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    When you’re in pain, it’s natural to want relief. Whether you’re suffering from arthritis, menstrual cramps, or a pulled muscle, over-the-counter (OTC) pain relievers can ease your aches and help you get on with your life. But like all medicines, OTC pain relievers can cause side effects and may not be safe for everyone.

    “Many people assume that because these drugs are sold over the counter that they are completely safe,” says Elliott Antman, MD, professor of medicine at Harvard Medical School and Brigham and Woman’s Hospital in Boston. “But they can also have consequences that are important to understand.”

    So before you reach for one of the many bottles on the drugstore shelf, read on to learn about one type of OTC pain relievers -- non-steroidal anti-inflammatory drugs (NSAIDs) -- and the benefits and risks of taking them.

    How Do NSAIDs Relieve Pain?

    NSAIDs are one of two major types of OTC pain relievers. The other is acetaminophen (Tylenol).

    A few different types of NSAIDs are available over the counter:

    • Aspirin (Bayer, Bufferin, Excedrin)
    • Ibuprofen (Advil, Motrin IB)
    • Naproxen (Aleve)

    Stronger doses of some of these drugs, as well as other NSAIDs, are also available by prescription.

    NSAIDs are used to reduce fever and relieve mild aches and pains.They can be used for everything from a mild toothache or headache to cramps. Many people also use NSAIDs to relieve the pain of arthritis or to treat the aches and pains of the common cold and flu.

    NSAIDs work by blocking enzymes in the body that help make chemicals that signal pain. When these enzymes are blocked, you feel less pain.

    Side Effects of NSAIDs

    Like any drug, NSAIDs can have side effects. The side effects can vary a bit from drug to drug, but most commonly include:

    • Stomach upset or nausea
    • Stomach pain
    • Heartburn
    • Diarrhea

    Less common but potentially serious side effects of NSAIDs include:

    • Stomach ulcer and bleeding
    • Increased blood pressure
    • Allergic reaction -- hives, facial swelling, asthma/wheezing

    Some people may be at higher risk for side effects or other problems with NSAIDs. Talk with your doctor before taking any NSAID if you:

    • Are over age 60
    • Are pregnant or nursing
    • Have three or more drinks of alcohol every day
    • Have bleeding problems
    • Have liver or kidney disease
    • Have heart disease
    • Take a medicine to thin the blood, such as warfarin (Coumadin)
    • Take a medicine for high blood pressure

    Children and teenagers who are recovering from a viral infection such as the flu or chickenpox should not take aspirin. It has been linked to Reye’s syndrome, a serious but rare condition that can result in brain, kidney, and liver damage. Naproxen sodium is not recommended for children under 2. Ibuprofen is considered safe for children 6 months and older in the right dose.

    Choosing an OTC Pain Reliever

    What you need to know to make a safe and effective choice.
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