Bakers Cyst or Popliteal Cyst- Causes and Treatment

Definition

Bakers Cyst is the type of cyst filled with fluid and causes a bulge and feeling of tightness just behind your knees. It accompanies severe pain which worsens gradually when you fully flex or extend the knee or when you are active.

Also called popliteal cyst, Baker’s Cyst is basically caused due to knee joint conditions like cartilage tear or arthritis. These are the knee joint conditions that cause the knee to create excessive fluid and this leads to Baker’s Cyst. In most of the cases, Baker’s Cyst also causes swelling in the knee area and it makes movement challenging and complicated. Treatment is available for curing the underlying cause which provides relief from Baker’s Cyst.

Causes of Bakers Cyst

There are two different ways in which a Baker’s cyst can form:

Primary or Idiopathic Baker’s Cyst

• This type of Baker’s cyst is formed which forms when synovial fluid from within the joint seeps into the popliteal bursa. The connection between the knee joint and the popliteal bursa causes the cyst to occur.
• This type of cyst is also known as an idiopathic Baker’s cyst. It develops at the back of a healthy knee joint and is mostly observed in younger adults and children.

Secondary Baker’s Cyst

• In the case of a secondary Baker’s cyst an underlying problem like osteoarthritis or tear in the meniscal cartilage that protects the knee joint causes the cyst to form. One of these underlying problems increases the production of synovial fluid inside the knee joint.
• This causes an elevation in pressure on the joint as a result of which the joint capsule stretches and bulges out into the popliteal bursa. As a result of this, a Baker’s cyst filled with synovial fluid is formed.

Risk factors of Bakers Cyst

You may be more likely to get a Baker cyst if you have other problems of the knee joint, such as:

• Osteoarthritis of the knee
• Rheumatoid arthritis of the knee
• Tearing of the pads of cartilage (menisci) inside the knee
• Infectious arthritis

Bakers Cyst symptoms

Often a Baker’s cyst causes no pain. When symptoms occur, they may include:

• Tightness or stiffness behind the knee.
• Swelling behind the knee that may get worse when you stand.
• Slight pain behind the knee and into the upper calf. You are most likely to feel this when you bend your knee or straighten it all the way.

Sometimes the pocket of fluid behind the knee can tear open and drain into the tissues of the lower leg. This can cause swelling and redness in that part of the leg.

Bakers Cyst complications

Recognized complications include:

Dissection: The cyst usually dissects inferomedially but can dissect proximally, anteriorly, intermuscularly or intramuscularly

Rupture: Leaking of cyst fluid into the popliteal fossa, between fascial planes and surrounding the hamstrings and medial gastrocnemius muscles; moreover, there is edema of the soft tissue and irregularity of the cyst wall

Compression: of the popliteal vessels and tibial nerve

Compartment syndrome: Can be either anterior or posterior

Diagnosis and tests

You need a professional medical exam to diagnose a Baker’s cyst. Here are the ways a doctor diagnoses a Baker’s cyst:

Taking a medical history: This will include information on the previous injury to the knee.

X-ray: You will not see the lump through the X-ray, but it will help determine if there is arthritis present in the knee. This can be the cause of Baker’s cyst.

Magnetic resonance imaging (MRI) scans: An MRI uses magnetic waves instead of X-rays to show images.

Ultrasound test: Ultrasound uses sound waves to determine if the lump is solid or filled with fluid

Treatment

Most often, Baker’s cyst does not require treatment and may disappear on its own. However, if the cyst is large and causes a lot of pain, the following treatments may be performed:

Medications: Your doctor injects corticosteroid medications into your knee to reduce pain. However, this doesn’t always prevent the reoccurrence of the cyst.

Fluid drainage: Fluid from your knee is drained using a needle that is guided by ultrasound. Steroid injections sometimes follow fluid drainage to reduce inflammation and pain.

Fluid drainage from bakers cyst

Physical therapy: Your doctor may suggest the application of ice and a compression wrap or crutches to help reduce the pain and swelling. He/she may also include strengthening and range-of-motion exercises for the muscles around the knee.

Physical therapy

Surgery: Your doctor may treat the underlying cause rather than the condition itself. If a cartilage tear is causing the overproduction of synovial fluid, surgery may be determined to repair the cartilage.

Depending on your condition, your doctor will determine the best treatment that will help alleviate your symptoms of Baker’s cyst.

Lifestyle and home remedies

If your doctor determines that arthritis is causing the cyst, he or she may advise you to take some or all of the following steps:

Follow the R.I.C.E. principles: These letters stand for rest, ice, compression and elevation. Rest your leg. Ice your knee. Compress your knee with a wrap, sleeve or brace. And elevate your leg when possible, especially at night.

Try over-the-counter pain-relieving medications: Drugs such as ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, others), acetaminophen (Tylenol, others) and aspirin can help relieve pain. Follow the dosing instructions on the package. Don’t take more than the recommended dosage.

Reduce your physical activity: Doing so will reduce irritation of your knee joint. Your doctor can offer you guidance on how long you need to reduce your activity levels, and he or she may be able to suggest alternative forms of exercise you can do in the meantime.

Prevention of Bakers Cyst

Knee joints are susceptible to injury during sporting activities. Preventing knee injuries from occurring can reduce the risk of a Baker’s cyst developing in the first place or coming back.

Things you can do to prevent knee injuries include:

• Warming up and cooling down before and after exercising or playing sports
• Wearing supportive footwear
• Trying to turn on the balls of your feet, rather than through your knees.

If you injure your knee, stop your activity immediately, apply ice packs to treat the swelling and seek medical advice.