An expert has explained that 'over-the-counter' does not mean 'low-risk'Neil Shaw Assistant Editor (Money and Lifestyle)06:31, 05 Jun 2026A new warning has been issued for millions of people taking the painkiller ibuprofen for joint pain or arthritis. The painkiller is available for pennies without a prescription in shops across the country, as well as being one of the most prescribed drugs in the UK.‌Ibuprofen belongs to a group of medicines called non-steroidal anti-inflammatory drugs, or NSAIDs, which work by reducing inflammation, swelling and pain - temporarily improving comfort and movement.‌Anthony Paul Smith, Musculoskeletal Postgraduate Lecturer at the University of Essex, said: "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."‌Anthony said that while ibuprofen is eay to get, that does not make it safe, adding: "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'."He told The Conversation : "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."Anthony warned about taking multiple pills. He said: "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."‌He added: "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 ibuprofenAnthony said there are alternatives for managing pain, inflammation, and lack of movement - such as exercise. He said: "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.Article continues below"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."He added: "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."Anthony said: "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."