Nonsteroidal anti-inflammatory pain medications, commonly referred to as NSAIDs, are some of the most commonly prescribed pain medications. These medications are available over-the-counter or as a prescription. NSAIDs are effective to relieve pain (analgesic), reduce swelling (anti-inflammatory) and to reduce a fever (anti-pyretic). 1,2

NSAIDs are available as tablets, capsules, suppositories, creams, gels and injections. 2

Some examples of NSAIDs: 2

  • Ibuprofen
  • Naproxen
  • Diclofenac

To understand NSAIDs you first need to understand pain and inflammation.

Pain is a complex mechanism and is the result of an electrical signal being sent from your nerves to your brain. But the process is not only electrical. When you get injured say with a sprain the damaged tissue releases chemicals called prostaglandins, which are like hormones. These prostaglandins cause the tissue to swell. 3

Prostaglandins are natural chemicals, and certain (or specific) types of prostaglandins increase the sensitivity of your nerve endings, basically they increase the pain you feel. They also serve as messengers that promote inflammation. 4,5 By inhibiting the body’s production of prostaglandins, NSAIDs decrease inflammation and the symptoms and signs of inflammation, such as pain, tenderness, and fever. 4

COX-1 (cyclo-oxygenase-1) and COX-2 (cyclo-oxygenase-2) are two enzymes that play a key role in making prostaglandins. By blocking the COX-enzymes, NSAIDs stop your body from making as many prostaglandins. This means less swelling and less pain. 3

Prostaglandins also play a role in controlling your body temperature. By blocking the production of the prostaglandins, NSAIDs will also help to bring down your fewer. 5

NSAIDs can be helpful in reducing many types of discomfort, including: 5

  • Headache
  • Backache
  • Muscle aches
  • Inflammation and stiffness caused by arthritis and other
  • Menstrual aches and pains
  • Pain after a minor surgery
  • Sprains or other injuries

NSAIDs are intended for occasional and short-term use. Your risk of side effects increases the longer you use them. 5

Possible side effects of NSAIDs may include: 2

  • Indigestion e.g. stomach aches and diarrhoea
  • Stomach ulcers
  • Headaches
  • Drowsiness
  • Dizziness
  • Allergic reactions

Some NSAIDs are also available in a topical gel (e.g. benzydamine, ibuprofen and diclofenac). Your healthcare professional may recommend this rather than the oral form if:6

  • Your stomach is sensitive to NSAIDs. Using topical NSAIDs may help you avoid a tummy ache. But if you have a history of ulcers or gastrointestinal bleeding, the medicine in the drug travels through your blood and can still put you at risk
  • You have arthritis in smaller joints. Topical NSAIDs penetrate the skin and help reduce pain locally. They work best on joints that are closer to the surface, such as the hands, knees, elbows and ankles
  • You are older than 65.A lot of elderly patients can’t take oral NSAIDs because they have stomach or heart-related risk factors, and they can’t take narcotic analgesics because they could become so drowsy, they could fall and break a bone
  • You have heart-related risk factors. The gel’s active ingredients still make it into your bloodstream and can still affect your cardiovascular system. However, the amount absorbed is much less, reducing your heart-related risk compared with oral NSAIDs

Some NSAIDs can react unpredictably with other medicines. This can affect how well either medicine works or increase the risk of side effects. Tell your doctor or pharmacist if you are taking any other medication. 2

Speak to your healthcare provider or pharmacist to determine which treatment option is most suitable for you.

DISCLAIMER: This editorial has been commissioned and brought to you by iNova Pharmaceuticals. Content in this editorial is for general information only and is not intended to provide medical or other professional advice. For more information on your medical condition and treatment options, speak to your healthcare professional.

Name and business address of the holder of the certificate of registration: iNova Pharmaceuticals (Pty) Ltd,. Co. Reg. No. 1952/001640/07, 15e Riley Road, Bedfordview. Tel. No. 011 087 0000. www.inovapharma.co.za. For further information, speak to your healthcare professional. Further information is available on request from iNova Pharmaceuticals.


  1. Nonsteroidal Anti-Inflammatory Pain Medications (NSAIDs). [online] 17 July 2022 [cited November 2022]; Available from URL: https://www.verywellhealth.com/nonsteroidal-anti-inflammatory-pain-medications-nsaids-2548736?print
  2. NSAIDs. [online] 7 October 2022 [cited November 2022]; Available from URL: https://www.nhs.uk/conditions/nsaids/
  3. Pain Relief: How NSAIDs Work. [online] [cited November 2022]; Available from URL: https://www.webmd.com/arthritis/features/pain-relief-how-nsaids-work?print=true
  4. Medical Definition of NSAID. [online] 29 March 2021 [cited November 2022]; Available from URL: https://www.medicinenet.com/script/main/art.asp?articlekey=4592
  5. Guide to OTC Anti-Inflammatories. [online] 10 March 2020 [cited November 2022]; Available from URL: https://www.healthline.com/health/pain-relief/otc-anti-inflammatories#takeaway
  6. Arthritis Foundation. Topical NSAIDs Offer Rub-on Relief. [online] [cited November 2022]; Available from URL: https://www.arthritis.org/living-with-arthritis/treatments/medication/drug-types/nsaids/voltaren-gel-relief.php

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