NSAIDs are the more common painkillers in our life, with antipyretic, analgesic and anti-inflammatory effects. How to choose the right one is indeed a headache. For the common rheumatic diseases: ① rheumatoid arthritis inflammatory manifestation is prominent, the involvement of many joints, most need long-term medication. The drugs with high safety should be chosen, such as nimesulide, meloxicam and COX-2 specific inhibitors such as celecoxib, or precursors with low gastrointestinal irritation such as loxoprofen sodium and non-acidic drugs such as nedimethicone. (ii) However, COX-2 specific inhibitors such as celecoxib should be used with caution in patients at risk of cardiovascular accidents. ③ And a history of peptic ulcer, gastric bleeding and perforation, or people with these potential risks, optional COX-2 specific inhibitors, but also can be used to rectal administration such as suppositories, such as ibuprofen suppositories and anti-inflammatory pain suppositories. In the case of osteoarthritis, the inflammatory manifestations are generally mild and the joints are less involved, so you can choose drugs with fast action and few adverse effects, such as acetaminophen or topical drugs, and pay attention to the application of small doses and avoid prolonged use. Gastric mucosa protective drugs can also be used in combination to reduce the stimulation of the gastrointestinal tract. ⑤ Reduce the dosage as appropriate for elderly and pediatric patients. In addition, for people with severe pain and pain sensitivity, we can use tramadol hydrochloride in combination; however, these analgesics, in many cases, have limited effects, and it is especially important to monitor the adverse drug reactions in patients with long-term NSAID application. Blood, urine and stool routine and liver and kidney functions should be checked regularly before and during treatment, and blood pressure should be measured regularly, and once abnormalities appear, the drug should be stopped immediately and appropriate treatment should be given. It is recommended that you consult a rheumatology specialist as soon as possible for a clear diagnosis and targeted treatment.