From the Guidelines
Naproxen is an appropriate medication for treating cervical strain, and I recommend taking naproxen 500 mg twice daily with food for 7-10 days to help manage pain and inflammation associated with cervical strain, as supported by the American College of Physicians and the American Pain Society guidelines 1. The maximum daily dose should not exceed 1000 mg. Naproxen works by reducing inflammation and pain by inhibiting prostaglandin synthesis through blocking cyclooxygenase enzymes. In addition to medication, apply ice for the first 48-72 hours (20 minutes on, 20 minutes off), then switch to heat therapy. Gentle stretching, maintaining good posture, and avoiding activities that worsen pain are also important. If you have a history of stomach ulcers, kidney disease, heart problems, or are taking blood thinners, consult your healthcare provider before using naproxen, as nonselective NSAIDs like naproxen are associated with well-known gastrointestinal and renovascular risks 1. Side effects may include stomach upset, heartburn, and dizziness. If symptoms worsen or don't improve after 10 days, or if you experience severe headache, weakness, or numbness in the arms, seek medical attention promptly. It's also important to note that the use of NSAIDs, including naproxen, has been associated with increased cardiovascular risk, particularly in patients with established cardiovascular disease 1. Therefore, clinicians should assess cardiovascular and gastrointestinal risk factors before prescribing NSAIDs and recommend the lowest effective doses for the shortest periods necessary 1.
From the Research
Naproxen for Cervical Strain
- There are limited studies directly addressing the use of naproxen for cervical strain. However, studies on low back pain and muscle spasm can provide some insights.
- A study published in 2015 2 compared the effectiveness of naproxen alone, naproxen with cyclobenzaprine, and naproxen with oxycodone/acetaminophen for treating acute low back pain. The results showed that adding cyclobenzaprine or oxycodone/acetaminophen to naproxen did not improve functional outcomes or pain at 1-week follow-up.
- Another study from 1990 3 investigated the use of cyclobenzaprine and naproxen versus naproxen alone in the treatment of acute low back pain and muscle spasm. The results suggested that combination therapy was associated with less objective muscle spasm and tenderness, and greater motion of the lumbosacral spine.
- A review of evidence-based guidelines for diagnosing and treating cervical spine disorders published in 2019 4 may provide some general guidance on managing cervical strain, but it does not specifically address the use of naproxen.
- Studies on ibuprofen and cyclobenzaprine for acute cervical strain 5 and low-dose cyclobenzaprine versus combination therapy with ibuprofen for acute neck or back pain with muscle spasm 6 may also be relevant, but they do not directly address the use of naproxen for cervical strain.