If you have pain...

...and if you are under 60, have never had ulcers or gastrointestinal bleeding, and aren't taking a blood thinner or oral steroid...

...and if you are over 60, have ever had ulcers or gastrointestinal bleeding, or take a blood thinner or an oral steroid...

...and your heart risk is low and you don't need to take aspirin regularly...

...Consider a traditional NSAID such as ibuprofen or naproxen. These are available as prescription drugs or over the counter as brand name drugs (Advil, Aleve, Motrin, Nuprin) or as less-expensive store brands that contain the same drug and are just as effective. Acetaminophen (Tylenol or store brand) might also work.

...Consider a non-NSAID such as acetaminophen (Tylenol). Or, if necessary, you could take a traditional NSAID (such as ibuprofen or naproxen, prescription or over-the-counter), together with a proton pump inhibitor drug (Nexium, Prevacid or Prilosec) to protect your stomach.

...and if you have risk factors for heart disease (history of heart attack, stroke or chest pain, or smoking, high blood pressure, high cholesterol or family history of heart disease)

...Consider a non-NSAID such as acetaminophen (Tylenol) or try a traditional NSAID, such as ibuprofen or naproxen (prescription or over-the-counter). If you're taking aspirin to protect your heart, you may want to add a proton pump inhibitor drug (Nexium, Prevacid or Prilosec) because of the added gastrointestinal risk that comes from taking aspirin and another NSAID. If you're not on aspirin, ask your doctor if you should be.

... Ask your doctor if you should take acetaminophen or a low-dose non-NSAID painkiller. If an NSAID is necessary, you must combine with a proton pump inhibitor drug (Nexium, Prevacid or Prilosec) to protect your stomach. If you're not on aspirin, ask your doctor if you should be.