DEAR DR. ROACH: I am a woman in my 80s. Is it safe to take 400 mg of ibuprofen a day? I take it with breakfast. I never take more than this. — J.S.B.

ANSWER: Ibuprofen has the potential for many serious side effects, but most of them are unusual, especially at the low dose you are taking. Kidney damage, meningitis (which is not an infection but a direct toxic effect of ibuprofen on the lining of the brain), liver disease, bleeding, and severe allergies are all well-described complications of ibuprofen. But they range from uncommon to very rare.

The biggest concern I have with daily ibuprofen use in a woman in her 80s is damage to the stomach, including ulcers. Ulcers without risk factors are uncommon, and only about 0.2% of adults will get one per year. However, for women (who are at a higher risk than men) in their 80s (who are at a much higher risk than people below 60), the risk is closer to 1% per year.

Low-dose ibuprofen probably doubles this risk to perhaps 2% per year. Women who take full-dose anti-inflammatories (called NSAIDs) like ibuprofen at the dosage of 600-800 mg three times daily for a long period of time have a 10% to 30% prevalence of stomach ulcers. They also have a 2% to 4% risk per year of a serious complication that requires hospitalization.

These numbers may not sound very high at an individual level, but we see many older people who get admitted to the hospital due to complications from long-term use of anti-inflammatory drugs. For this reason, I try hard to find alternatives to long-term NSAID use.

You have a risk of developing symptomatic stomach damage from low-dose ibuprofen, but it is very small. You have to balance this small risk against the benefit of ibuprofen. Acetaminophen (Tylenol) that is taken occasionally and at a low dose is safer. Topical NSAIDs like diclofenac gel are safer still.

If you are getting good relief from ibuprofen and have had no troubles, it’s reasonable to continue, but you could consider trying one of these lower-risk alternatives.

DEAR DR. ROACH: I’m in considerable pain from sciatica. I wanted to know whether it’s a good idea to make myself walk around and try to walk off the pain, which is at a level 8 out of 10. It slightly lessens when I do. I don’t have any choice since I live alone. — P.L.

ANSWER: The best answer I have is that if your activities help reduce the pain, you should do them. I don’t recommend forcing yourself to stay in bed if you don’t need to, but I also don’t recommend pushing yourself into doing activities that are painful.

Most cases of sciatica, such as those caused by a herniated disc, start to get better in a week or so but may take several weeks to get completely better (or nearly so). Physical therapy is an effective treatment to reduce disability and improve pain.

People who aren’t getting better from sciatica need to get reevaluated and will likely need imaging, such as an MRI, to find out what is causing the pain. People with progressive weakness need immediate evaluation.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2025 North America Syndicate Inc. All Rights Reserved