A small lump develops behind your knee. It causes pain and stiffness, making it difficult to move your body’s largest joint.
What could it be? Most likely, a Baker’s cyst.
“Baker’s cyst is a very common issue affecting the knees and quality of life,” says Dr. Cory A. Messerschmidt, FAAOS, a board-certified, fellowship-trained orthopedic surgeon at Beaufort Memorial Orthopaedic Specialists. “Fortunately, it is usually easy to treat and rarely requires surgical intervention.”
Recognizing and treating this common condition helps you regain mobility and get back to life.
Read More: What Meniscus Tear Symptoms May Mean for Your Knee
What Causes the Cyst
Your knee joint can move smoothly thanks to synovial fluid. This thick lubricating fluid allows your knee to move back and forth without pain. It serves as a protective barrier, protecting and cushioning the parts of the knee while moving. Get too much synovial fluid, and pressure builds up. The excess fluid may then flow into the area behind your knee. The result is a Baker’s cyst.
Though these cysts affect people of all ages, they’re more common in older adults. They can be the result of any knee problem that results in swelling or inflammation.
According to the National Institutes of Health, common causes include the following:
- Arthritis in the knee
- Gout
- Rheumatoid arthritis
- Torn meniscal cartilage
Read More: Knees and Osteoarthritis
Symptoms of Baker’s Cyst
Many Baker’s cysts cause no symptoms. Others, especially as they grow larger, may cause the following:
- Feelings of tightness or stiffness behind the knee
- Knee and lower leg swelling
- Knee pain
- Lump or full feeling behind the knee (may feel like a full water balloon)
Some of these cysts can become so full that they burst. If this happens, you may experience pain, bruising and swelling on the calf and back of the knee. This can lead to additional complications. Before this point, Dr. Messerschmidt encourages you to notice the symptoms and take action.
“A blood clot in the leg can cause the same symptoms as a Baker’s cyst,” Dr. Messerschmidt says. “Therefore, it’s important to seek medical attention if you notice symptoms to make sure there isn’t something more serious going on.”
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Diagnosing Baker’s Cyst
Your primary care provider or orthopedic specialist can often detect a Baker’s cyst during an office visit. To do so, your healthcare provider will take the following steps:
- Review your medical history — Your health provider will ask whether you’ve experienced a knee injury that may allow synovial fluid to leak into the area behind the knee. You’ll also discuss the symptoms that may indicate the presence of a cyst.
- Perform a physical examination — Your health provider will compare your two knees to determine how much difference there is in the affected knee. During this exam, your care provider reviews knee stability, range of motion, stiffness, swelling and other signs that may indicate a Baker’s cyst.
In the event your healthcare provider needs more information, imaging services can help. Imaging exams that your care team may use for an inside look at your knee include:
- Magnetic resonance imaging (MRI) — MRIs help visualize muscles, tendons and other soft tissue. This scan can help find a torn meniscus, get more insight into your cyst or find other issues affecting your knee.
- Ultrasound — With this technology, your healthcare provider can view the problem area behind your knee. In the process, your health provider can determine if the cyst contains fluid or is solid.
- X-ray — Your healthcare provider may prescribe an X-ray to look for signs of arthritis, joint abnormalities or other bone-related issues.
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Treatment Approaches for Baker’s Cyst
Every Baker’s cyst is unique. Proper treatment should be as well.
“Treating a Baker’s cyst depends on the cyst and its symptoms,” Dr. Messerschmidt says. “Finding and choosing the appropriate treatment approach leads to fast, long-lasting results.”
Talk with your healthcare provider to determine the best treatment approach for you.
Watchful Waiting
When a Baker’s cyst doesn’t cause symptoms, you may not need to treat the condition. Rather, you can simply monitor the cyst. If it begins to grow or cause symptoms, contact your care provider. It may be time to treat the cyst.
However, the American Academy of Orthopaedic Surgeons states that most Baker’s cysts will go away on their own. So, don’t be surprised if the lump behind your knee heals itself, leaving you with nothing to monitor.
Conservative Treatment
Cysts that cause symptoms require some sort of intervention. Dr. Messerschmidt states that Beaufort Memorial orthopedic specialists always start with the least invasive option first.
Conservative treatment approaches your care team may recommend include:
- Aspiration — Your healthcare provider drains fluid from the cyst through a thin needle. Before the office procedure, your care provider will numb your knee.
- Injections — A steroid injection from your healthcare provider helps reduce inflammation and promote healing. This injection only takes a moment and may provide quick relief.
- Lifestyle changes — By not running or participating in any other activity that causes pain or other symptoms, you give your leg time to heal.
- Medications — Nonsteroidal anti-inflammatory drugs (NSAIDs) help manage pain and swelling caused by inflammation. Over-the-counter options include naproxen and ibuprofen.
- Physical therapy — A physical therapist works with you to perform special strengthening and range-of-motion exercises. These help to reduce your pain and the size of your cyst.
Surgical Care for Baker’s Cyst
When other treatment approaches are ineffective, surgery may be necessary. Surgery may be used to correct a torn meniscus or other root cause of your cyst. In rare cases, an orthopedic surgeon will perform surgery to remove the cyst.
No matter what treatment your healthcare provider prescribes, the goal is to cure your cyst and address whatever caused the cyst in the first place.
“Just getting rid of the cyst will help improve symptoms right away, but it may not provide lasting relief,” Dr. Messerschmidt says. “The only way to move past a Baker’s cyst and prevent them in the future is by treating any underlying condition that caused the cyst.”
Call 843-522-7435 to find an orthopedic specialist at Beaufort Memorial or request an appointment online.
