NSAIDs — how to use them safely for pain and inflammation
NSAIDs (nonsteroidal anti-inflammatory drugs) are the go-to for sore muscles, headaches, menstrual cramps, and joint pain. They reduce pain and swelling by blocking enzymes that make inflammatory chemicals. Common names you’ll see at the pharmacy are ibuprofen, naproxen, aspirin and diclofenac. They work fast, but they’re not risk-free. Use them smartly and you’ll get relief without surprises.
When to pick an NSAID — and when not to
Pick NSAIDs when inflammation is part of the problem — for example a sprain, tendon pain, or arthritis flare. If you only need a fever reducer or basic pain relief without inflammation, acetaminophen (paracetamol) is often a safer first choice. Avoid NSAIDs if you have active stomach ulcers, recent GI bleeding, severe kidney disease, or certain heart conditions unless your doctor okays it. Also skip NSAIDs in the third trimester of pregnancy — they can affect the baby’s circulation.
Practical safety tips you can use today
Start with the lowest effective dose for the shortest time. For over-the-counter ibuprofen that usually means 200–400 mg every 4–6 hours as needed, not to exceed the label limit. Always follow the package or your prescriber's directions. Take NSAIDs with food or milk to lower stomach upset. Don’t combine two oral NSAIDs (for example, ibuprofen plus naproxen) — that just increases side effects without extra benefit.
Watch for warning signs: black or tarry stools, vomit that looks like coffee grounds, sudden severe belly pain, shortness of breath, chest pain, swelling in hands or ankles, or unusual bruising. Those need immediate medical attention. If you’re on blood thinners, have high blood pressure, heart disease, or take ACE inhibitors/ARBs or diuretics, talk to your doctor before using NSAIDs — these drugs can raise bleeding risk, blunt blood pressure medicines, and harm kidneys when combined with other meds.
Older adults are more sensitive to side effects. Many seniors do better with lower doses, topical NSAIDs (gels or creams) for localized joint pain, or switching to acetaminophen when appropriate. For long-term pain control, discuss risks and monitoring (kidney tests, blood pressure checks) with your clinician.
Topical NSAIDs give targeted relief with fewer systemic effects — useful for knees, wrists, or shoulders. They’re not right for deep muscle pain but are worth trying if you want to limit tablets. If pain doesn’t improve after a week or two, or if it gets worse, get checked. Persistent pain may need a different treatment plan: physical therapy, tapered prescription meds, injections, or other options.
Bottom line: NSAIDs are effective and convenient when used correctly. Know your health risks, follow dosing rules, avoid mixing similar drugs, and get medical advice if you have heart, kidney, or bleeding issues. Smart use keeps the benefit high and the problems low.
