Welcome to Health Care Magic, According to instructions posted by you, it seems you suffer from chronic arthritis under treatment of NSAIDs (Ibuprofen) medications. As you know, chronic arthritis arises from inflammation in joints and mostly appears to be migratory when spreads from one part to other parts of the body because of autoimmune issues. The patients feel pain and stiffness in joints either. There are many reasons for arthritis which have to be taken into our account to plan a proper treatment, otherwise, the patient cannot proceed an acceptable life with better quality of life. Researchers have shown that many causes may mimic the symptoms of chronic arthritis such as viruses (hepatitis B, C), Rheumatic fever and arthritis, Infections, Systemic lupus erythematosus and other autoimmune disorders, Polymyalgia rheumatic, Psoriasis, Gout, etc. Looking back on the information posted by you and my experience with this illness and similar cases, I recommend you as follows: 1. You demand specific, routine and complete blood tests to rule out autoimmune disorders and other causes of your symptoms and finally biopsy may help for this purpose of differential diagnosis. 2. To address, your main chief complaint and inquiry regarding treatment of illness, NSAIDS (such as ibuprofen, naproxen, etc.) help to reduce inflammation and pain. However, in some cases, corticosteroids might be a good choice for controlling the symptoms after visiting rheumatologist. 3. Researches have demonstrated that proper plan of exercise, physiotherapy and nutrition greatly help the process of recovery and recurrent symptoms. Omega 3 oils are suggested to decrease the severity of this disease in many cases. 4. Personally I refuse opiates for treatment of painful arthritis due to many consequences such as addiction, physical and psychological dependence and withdrawal syndrome in long-term use for this chronic disease. 5. There are some newly discovered medications with the similar effect of opiates without addiction such as new generations of Ketorolac, etc. 6. Specific medications for treatment of arthritis ( in etiology perspective) may be applied such as allopurinol for Gout, methotrexate for Psoriasis. Conclusion: I reject treatment with tramadol for arthritis in your case and suggest newly produced strong non-opiates analgesics for substitution. Hope you find my suggestions helpful, Regards