By Jonathan Kamerlink, M.D., Pain Medicine Specialist
Ibpuprofen and naproxen, both common nonsteroidal anti-inflammatory drugs (NSAIDs) work well for pain that comes from inflammation in irritated joints, disc flare-ups or muscle strains. So, when the pain might signal something more serious, patients often ask two questions:
“Can I just take an anti-inflammatory to get through this?”
“Will exercise help my back or make it worse?”
NSAIDs Have a Real Job. It’s Just Not a Daily One
Both questions come from a reasonable place, but neither one has a one-word answer. NSAIDs are not built to be a daily habit. A systematic review of the evidence found that NSAIDs are relatively safe when used at the most effective dose for 10 days or fewer. Beyond that window, the risk changes.
Regulatory agencies and medical societies have landed on the same guidance for years: use the lowest effective dose for the shortest time that controls the symptom, then stop.
The cautious guidance is real. Longer NSAID use raises the risk of stomach ulcers and GI bleeding, especially in older adults. It also strains the kidneys, particularly in patients who already have reduced kidney function, heart failure, or take certain blood pressure medications.
For patients with existing heart disease, even short-term use carries added cardiovascular risk, and there isn’t a fully safe window in that group. That’s exactly why I ask about heart, kidney, and stomach history before recommending one.
None of that takes NSAIDs off the table as a viable solution for pain. It just means they work best as a short-term tool for a specific flare, not a standing prescription for chronic pain.
Exercise Does More Than People Expect
The second question, whether movement helps alleviate pain, has a clearer answer. For most back and neck pain, it absolutely helps. The CDC recommends 150 minutes of moderate activity a week, which works out to about 20 to 30 minutes a day. A study following more than 2,300 adults found that people who met that movement target reported meaningfully less low back pain than people who didn’t. Clinical guidelines for treating low back pain list exercise as a first-line treatment, right alongside staying active and skipping bed rest.
I tell patients the same thing every time: walking counts. So does swimming, a bike ride or any other low impact activity that gets the body moving. The type of exercise is less important than making it a daily habit along with stretching.
The type of movement matters far less than doing some version of it daily. Pain that flares up after a long stretch of sitting usually responds better to a short walk than to another dose of ibuprofen.
Where the Two Meet
Used together, these aren’t competing strategies. An NSAID can get someone through the first few days of a bad flare, when movement of any kind feels impossible. Once the acute pain eases, daily movement is what keeps it from coming back, and it does that without touching the stomach, kidneys, or heart the way a daily pill would. That’s the sequence I recommend: treat the flare briefly, then move every day.