Lifestyle

What Most People Don’t Know About the Pain Reliever They Take Every Day

By Mike Harper · August 29, 2026

It’s in every medicine cabinet in America. You take it for headaches, back pain, arthritis, and sore muscles. And if you’re over 50, it may be quietly damaging your kidneys, your stomach, and your heart.

Ninety percent of all NSAID prescriptions go to patients over the age of 65. Millions more buy ibuprofen, naproxen, and aspirin over the counter without a prescription. The drugs work. That’s not the question. The question is what happens when you take them regularly at an age when your body processes them differently.

Your kidneys are already working harder than they used to. NSAIDs block chemicals called prostaglandins that maintain blood flow to the kidneys. In younger adults, the kidneys compensate. In adults over 50, kidney function has already declined naturally, and blocking prostaglandins can push them further toward injury. A large study found that prescription NSAID use in adults over 65 resulted in 25 excess kidney-failure hospitalizations per 10,000 patient-years. The damage often develops gradually — decreased urination, swelling in the legs, unexplained fatigue — and may not be obvious until it’s advanced.

Daily use raises your risk of stomach bleeding — without warning. NSAIDs can cause bleeding in the stomach or digestive tract that comes on without warning signs, according to the FDA. The risk is higher in adults over 65, people with a history of ulcers, and anyone taking blood thinners. Taking ibuprofen with food reduces stomach irritation but doesn’t eliminate the bleeding risk. A GI bleed caused by chronic NSAID use can land you in the hospital before you know it’s happening.

They raise your blood pressure — and your cardiologist may not know you’re taking them. NSAIDs cause sodium retention, fluid buildup, and blood vessel constriction that can raise blood pressure significantly in people who are already managing hypertension. If you’re taking medication to lower your blood pressure and simultaneously taking ibuprofen for joint pain, the two drugs are working against each other. Many patients don’t mention OTC medications to their cardiologist because they don’t think of them as “real” drugs.

The heart attack and stroke risk increases with regular use. The FDA strengthened its warning in 2015: NSAIDs increase the risk of heart attack and stroke, even in people without prior heart disease. The risk rises with higher doses and longer duration. Naproxen appears to carry somewhat lower cardiovascular risk than ibuprofen or diclofenac — but no NSAID is risk-free with daily use.

There are alternatives your doctor may not have offered. Topical NSAIDs like diclofenac gel (Voltaren) deliver medication directly to the joint with significantly lower systemic risk. Acetaminophen (Tylenol) works differently and doesn’t carry the stomach, kidney, or cardiovascular risks of NSAIDs — though it has its own liver concerns at high doses. Physical therapy, acupuncture, and targeted exercise programs treat chronic pain without medication. The ibuprofen bottle is the path of least resistance. It’s not always the safest path.

The pill you take without thinking twice may be the one your body is paying for. If you’re over 50 and taking any NSAID more than twice a week, that’s a conversation worth having with your doctor — before your kidneys, your stomach, or your heart have it for you.