to continue in spite of discomfort. In small doses, it produces stimulating effects. Larger doses can lead to sedation.
While not an opiate itself, kratom is a mu-opioid agonist that affects the same brain receptors as opiates such as hydrocodone. Effects include increased pain tolerance, improved mood and feelings of intoxication.
Like hydrocodone, kratom has the potential to cause addiction and withdrawal. According to Erowid, peasant workers in Asia frequently become addicted to the herb and suffer withdrawal upon cessation. Kratom is illegal in Thailand and many other nations but is not currently scheduled in the U.S. Those who choose to use kratom should do so with extreme caution and only under a doctor's supervision.
Willow bark is among the most popular and effective anti-inflammatory herbs. It contains salicylin, the same active compound as aspirin (salicylic acid). According to the National Institutes of Health, willow bark is superior to placebo in relieving the pain of osteoarthritis and is well tolerated by most patients. It may also be useful for treating other types of inflammatory pain, such as that associated with minor injury, toothache, menstrual cramps and burns or cuts.
Like aspirin, willow bark may increase the risk for stomach bleeding, especially when taken with NSAID pain relievers such as ibuprofen or naproxen.
Known more for its hot and spicy flavor than its painkilling ability, cayenne pepper is sometimes used to treat joint pain in patients with certain types of arthritis. It contains capsaicin, which acts as a counterirritant when applied to the skin and distracts the brain from underlying pain.
When taken internally, cayenne causes a burning sensation in the mouth, which triggers the release of endorphins in the brain. Endorphins are naturally occurring chemicals that produce effects similar to those of hydrocodone and other opiates, including improved mood and increased pain tolerance.
Sometimes referred to as “nature’s Valium,” valerian root is a wildly popular herbal supplement in the U.S. It's native to Europe but grows freely in many parts of the world and has been used traditionally to treat everything from nervousness to epilepsy.
The active compound in valerian root is valerenic acid, which affects the same neurotransmitters as benzodiazepines like diazepam (Valium). In addition to its calming effects, valerian root is a mild muscle relaxant and may reduce spasms that cause certain types of pain. According to Medline Plus, valerian root can be used to treat the pain of menstrual cramps, angina, nerve pain and rheumatic pain, though evidence for its effectiveness is inconclusive.