Not long ago, choosing a pain reliever meant finding one that eased your pain without being too hard on the stomach. Researchers found out that some commonly used pain medications can raise the risk of having stroke and heart attack.  Recommendations from the American Heart Association can aid in choosing a pain reliever that is good for thr heart and stomach.  To quell muscle or joint pain the AHA suggests starting with aspirin or acetaminophen (Tylenol).  It is found out that aspirin is good for the heart and acetaminophen does not have effects on blood clotting.  The nest step for most people would be a nonsteroidal anti-inflammatory drug (NSAID) if all else fails.  Try naproxen (Aleve) first, then ibuprofen (Advil). Next is diclofenac, but more caution is needed with this drug (which is available only by prescription). Celebrex, the only drug in the class known as COX-2 inhibitors that remains on the market, should be the last resort for managing pain. In addition to the side effect of increasing the risk of clots in the bloodstream, COX-2 inhibitors can also helps in the reduction of blood flow through the kidneys and raise blood pressure. For short-term pain in some people, a narcotic pain reliever such as tramadol (Ultram), codeine, or fentanyl (Actiq, Duragesic) may be an option. For occasional aches and pain, you should not be afraid to take aspirin like ylenol, Advil, or Aleve for occasional aches and pains, the Harvard Heart Letter notes.  talk with your doctor and pay closer attention to your choices whenever you need a pain reliever several times a week.