Taking Naproxen (Aleve) After a Steroid Injection in the Back
It is generally safe to take naproxen (Aleve) after a steroid injection in the back, as there is no evidence of harmful interaction between these treatments.
Rationale for Safety
Naproxen (Aleve) is a nonsteroidal anti-inflammatory drug (NSAID) that can be used for pain management following steroid injections in the back. The evidence supports this approach:
- The FDA drug information for naproxen does not list any specific contraindications regarding its use after steroid injections 1
- Research specifically examining hemorrhagic complications in patients undergoing epidural steroid injections found that NSAIDs did not increase the frequency of minor hemorrhagic complications 2
Timing Considerations
When taking naproxen after a steroid injection:
- Wait 24-48 hours after the steroid injection before starting naproxen
- This allows the initial effects of the steroid injection to be assessed without confounding from the NSAID
- The steroid injection itself may take 2-3 days to reach maximum effectiveness
Dosing Guidelines
- Standard dosing for naproxen (Aleve) is 220-500 mg every 8-12 hours as needed for pain
- Do not exceed 1000 mg per day of naproxen for short-term use
- Limit use to the lowest effective dose for the shortest duration possible
Potential Benefits of Combined Therapy
- Naproxen can provide additional pain relief while waiting for the full effects of the steroid injection
- The combination may provide more comprehensive pain management through different mechanisms:
- Steroids reduce inflammation at the injection site
- Naproxen provides systemic anti-inflammatory and analgesic effects
Precautions and Contraindications
Be cautious or avoid naproxen if you have:
- History of gastrointestinal bleeding or ulcers
- Kidney disease or impaired kidney function
- Heart disease or high blood pressure
- Liver disease
- Allergies to aspirin or other NSAIDs
- Are taking blood thinners
Monitoring for Side Effects
Watch for:
- Gastrointestinal symptoms (stomach pain, heartburn, nausea)
- Signs of bleeding (unusual bruising, black/tarry stools)
- Swelling in extremities
- Skin rash or itching
- Changes in urination patterns
When to Contact Your Healthcare Provider
Contact your doctor if:
- Pain worsens significantly despite medication
- You experience new neurological symptoms (numbness, weakness, radiating pain)
- You develop side effects from either the steroid injection or naproxen
- Your symptoms don't improve within 1-2 weeks
Remember that while both treatments are generally safe to use together, always follow your healthcare provider's specific instructions regarding your individual treatment plan.