For most body aches, over-the-counter anti-inflammatory drugs like ibuprofen and naproxen are the most effective starting point, especially when inflammation or muscle strain is involved. Acetaminophen is another solid option, particularly if you can’t take anti-inflammatories. The best choice depends on what’s causing your aches, how long they last, and what other health conditions you have.
Anti-Inflammatory Painkillers (NSAIDs)
Ibuprofen and naproxen are both non-steroidal anti-inflammatory drugs, meaning they reduce both pain and the underlying inflammation that often causes body aches. This makes them particularly effective for muscle soreness, pulled or strained muscles, joint stiffness, and the widespread achiness that comes with colds and flu. If your body aches involve any swelling or tissue inflammation, NSAIDs will typically outperform acetaminophen.
The main practical difference between ibuprofen and naproxen is how long each dose lasts. Ibuprofen is short-acting, taken every six to eight hours. Naproxen provides longer relief, so you only need it twice a day. If your aches are keeping you up at night, naproxen before bed can carry you through more of the night than ibuprofen will. For quick daytime relief that you want more control over, ibuprofen’s shorter window lets you adjust your dosing more precisely.
NSAIDs do come with real risks for certain people. They can raise the chance of stomach bleeding, and they increase the risk of heart attack, heart failure, and stroke with prolonged use. People with kidney disease (particularly those with reduced kidney function), liver disease, heart disease, or high blood pressure should avoid NSAIDs. If you take blood pressure medications, including ACE inhibitors or diuretics, NSAIDs can interfere with them.
Acetaminophen
Acetaminophen is a pain reliever and fever reducer, but it is not an anti-inflammatory. It won’t bring down swelling the way ibuprofen or naproxen will. That said, it works well for general achiness, headaches, cold and flu discomfort, and mild to moderate pain where inflammation isn’t the primary driver.
Its biggest advantage is that it’s gentler on the stomach and safe for many people who can’t tolerate NSAIDs. The critical safety limit is 4,000 milligrams per day from all sources combined. That “all sources” part matters, because acetaminophen is an ingredient in dozens of cold medicines, sleep aids, and combination products. Taking a cold remedy and a separate acetaminophen tablet at the same time can push you over the limit without you realizing it. Exceeding that threshold risks severe liver damage. People with liver disease should be especially cautious and may need a lower ceiling.
Combining Ibuprofen and Acetaminophen
Taking ibuprofen and acetaminophen together is not only safe when done correctly, it can work better than either one alone. An FDA-approved combination product pairs 250 mg of ibuprofen with 500 mg of acetaminophen per dose. In clinical trials, this combination provided significantly better pain relief than either ibuprofen or acetaminophen taken separately, with meaningful relief starting within about 48 to 59 minutes and lasting around seven hours.
The side effects in trials were minimal, no worse than placebo. You can also combine the two by simply taking separate pills of each, alternating doses throughout the day. The key is staying within the safe daily limits for both.
Topical Options for Localized Aches
When your aches are concentrated in one area, like a sore shoulder, stiff neck, or aching knee, topical anti-inflammatory products let you target the pain directly. Diclofenac, a prescription and over-the-counter NSAID, comes in gels, creams, patches, and solutions that you apply to the skin over the sore area. These are designed for acute pain from minor strains, sprains, and bruises.
Topical NSAIDs deliver the drug locally with far less absorption into your bloodstream, which means fewer of the stomach and cardiovascular concerns that come with oral NSAIDs. They’re not meant for long-term use, and you shouldn’t apply them to broken skin, wounds, burns, or areas with eczema or infection. Menthol-based creams and patches are another over-the-counter option that work by creating a cooling or warming sensation to override pain signals, though they don’t address inflammation.
Nighttime Formulas
If body aches are disrupting your sleep, “PM” pain products typically combine a standard pain reliever with diphenhydramine, an antihistamine that causes drowsiness. A common liquid formula, for example, contains 1,000 mg of acetaminophen and 50 mg of diphenhydramine per dose. The pain reliever handles the aches while the sleep aid helps you fall and stay asleep.
These work well as a short-term fix, but diphenhydramine isn’t meant for nightly use. It can leave you groggy the next morning, and your body builds tolerance to its sleep effects quickly. If body aches are interrupting your sleep for more than a few nights, it’s worth addressing the underlying cause rather than relying on PM formulas.
When Body Aches Come From the Flu
Flu-related body aches are caused by your immune system’s inflammatory response to the virus, not by the virus damaging your muscles directly. NSAIDs and acetaminophen both help manage the discomfort, but they’re treating the symptom. Prescription antiviral medications can shorten the duration of illness by about a day and lessen symptom severity overall, including body aches. The catch is that antivirals work best when started within one to two days of symptoms appearing, so timing matters.
Magnesium for Muscle Soreness
If your body aches are tied to exercise, physical labor, or chronic muscle tension, magnesium supplementation may help. Magnesium plays a direct role in muscle relaxation and acts as a natural vasodilator. Clinical research shows it can reduce muscle soreness from exercise-induced damage, lower lactate levels, and support faster recovery. It also helps prevent a process called central sensitization, where your nervous system becomes overly responsive to pain signals from repeated muscle injuries.
The recommended daily intake for adults is 320 to 360 mg for women and 410 to 420 mg for men. Many people fall short of this through diet alone. Clinical studies have used supplemental doses ranging from 300 to 500 mg per day, with some research suggesting that active individuals benefit from intake 10 to 20 percent above the standard recommendation. Magnesium won’t provide the immediate relief of an ibuprofen tablet, but consistent supplementation over weeks can meaningfully reduce the frequency and severity of muscle-related aches.
Choosing the Right Option
- Muscle soreness, joint pain, or swelling: Start with an NSAID like ibuprofen or naproxen. They address both the pain and the inflammation behind it.
- General achiness, fever, or headache: Acetaminophen works well and is easier on the stomach.
- Pain in one specific area: A topical NSAID gel or patch targets the spot without systemic side effects.
- Aches keeping you awake: A PM formula with acetaminophen and diphenhydramine handles both problems, but keep it short-term.
- Recurring muscle aches from activity: Daily magnesium supplementation can reduce soreness over time.
- Stubborn pain that doesn’t respond to one drug: Combining ibuprofen and acetaminophen provides stronger relief than either alone.
Aspirin is another NSAID that can help with body aches, but it carries additional blood-thinning effects and should not be given to anyone under 19 due to the risk of Reye’s syndrome, a rare but dangerous condition. For most adults, ibuprofen or naproxen are more practical anti-inflammatory choices for body aches.