All I can say is that I used it for 3 decades regularly, for menstrual cramps and sciatica, at the age of 64, I could no longer take it due to stomach damage, not an ulcer, but I developed a thickening ring in my esophagus. My doctor said it probably did a number on my arteries also. I have chronic long term, end stage Lyme disease. I have been taking Tramadol, a low level opioid like medicine since then, and I can never get off of it. I have not had to raise that medication,but it is not an anti inflammatory, and I miss that , so I try my best to follow an anti inflammatory diet. I refuse steroids, and those shots they give you. I also use marijuana, muscle relaxants when I need them. Due to Lyme, I have zero cartilage left. Pain is managed, but not gone. The Advil allowed me to work, I have done personal care with disabled persons all of my life, and have always been very physical.While leading an active life, I probably wore my joints down worse, due to Advil. I guess it was a trade off. Most of us cannot take time off due to pain, and my gardens are glorious, and the activity helped me build up a core, so my muscles hold me together when my skeleton cannot.