Treating Knee Synovitis Swelling and Pain
Medically reviewed by Amy Kwan, PT, DPT
Knee synovitis is inflammation of the synovium, a membrane that lines the joints and the tendons surrounding the joints. Inflammation in the synovium of the knee can lead to various symptoms, including swelling and pain.
Knee synovitis is commonly caused by overuse in active individuals, but it can also develop in people with various types of inflammatory arthritis affecting the knee. While there is no cure, knee synovitis can be treated using anti-inflammatory drugs and other methods.
This article discusses the symptoms, causes, and treatment options for knee synovitis.
Luis Alvarez / Getty Images
Knee Synovitis Pain From Fluid Inflammation
Different anatomical points in the knee may be affected when the synovial membrane becomes inflamed in knee synovitis. The posterior cruciate ligament, the strongest ligament in the knee, is one of the most common areas affected. It runs down the back of the leg, from the top of the bone between the knee and ankle, and the bottom of the bone that runs from the pelvis to the knee.
The suprapatellar region is also likely to be affected. It is located on the front side of the leg, between the leg bone in the thigh and the quadriceps tendon.
Symptoms of Knee Synovitis
When people develop knee synovitis, they experience various symptoms associated with the disease because of inflammation and damage. The symptoms associated with knee synovitis include:
Swelling in the knee
A warm sensation in the joint
What Causes Symptoms?
Bone erosion, swelling caused by a synovial fluid buildup and an inflamed synovial membrane can all drive damage to the joint and symptoms. A joint may hurt in some cases, but there will be no visible swelling.
Is Knee Synovitis Related to Arthritis?
Knee synovitis can be due to certain types of arthritis, but in some types of arthritis, the synovium is unaffected. That said, many types of arthritis can cause knee synovitis.
Knee Synovitis Causes
There are two leading causes of knee synovitis: overuse and an underlying health condition that affects the joints. In healthy and active individuals, swelling of the synovium can occur due to an overworking of the knee. The stress put on the joint drives an inflammatory response and the symptoms that come with that inflammation.
Certain types of arthritis and other health disorders are associated with knee synovitis, including:
Post-traumatic arthritis (arthritis caused by an injury)
Chronic infections, such as tuberculosis
Synovial disorders
Knee Arthritis Causes
Knee arthritis is not always associated with with knee synovitis. Knee arthritis can cause synovitis, but that’s not always the case. Other causes of knee arthritis include:
Wear and tear over time
Autoimmune responses in the body
Knee injuries
Carrying excess weight, as is the case for someone who has obesity
Underlying health disorders
Can Knee Synovitis Cause Knee Arthritis?
Synovitis and arthritis are closely related but are two different conditions, but, in some cases, knee synovitis can lead to the development of osteoarthritis, a form of degenerative arthritis that worsens over time.
Tests and Imaging to Diagnose Knee Synovitis
There are several imaging tests used in the diagnostic process of knee synovitis. They aim to detect the presence and severity of the inflammation. Tests used include:
Synovial fluid analysis: A collection of synovial fluid via needle to check for signs of disease
Magnetic resonance imaging (MRI): To get a closer look inside the knee to check for inflammation
Musculoskeletal ultrasound: To get better images of what’s going on within the knee and synovial membrane
X-rays: To get a detailed picture of the bone and other dense structures in the knee to check for damage
Computer tomography (CT): A scan to check on the severity of damage to the bone and soft tissues in the knee
These tests diagnose knee synovitis when combined with a health history and symptoms that point to the disease. The imaging tests are also used to determine the severity of synovitis.
First-Line Knee Synovitis Treatment
Treatments for knee synovitis center around reducing symptoms and managing any underlying health disorders that drive knee inflammation. Nonsteroidal anti-inflammatories (NSAIDs) like Advil or Motrin (ibuprofen) are typically given first to reduce pain and inflammation.
Other treatments can include:
Draining the fluid that is built up in the knee
Disease-modifying antirheumatic drugs (DMARDs) to manage inflammatory causes
Steroid injections to reduce swelling and pain
What Happens If Treatment Doesn’t Work?
If first-line therapies do not help with your knee synovitis, you may have to undergo surgery or consider alternative therapies alongside first-line treatments to improve symptoms further.
Complementary Therapies
While little scientific evidence exists on alternative therapies for knee synovitis, some of these treatments may help to reduce pain and swelling while you take other medications or explore other medical treatments. Some options include:
Resting the knee
Using ice or heat therapy
Knee compression
Knee elevation
Wearing knee braces, bandages, tapes, and sleeves
Using Rest and Ice/Heat Appropriately
When using rest or ice/heat to cope with symptoms of knee synovitis, it’s important to limit how often you do so. This is because too much rest or ice can harm the joint, which could cause more problems in the long term.
Surgical Considerations for Knee Synovitis
If medications and other therapies do not work for knee synovitis and you continue to experience worsened pain and inflammation, your healthcare provider may recommend a surgery known as synovectomy. The surgery removes the synovium entirely.
There are two types of synovectomies: arthroscopic and open. An arthroscopic procedure is less invasive than open. According to studies, both types of surgery have similar results. Both surgeries provide relief relatively quickly following the procedure.
Open vs. Arthroscopic
Both types of surgeries will yield good results in terms of symptom relief. However, since an open synovectomy requires more invasive techniques, healing from this type may take longer and come with more postsurgical pain.
Recovery Period, Walking, and Physical Therapy
It can be hard to determine an exact timeline for recovery after a synovectomy because all people are different. Typically, a person will have to get physical therapy starting one or two days following surgery to help improve the mobility and flexibility of the knee while it heals.
People will also have to continue taking their medications as prescribed even after surgery to prevent the inflammation from returning. You are also encouraged to walk following surgery and put weight on the knee while avoiding strenuous activities.
You will likely do a follow-up with your healthcare provider within seven to 10 days following surgery, where you will learn the next steps in the healing process.
Living With Chronic Symptoms
When you have chronic symptoms of knee synovitis, it’s essential to explore your treatment options with your healthcare provider. You do not have to live with pain. In the meantime, you can focus on walking an adequate amount to keep the joint and muscles around it mobile and rest the knee for a period every day.
Summary
Knee synovitis can be a painful and debilitating condition, but several options can help reduce pain and improve mobility. Surgery is the last resort because first-line therapies, such as pain medications and steroid injections, can often reduce symptoms and inflammation causing symptoms.
Complementary therapies are an excellent addition to a treatment plan and can improve knee synovitis. If you experience knee pain and swelling, contact your healthcare provider. They will help you determine what is causing it and offer treatment options.
