NSAID alternatives: safer ways to manage pain and inflammation

NSAIDs work for a lot of people, but they also cause stomach upset, raise bleeding risk, and can affect kidneys and the heart. If you can’t take NSAIDs or want to limit them, there are practical options that often help just as well—depending on the kind of pain you have.

Quick non-drug choices that actually help

Start with simple, low-risk steps. Ice for the first 48–72 hours after an injury reduces swelling; heat helps chronic muscle tightness. Gentle movement and targeted exercise prescribed by a physical therapist can cut pain and prevent future flare-ups. Losing a few pounds eases pressure on knees and hips. TENS units, massage, and acupuncture can give noticeable relief for some people. These don’t carry the systemic risks of oral NSAIDs and are worth trying first for many aches.

Medicines and medical options beyond NSAIDs

For short-term pain, acetaminophen (paracetamol) can work for headaches and mild musculoskeletal pain. It won’t reduce inflammation but usually sits easier on the stomach—watch liver limits and avoid mixing with heavy alcohol use. For localized pain, topical treatments like lidocaine patches, capsaicin cream, or menthol gels can numb or reduce pain without much blood exposure. Topical diclofenac is an option too; it’s an NSAID but has much lower systemic absorption than pills.

If pain is chronic or nerve-related, other drug classes may be better choices. Duloxetine (an SNRI) often helps chronic musculoskeletal pain and fibromyalgia. Gabapentin or pregabalin target neuropathic pain. These drugs need medical supervision for dosing and side effects. Short courses of opioids can be appropriate for severe acute pain but come with addiction and side-effect risks—use only under close medical guidance.

For joint problems, steroid injections can deliver strong relief to a single joint. Hyaluronic acid injections or platelet-rich plasma (PRP) are other clinic-based choices for knee osteoarthritis; evidence varies by condition, so discuss realistic outcomes with your doctor. Surgical options exist when structural damage demands it.

Some people try dietary supplements: curcumin (turmeric), omega-3 fish oil, glucosamine/chondroitin. Evidence is mixed—some users feel better, others don’t. If you try supplements, buy from reputable brands and tell your clinician, especially if you take blood thinners.

Practical tips: match the approach to the pain type (inflammatory, mechanical, neuropathic). Don’t stop a prescribed NSAID or heart medication without talking to your doctor. If pain is severe, lasts more than a few weeks, or comes with fever, numbness, weakness, or unexplained weight loss—see a clinician quickly.

Want help choosing the best alternative for your situation? Talk to your pharmacist or primary care provider and, when appropriate, ask for a referral to physiotherapy or pain management. Small changes—targeted exercise, topical treatments, or the right clinic procedure—can cut pain without the risks of long-term oral NSAIDs.