Treatment Overview

Living with synovitis means dealing with joints that feel swollen, warm, and painful to move. This condition, characterized by inflammation of the synovial membrane that lines the joints, can turn simple actions like gripping a cup or walking down stairs into painful challenges. Whether it appears suddenly due to overuse or persists as part of a chronic condition like arthritis, the discomfort can severely impact daily mobility and quality of life.

Treatment is essential not only to relieve the immediate pain and swelling but also to prevent long-term damage to the joint cartilage and underlying bone. The approach to treatment varies significantly depending on the root cause whether it is an injury, an infection, or an autoimmune disease. Therefore, medication choices are tailored to the severity of the inflammation and the specific needs of the patient (Arthritis Foundation, 2022).

Overview of treatment options for Synovitis

The primary goal of treating synovitis is to reduce inflammation in the synovial lining and manage pain. By controlling the swelling, the production of excess joint fluid is reduced, which relieves pressure and restores movement.

Treatment usually begins with conservative medication-based strategies. For acute cases caused by injury, short-term anti-inflammatory drugs are often sufficient. However, when synovitis is chronic or related to conditions like rheumatoid arthritis, the strategy shifts toward long-term disease management to suppress the immune system. While resting the joint and applying ice are helpful supportive measures, medications are the primary tools used to chemically halt the inflammatory process. In cases where fluid buildup is severe, a doctor may perform a procedure to drain the joint (aspiration) alongside medication therapy.

Medications used for Synovitis

Non-steroidal anti-inflammatory drugs (NSAIDs) are the standard first-line treatment for most cases of synovitis. Common over-the-counter options like ibuprofen and naproxen helps reduce both pain and swelling. Clinical experience suggests that prescription-strength NSAIDs may be necessary for more significant inflammation. Patients typically feel relief within hours of taking these medications.

Corticosteroids are a powerful second-line option often used when NSAIDs are not enough. These can be taken orally (such as prednisone) or injected directly into the inflamed joint. Injections deliver high concentrations of the medication right to the source of the problem, often providing rapid relief that can last for weeks or months.

If synovitis is persistent and caused by an autoimmune condition, doctors prescribe Disease-Modifying Antirheumatic Drugs (DMARDs). Medications like methotrexate or hydroxychloroquine are used to treat the underlying immune dysfunction. Unlike NSAIDs, these drugs take weeks or even months to show full effects. For severe, resistant cases, biologic agents such as TNF inhibitors, may be introduced to target specific parts of the immune system (Mayo Clinic, 2023).

How these medications work

NSAIDs work by blocking enzymes (COX-1 and COX-2) that produce prostaglandins, the chemical messengers responsible for triggering inflammation and pain signals in the body. By lowering the levels of these chemicals, the redness, heat, and swelling of the synovium decrease.

Corticosteroids are synthetic versions of cortisol, a hormone naturally produced by the adrenal glands. They act as potent anti-inflammatories by suppressing multiple immune pathways and reducing the migration of white blood cells to the joint. This rapidly calms the angry, inflamed tissue.

DMARDs and biologics work on a deeper level by interfering with the immune system’s attack on the joint lining. For example, they may block specific signals that tell cells to attack the synovium, thereby preventing the inflammation from starting in the first place. This helps preserve the joint structure over time (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023).

Side effects and safety considerations

While effective, these medications carry risks. Long-term use of NSAIDs can lead to stomach ulcers, gastrointestinal bleeding, and kidney strain. Oral corticosteroids, especially long-term use, can lead to weight gain, high blood pressure, high blood sugar, and osteoporosis.

DMARDs and biologics suppress the immune system, increasing infection risk. Regular blood tests are needed to monitor liver function and blood counts. Biologics are usually avoided with active infections or certain cancers. Seek immediate medical attention if signs of infection (like fever or chills) occur.

Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.

References

  1. Arthritis Foundation. https://www.arthritis.org
  2. Mayo Clinic. https://www.mayoclinic.org
  3. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov
  4. Hospital for Special Surgery. https://www.hss.edu

Medications for Synovitis

These are drugs that have been approved by the US Food and Drug Administration (FDA), meaning they have been determined to be safe and effective for use in Synovitis.

Found 9 Approved Drugs for Synovitis

MethylPREDNISolone

Brand Names
Solu-Medrol MethylPREDNISolone, Solu-Medrol, Medrol

MethylPREDNISolone

Brand Names
Solu-Medrol MethylPREDNISolone, Solu-Medrol, Medrol
Form: Injection, Tablet
Method of administration: Oral, Intravenous, Intramuscular
FDA approval date: October 24, 1957
Classification: Corticosteroid
When oral therapy is not feasible, and the strength, dosage form, and route of administration of the drug reasonably lend the preparation to the treatment of the condition, the intravenous or intramuscular use of Methylprednisolone Sodium Succinate for Injection, USP, is indicated as follows: Allergic states Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis, serum sickness, transfusion reactions. Dermatologic diseases Bullous dermatitis herpetiformis, exfoliative erythroderma, mycosis fungoides, pemphigus, severe erythema multiforme (Stevens-Johnson syndrome). Endocrine disorders Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy, mineralocorticoid supplementation is of particular importance), congenital adrenal hyperplasia, hypercalcemia associated with cancer, nonsuppurative thyroiditis. Gastrointestinal diseases To tide the patient over a critical period of the disease in regional enteritis (systemic therapy) and ulcerative colitis. Hematologic disorders Acquired (autoimmune) hemolytic anemia, congenital (erythroid) hypoplastic anemia (Diamond-Blackfan anemia), idiopathic thrombocytopenic purpura in adults (intravenous administration only; intramuscular administration is contraindicated), pure red cell aplasia, selected cases of secondary thrombocytopenia. Miscellaneous Trichinosis with neurologic or myocardial involvement, tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy. Neoplastic diseases For the palliative management of leukemias and lymphomas. Nervous System Acute exacerbations of multiple sclerosis; cerebral edema associated with primary or metastatic brain tumor, or craniotomy. Ophthalmic diseases Sympathetic ophthalmia, uveitis and ocular inflammatory conditions unresponsive to topical corticosteroids. Renal diseases To induce diuresis or remission of proteinuria in idiopathic nephrotic syndrome or that due to lupus erythematosus. Respiratory diseases Berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy, idiopathic eosinophilic pneumonias, symptomatic sarcoidosis. Rheumatic disorders As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis; acute rheumatic carditis; ankylosing spondylitis; psoriatic arthritis; rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy). For the treatment of dermatomyositis, temporal arteritis, polymyositis, and systemic lupus erythematosus.

Kenalog

Brand Names
Lidolog, Mlk F3, Mlk F1, Pro-C-Dure 6, Bupivilog

Kenalog

Brand Names
Lidolog, Mlk F3, Mlk F1, Pro-C-Dure 6, Bupivilog
Form: Kit
Method of administration: Intra-articular, Epidural, Topical, Intramuscular, Infiltration
FDA approval date: January 16, 2014
Intramuscular Where oral therapy is not feasible, injectable corticosteroid therapy, including triamcinolone acetonide injectable suspension is indicated for intramuscular use as follows: Allergic states: Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis, serum sickness, transfusion reactions. Dermatologic diseases: Bullous dermatitis herpetiformis, exfoliative erythroderma, mycosis fungoides, pemphigus, severe erythema multiforme (Stevens-Johnson syndrome). Endocrine disorders: Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy, mineralocorticoid supplementation is of particular importance), congenital adrenal hyperplasia, hypercalcemia associated with cancer, nonsuppurative thyroiditis. Gastrointestinal diseases: To tide the patient over a critical period of the disease in regional enteritis and ulcerative colitis. Hematologic disorders: Acquired (autoimmune) hemolytic anemia, Diamond-Blackfan anemia, pure red cell aplasia, selected cases of secondary thrombocytopenia. Miscellaneous: Trichinosis with neurologic or myocardial involvement, tuberculous meningitis with subarachnoid block or impending block when used with appropriate antituberculous chemotherapy. Neoplastic diseases: For the palliative management of leukemias and lymphomas. Nervous system: Acute exacerbations of multiple sclerosis; cerebral edema associated with primary or metastatic brain tumor or craniotomy. Ophthalmic diseases: Sympathetic ophthalmia, temporal arteritis, uveitis and ocular inflammatory conditions unresponsive to topical corticosteroids. Renal diseases: To induce diuresis or remission of proteinuria in idiopathic nephrotic syndrome or that due to lupus erythematosus. Respiratory diseases: Berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy, idiopathic eosinophilic pneumonias, symptomatic sarcoidosis. Rheumatic disorders: As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis; acute rheumatic carditis; ankylosing spondylitis; psoriatic arthritis; rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy). For the treatment of dermatomyositis, polymyositis and systemic lupus erythematosus. Intra-Articular The intra-articular or soft tissue administration of triamcinolone acetonide injectable suspension is indicated as adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis, acute and subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, rheumatoid arthritis, synovitis of osteoarthritis.

Turalio

Generic Name
Pexidartinib

Turalio

Generic Name
Pexidartinib
Form: Capsule
Method of administration: Oral
FDA approval date: February 01, 2023
Classification: Kinase Inhibitor
TURALIO is indicated for the treatment of adult patients with symptomatic tenosynovial giant cell tumor (TGCT) associated with severe morbidity or functional limitations and not amenable to improvement with surgery. TURALIO is a kinase inhibitor indicated for the treatment of adult patients with symptomatic tenosynovial giant cell tumor (TGCT) associated with severe morbidity or functional limitations and not amenable to improvement with surgery. ( 1 )

MethylPREDNISolone Acetate

Brand Names
Medroloan, Medroloan SUIK, Depo-Medrol, Dyural

MethylPREDNISolone Acetate

Brand Names
Medroloan, Medroloan SUIK, Depo-Medrol, Dyural
Form: Injection, Kit
Method of administration: Intra-articular, Intramuscular, Intrasynovial, Intralesional, Soft Tissue, Infiltration, Topical, Intrameningeal, Intra-arterial
FDA approval date: May 28, 1959
Classification: Corticosteroid
A. FOR INTRAMUSCULAR ADMINISTRATION When oral therapy is not feasible and the strength, dosage form, and route of administration of the drug reasonably lend the preparation to the treatment of the condition, the intramuscular use of Methylprednisolone Acetate Injectable Suspension is indicated as follows: A llergic States : Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, serum sickness, transfusion reactions. De rmatologic Diseases : Bullous dermatitis herpetiformis, exfoliative erythroderma, mycosis fungoides, pemphigus, severe erythema multiforme (Stevens-Johnson syndrome). E ndocrine Disorders : Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy, mineralocorticoid supplementation is of particular importance), congenital adrenal hyperplasia, hypercalcemia associated with cancer, nonsuppurative thyroiditis. G astrointestinal Diseases : To tide the patient over a critical period of the disease in regional enteritis (systemic therapy) and ulcerative colitis. Hem atologic Disorders : Acquired (autoimmune) hemolytic anemia, congenital (erythroid) hypoplastic anemia (Diamond Blackfan anemia), pure red cell aplasia, select cases of secondary thrombocytopenia. M iscellaneous : Trichinosis with neurologic or myocardial involvement, tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy. Neoplastic Diseases : For palliative management of leukemias and lymphomas. Nervous System : Cerebral edema associated with primary or metastatic brain tumor or craniotomy. O phthalmic Diseases : Sympathetic ophthalmia, temporal arteritis, uveitis and ocular inflammatory conditions unresponsive to topical corticosteroids. Re nal Diseases : To induce diuresis or remission of proteinuria in idiopathic nephrotic syndrome, or that due to lupus erythematosus. Re spiratory Diseases : Berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy, idiopathic eosinophilic pneumonias, symptomatic sarcoidosis. R heumatic Disorders : As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis; acute rheumatic carditis; ankylosing spondylitis; psoriatic arthritis; rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy). For the treatment of dermatomyositis, polymyositis, and systemic lupus erythematosus. B. FOR INTRA-ARTICULAR OR SOFT TISSUE ADMINISTRATION (See WARNINGS) Methylprednisolone Acetate Injectable Suspension is indicated as adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis, acute and subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, rheumatoid arthritis, synovitis of osteoarthritis. C. FOR INTRALESIONAL ADMINISTRATION Methylprednisolone Acetate Injectable Suspension is indicated for intralesional use in alopecia areata, discoid lupus erythematosus, keloids, localized hypertrophic, infiltrated, inflammatory lesions of granuloma annulare, lichen planus, lichen simplex chronicus (neurodermatitis), and psoriatic plaques, necrobiosis lipoidica diabeticorum. Methylprednisolone Acetate Injectable Suspension also may be useful in cystic tumors of an aponeurosis or tendon (ganglia).

Romvimza

Generic Name
Vimseltinib

Romvimza

Generic Name
Vimseltinib
Form: Capsule
Method of administration: Oral
FDA approval date: February 14, 2025
ROMVIMZA is indicated for treatment of adult patients with symptomatic tenosynovial giant cell tumor (TGCT) for which surgical resection will potentially cause worsening functional limitation or severe morbidity. ROMVIMZA is a kinase inhibitor indicated for treatment of adult patients with symptomatic tenosynovial giant cell tumor (TGCT) for which surgical resection will potentially cause worsening functional limitation or severe morbidity. ( 1 )
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