If you live with chronic pain may rely on painkilling medications like ibuprofen, aspirin or acetaminophen to help you make it through the day-to-day grind. However, if you rely too heavily on over-the-counter (OTC) pain medications, you may run the risk of developing long term and potentially deadly health risks. 

Studies say that taking ibuprofen, naproxen, and other non-steroidal anti-inflammatory medications long term can cause gastrointestinal problems,like ulcers and gastritis, and kidney disease.  Recent research says it can even cause kidney cancer. In fact, scientists say that people who take anti-inflammatory drugs like ibuprofen for more than a decade triple their risk of kidney cancer.

A study of over 125,000 participants found that those who regularly took anti-inflammatories were 51 percent more likely to develop the disease than those who took them less frequently. Those who took them for more than a decade, such as chronic pain sufferers with arthritis, were almost three times more likely to suffer renal cell cancer (RCC), the most common form of kidney cancer. Aspirin use was not associated with kidney disease.

Development of renal cancer is not common and data suggests that the first four years of taking non-aspirin NSAIDS is actually associated with a 19 percent reduction in kidney cancer.  In years four through ten, however, there was a 36 percent increase in renal cancer rates and after ten years, those rates tripled. 

Additionally, acetaminophen, a commonly used OTC treatment, can cause liver disease if taken at higher doses than the maximum amount recommended. That said, it does not appear to cause long term liver damage when taken at appropriate doses. One study, however, demonstrated that appropriate doses of acetaminophen can cause elevations of liver enzymes in the blood suggesting injury to the liver. In a study of 145 healthy subjects, patients were randomized to receive placebo or 4 grams of acetaminophen daily for two weeks. Subjects in the placebo group experienced no elevations of ALT, a liver enzyme, but 33 percent-44 percent of the subjects in the acetaminophen group had ALT elevations greater than three times the upper limits of normal. This elevation was found to be reversible, however, when acetaminophen use was reduced or stopped altogether.

How Can You Avoid the Risks

Doctors advise that risks for renal cancer are still very low (even when NSAIDS are taken long term) and most patients don't develop liver disease. Patients should talk to their doctors about the benefits of taking painkillers to reduce pain and increase quality of life versus the health risks of taking them long term. The general rule is to take the lowest dose possible for the shortest period of time.  If medication is needed long term, have your pain management supervised by your physician. 


Archives of Internal Medicine

Prospective Evaluation of Analgesic Use and Risk of Renal Cell Cancer
Arch Intern Med, Sep 2011; 171: 1487 - 1493.

Eunyoung Cho; Gary Curhan; Susan E. Hankinson; Philip Kantoff; Michael B. Atkins; Meir Stampfer; Toni K. Choueiri

Pharmacotherapy 2007: 27(9):1219-1230, Pharmacotherapy Publications, Inc.