Dear , This is Dr. S. Tomar from healthcaremagic.com s medical team and I ll be your medical adviser for this question. First of all thank you for sharing your concern with us and showing trust on us. Heart patients should follow a step up approach for dealing with arthritic pain , fibromyalgia as follows: 1st step: Use physical methods like heating pads , ice packs , physical therapy . The benefit of these physical methods is that the lower doses of pain killers would be enough to control pain . If this step does not provide optimum relief then step up to 2nd step. 2nd step: use aspirin or tylenol as prescribed by your healthcare providers. 3rd step: use naproxen 4st step: use tramadol Always insist your healthcare providers to prescribe the safest drug in lowest effective dosage for the shortest period of time . This is my initial response and discussion is open until you have any query or need further clarification. I wish you good health . sincerely, Dr. Shardendu Tomar