From the Guidelines
Treatment for heel bursitis should begin with conservative measures, including patient-directed measures such as regular calf-muscle stretching, cryotherapy, over-the-counter heel cushions and arch supports, weight loss (if indicated), activity limitation, and avoidance of flat shoes and barefoot walking, as recommended by the American College of Foot and Ankle Surgeons 1. Heel bursitis treatment options include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation reduction
- Padding and strapping of the foot
- Corticosteroid injections in appropriate patients
- Initial treatment options may also include open-backed shoes, orthoses, accommodative padding, and physical therapy 1 Key considerations for treatment include:
- Wearing properly fitted shoes with good arch support and cushioning
- Using heel pads or orthotic inserts for additional relief
- Avoiding activities that aggravate the condition
- Considering corticosteroid injections for persistent cases
- Surgical intervention may be considered in severe cases that don't respond to conservative treatment after 6-12 months, though this is rarely necessary 1
From the FDA Drug Label
For relief of the signs and symptoms of bursitis The recommended starting dose of naproxen is 500 mg, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as required. The initial total daily dose should not exceed 1250 mg of naproxen. Thereafter, the total daily dose should not exceed 1000 mg of naproxen.
The recommended treatment for heel bursitis is naproxen with a starting dose of 500 mg, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as required, with a maximum daily dose of 1000 mg 2.
- Key considerations include:
- Using the lowest effective dose for the shortest duration consistent with individual patient treatment goals
- Adjusting the dose based on observation of benefit and/or adverse events 2.