From the Guidelines
Naproxen is a suitable option for managing pain from heel fractures or heel spurs, as it helps reduce both pain and inflammation associated with these conditions. As a nonsteroidal anti-inflammatory drug (NSAID), naproxen works by inhibiting cyclooxygenase enzymes that produce prostaglandins, which are responsible for pain and inflammation 1. For adults, a typical dose is 250-500 mg twice daily, with a maximum of 1000 mg per day. Treatment duration should generally be limited to the shortest period needed to control symptoms, usually 1-2 weeks for acute pain.
Important Considerations
- Naproxen should be taken with food to minimize stomach irritation
- It may not be suitable for people with kidney problems, heart conditions, or a history of stomach ulcers
- It can interact with certain medications including blood thinners and some blood pressure medications
- For heel fractures specifically, naproxen should be part of a comprehensive treatment plan that includes rest, ice, compression, and elevation
- If pain persists beyond 7-10 days or worsens, medical evaluation is necessary as this might indicate complications or the need for alternative treatments 1.
Key Points to Consider
- Clinicians should assess cardiovascular and gastrointestinal risk factors before prescribing NSAIDs and recommend the lowest effective doses for the shortest periods necessary
- Strategies for minimizing adverse events in higher-risk patients who are prescribed NSAIDs, such as co-administration with a proton-pump inhibitor, should be considered
- Failure to respond to a time-limited course of opioids should lead to reassessment and consideration of alternative therapies or referral for further evaluation.
From the Research
Naproxen for Heel Fracture or Heel Spurs
- Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that is commonly used to manage pain and inflammation 2.
- However, its use for heel fracture or heel spurs is not well-established, and there are concerns about its potential impact on bone healing 3, 4, 5.
Efficacy of Naproxen for Pain Management
- Naproxen has been shown to be effective in managing post-operative pain and reducing the use of opioids 2.
- However, its efficacy for soft tissue injuries, such as ankle injuries, is similar to that of acetaminophen 6.
Potential Risks of Naproxen for Bone Healing
- Naproxen has been shown to impair load-induced bone formation, reduce bone toughness, and diminish woven bone formation following stress fracture in mice 3.
- NSAIDs, including naproxen, may inhibit fracture healing by inhibiting angiogenesis, which is essential for bone repair 5.
- The use of NSAIDs, including naproxen, may be associated with an increased risk of fracture nonunion, particularly in patients with delayed union or nonunion 4, 5.