Vitality

Advil vs. Tylenol For Headaches, Back Pain, And Cramps: How Ibuprofen And Acetaminophen Differ

For those of us dealing with the occasional aches and pains brought on by life's daily struggles, there's more painkilling options available over-the-counter (OTC) than ever before.

But despite the litany of different brand names and packages, there are basically two major types of OTC painkillers: acetaminophen, as found in a bottle of Tylenol; and non-steroidal anti-inflammatory drugs (NSAIDs), a broad class that contains ibuprofen (Advil), naproxen (Aleve), and aspirin.

But while acetaminophen and ibuprofen might seem interchangeable, there are plenty of subtle differences between them, including which conditions they best work for. Let's take a brief look.

NSAIDs What works better for certain kinds of pain — acetaminophen or ibuprofen? KAREN BLEIER/AFP/Getty Images

A Better Bargain

Though acetaminophen has been around longer, ibuprofen is recognized as the superior painkiller for most every situation.

Take, for instance, back pain and arthritis. Looking back at 13 randomized trials, a group of authors in The BMJ in 2015 quickly came to the conclusion that acetaminophen was “ineffective in the treatment of low back pain and provides minimal short term benefit for people with osteoarthritis.”

That's largely because acetaminophen doesn't work the same way as ibuprofen and other NSAIDs. While the former can reduce fever and pain, it doesn't reduce inflammation, which is a common source of pain. And even when it comes to fever, a 2005 review in Evidence Based Nursing found that a child’s fever was more effectively calmed down by ibuprofen than acetaminophen.

So although acetaminophen isn’t useless for cramps, tension headaches, and swollen ankles, most people will get a better bang for their buck by taking ibuprofen instead.

That isn't to say there aren't moments where acetaminophen isn't a better option. Leaving aside allergies, the side effects of NSAIDs include gastrointestinal bleeding and a slightly higher risk of heart attack and stroke. So those wary of stomach ills may prefer acetaminophen instead (the drug isn't free of its own unintended effects, though, like liver damage). Children under the age of six months are recommended only to take acetaminophen as well.

At the end of the day, our bodies are complex and we often respond to drugs in slightly different ways from one another. So if you swear by your Tylenol bottle, by all means stay true to it. For many of us, though, ibuprofen will be the better bargain.

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