Ibuprofen for joint pain: what you really need to know

Millions of people in the UK suffer from joint pain and arthritis. But with long wait times for scans, specialist appointments, physiotherapy and joint replacement surgery, many people turn to over-the-counter medicines, such as ibuprofen, to manage their joint pain, stay active and continue working.

Ibuprofen is one of the most prescribed drugs in England and one of the UK’s most purchased over-the-counter medicines.

Although ibuprofen is cheap and effective in the short term, it is not risk free – especially when used frequently.

Ibuprofen belongs to a group of medicines called non-steroidal anti-inflammatory drugs, or NSAIDs. These medicines work by reducing inflammation, swelling and pain.

For joint pain flare-ups, this can improve comfort and movement temporarily. Research suggests NSAIDs can provide modest short-term pain relief for arthritis, particularly during painful episodes.

But while it can ease symptoms, it does not address the underlying joint changes associated with arthritis, such as cartilage deterioration, bone changes and joint inflammation.

Some people may also come to rely on ibuprofen without trying other approaches to pain management, such as exercise, weight loss and physiotherapy, which are important for long-term joint health.

Why long-term use can become a problem

Many people assume that because ibuprofen is available without a prescription, it must be relatively harmless. But “over-the-counter” does not always mean “low risk”.

One of the main hazards of long-term ibuprofen use is stomach irritation. Ibuprofen can damage the stomach lining and increase the risk of ulcers and internal bleeding. Some people develop indigestion or stomach pain, while others may not notice symptoms until serious bleeding occurs.

This risk becomes greater with higher doses (particularly 2400mg a day or more), prolonged use over weeks to months and if a person is over the age of 65.

Ibuprofen can also harm the kidneys. The kidneys rely on healthy blood flow to work properly, and NSAIDs can reduce this blood supply. They do this by blocking the body’s natural chemicals that help keep blood vessels in the kidneys open, particularly during illness and periods of dehydration or reduced circulation.

This can injure the kidneys or worsen their function, particularly in people who are dehydrated, or those with chronic kidney disease or heart disease.

There are cardiovascular concerns, too. Long-term NSAID use has been associated with raised blood pressure, fluid retention and increased risk of heart complications in some patients.

Asthma is another important consideration. Some people with asthma are sensitive to NSAIDs and may experience wheezing or breathing difficulties after taking ibuprofen. This is thought to happen because NSAIDs alter natural chemicals in the body that help keep the airways open.

Older adults with joint pain are also more likely to be taking multiple prescribed medicines. Taking ibuprofen alongside blood pressure tablets, blood thinners, antidepressants or certain diabetes medications can increase the risk of complications or reduce how effectively other medicines work.

This is particularly important because osteoarthritis becomes more common with age. So the people most likely to use ibuprofen regularly are often those most vulnerable to its side-effects.

This doesn’t mean ibuprofen should never be used. For many people, short-term use at the lowest effective dose can be helpful. But regular, long-term use without consulting a doctor is where concerns begin to increase.

Alternatives to ibuprofen

Ibuprofen isn’t the only option for managing joint pain and stiffness.

Exercise, for instance, has strong research backing as a treatment for osteoarthritis.

This may sound counterintuitive to someone already in pain, but strengthening the muscles around painful joints can reduce pressure, improve movement and decrease symptoms over time. Walking, cycling, swimming and strengthening exercises – such as resistance exercise – can all help.

Weight management is also important, particularly for knee and hip pain. This is because reducing body weight can lessen stress and inflammation on joints.

Physiotherapy is also effective at helping people improve strength, mobility and confidence while learning how to manage flare-ups safely. Many GP practices across the UK now provide access to NHS First Contact Physiotherapists. These specialist physiotherapists can assess joint pain without patients needing to see a GP first.

They can help identify when pain may require further investigation, advise on exercise and self-management strategies, and support people in making informed decisions about medication use.

Other strategies that may help you manage joint pain include pacing your activities (breaking tasks into smaller periods with breaks), heat therapy (which can help relax muscles and reduce stiffness) and supportive footwear. Anti-inflammatory gels that are applied to the skin can also help reduce symptoms with fewer whole-body side-effects than tablets.

For some people, ibuprofen may still play an important role alongside these measures. But pain management is rarely about finding a single quick fix. Instead, it’s usually about balancing symptom relief with long-term health and function.

With NHS waiting lists continuing to experience pressure, more people are likely to depend on medicines such as ibuprofen to remain active and independent. But understanding both the benefits and harms of treatment choices is essential.

Ibuprofen can still be useful for managing joint pain. But it’s important it’s used safely, appropriately and alongside better long-term approaches for managing joint health.

Anthony Paul Smith does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.