Knee > Synovitis > Treatments

    Anti-Inflammatory Medication (Steroids, Gold)

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If synovitis is causing a large amount of swelling and pain, or if it is associated with rheumatoid arthritis or other joint diseases, your physician may prescribe oral corticosteroids to stop the inflammation. Corticosteroids are strong anti-inflammatories that typically help to decrease the production of extra fluid in your knee. They are usually prescribed either for a short period of time or at a low dose because there are long-term health risks associated with high-dose steroid use, such as hardening of the arteries and bone loss. The two most common oral corticosteroids are prednisolone and prednisone. Taking steroids usually has a positive feeling of strength associated with it; however, regular steroid use is dangerous for most people and is only prescribed when synovitis is caused by certain types of arthritis. Be sure to carefully follow your physician's instructions about steroids. Your physician may refer you to a specialist, such as a rheumatologist, who may prescribe alternative treatments such as gold. When taken orally, gold has many anti-inflammatory properties that may help decrease the swelling in your knee. When the swelling and pain subside, you can usually begin physical therapy for synovitis.

The underlying cause of synovitis, whether it was arthritis, torn cartilage, or other knee problems, usually dictates the specific rehabilitation program you need to undergo. In the absence of complications, your physician may prescribe visits to a physical therapist to begin supervised strengthening exercises as soon as your pain and swelling go away. Steroids usually provide enough pain relief for you to immediately begin physical therapy. The time you spend in rehab varies depending on your pain threshold and the severity of synovitis. After synovitis, you usually need to avoid strenuous activities that put pressure on the bones in your knee. Running, jumping, or twisting may aggravate the synovial membrane and increase its production of fluid, possibly causing your knee to swell again. Your physician and physical therapist can design a custom rehab program to address your needs. In general, the rehab program to help heal your knee after synovitis follows a pattern. Rehab progresses from stretching exercises to strengthening exercises that focus on the quadriceps and hamstrings ­ the main stabilizing muscles for your knee. Physicians suggest you gradually increase the amount of weight as your leg muscles get stronger. Strengthening exercises require dedication because results often take weeks and pain may recur. After a couple weeks of rehab, physical therapy may become activity-oriented as you regain the ability to perform complicated movements, using stationary bikes, elliptical machines, and cross-country skiing machines. Some cases of synovitis may take much longer to rehab before activities can begin. Physicians usually suggest that you continue strength training even after synovitis has healed. Have your physician periodically check your knee for strength and proper function.

Oral corticosteroids usually provide quick pain relief from synovitis. The swelling typically decreases and no longer gets in the way of knee movement. However, you may remain at risk for synovitis to recur. The best way to prevent recurring synovitis is to properly treat the knee problem or disease that caused synovitis. You may be able to reduce your chances of recurring synovitis by avoiding a sudden increase in activities that require repetitive motion, such as cycling or using a stair-climbing machine. Easing into an exercise routine after synovitis can help reduce stress on the synovial membrane and help you avoid irritation. In the absence of other knee complications, the amount of caution you should use during activities to prevent synovitis from recurring depends on your age as follows:

   Children - Synovitis usually does not hinder joint function after an injury. Once synovitis heals, it rarely returns.

   Adults - Synovitis may signal that you have sustained some degree of cartilage damage. Becoming less involved in strenuous activities, like contact sports or long distance running, may help prevent future synovitis. But you do not need to avoid activities or be overly concerned with prevention unless the underlying cause of your synovitis was a severe disease or injury that warrants extra prevention measures.

   Seniors - Synovitis may be more problematic later in life, harming the function of your knee joint, and you should continue to visit your physician for check-ups after your knee heals. Because synovitis is a common companion of rheumatoid arthritis and osteoarthritis, you should strongly consider cutting back your activity level to avoid situations that could strain your knee joint.

Weight control is also important. One extra pound of body weight translates into three or four pounds of weight across your knee every time you take a step. Lightening the load on your knees helps them to function better. Your physician may prescribe a lightweight knee brace to wear during sports that require side-to-side or twisting motions. You should also consider wearing kneepads during activities, such as in-line skating, that put you at risk for falling.