From the FDA Drug Label
Management of Pain, Primary Dysmenorrhea, and Acute Tendonitis and Bursitis Because the sodium salt of naproxen is more rapidly absorbed, naproxen sodium is recommended for the management of acute painful conditions when prompt onset of pain relief is desired. Naproxen may also be used 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 acute bursitis is naproxen 500 mg initially, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as needed, with a maximum daily dose of 1000 mg 1.
- Key considerations:
- The initial total daily dose should not exceed 1250 mg.
- Naproxen sodium is recommended for acute painful conditions when prompt pain relief is desired.
- Dosage adjustments may be necessary for patients with renal or hepatic impairment or elderly patients.
From the Research
Acute bursitis should be managed with a combination of rest, ice, compression, and elevation (RICE) of the affected area for the first 48-72 hours after onset, as well as nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen 400-800mg three times daily with food or naproxen 500mg twice daily for 7-14 days to reduce pain and inflammation, as recommended by recent studies 2. The management of acute bursitis involves a multi-faceted approach, including:
- Rest, ice, compression, and elevation (RICE) of the affected area for the first 48-72 hours after onset
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen 400-800mg three times daily with food or naproxen 500mg twice daily for 7-14 days to reduce pain and inflammation
- Application of ice for 15-20 minutes every 2-3 hours during the acute phase
- Medical evaluation if symptoms are severe or don't improve within a week, which may include aspiration of the bursa or corticosteroid injection (such as methylprednisolone 40mg or triamcinolone 40mg) For septic bursitis, which presents with more severe pain, redness, warmth, and systemic symptoms, antibiotics are required—typically cephalexin 500mg four times daily or clindamycin 300mg four times daily for 7-10 days, as supported by studies 3, 4, 2. Prevention of recurrence involves addressing underlying causes such as repetitive pressure or friction, using protective padding for vulnerable areas, and maintaining proper body mechanics during activities, as suggested by research 5, 6. Physical therapy may be beneficial for strengthening surrounding muscles and improving joint mechanics once acute symptoms subside, although more research is needed to confirm its effectiveness 5, 2. It is essential to note that the management of septic bursitis varies considerably across centers, and controlled trials are needed to establish standardized recommendations regarding antibiotic treatment protocols and the indications of surgery, as highlighted by recent studies 4, 2.