Nonsteroidal anti-inflammatory drugs or NSAIDs are extremely popular for easing a variety of aches and pains. Drugs like ibuprofen and naproxen are huge best sellers in the pharmacy. But such medications, whether prescription or over the counter, come with a long list of side effects. Not only can they irritate the digestive tract, but NSAIDs can cause heart attacks and strokes. That’s why people in Europe have been using topical NSAIDs for decades. Such formulations of creams and gels deliver the active drug more locally than pills do. A new meta-analysis of 34 placebo-controlled studies including more than 7,500 people shows that topical NSAIDs are just as effective as pill, and better than placebo. Use of the topical formulation resulted in fewer gastrointestinal reactions. In the US, most topical NSAIDs, such as Voltaren Gel, are available only by prescription.