1. Non-steroidal antiinflammatory drugs (NSAIDs) are among the most frequently prescribed medications and are used primarily to control pain, stiffness, and reduce inflammation. 2. One of the most common adverse effects of NSAID therapy is gastrointestinal (GI) problems, specifically indigestion, nausea, dyspepsia, diarrhea, constipation, and gastritis. 3. Considerations in chronic pain management include non-pharmacologic treatment options (i.e., physical therapy, behavioral therapy, etc.), use of misoprostol for clients at high risk for NSAID induced GI problems, and monitoring blood and urine every 3 months to 1 year with chronic NSAID therapy to detect liver, kidney, and hematologic problems. 4. Current research is focused on development of a prostaglandin H synthetase (PGHS-2) inhibitor which should offer efficacy equal to the most potent NSAIDs with minimal side effects, including gastric safety.