What Is A Synovial Cyst?
Synovial Cysts are benign fluid filled cysts that develop due to degeneration of the facet joints in the lumbar spine.1 Since these cysts form due to degeneration of the joints hence they are usually found in people above the age of 50. Synovium is a fluid which facilitates lubrication of the joints. When the facet joints start to degenerate then slowly this fluid starts to build up and takes the shape of a cyst and creates pressure on the nerves of the spinal cord.
What Causes Synovial Cyst?
As stated, Synovial Cysts are caused due to degeneration of the facet joints. As a matter of fact, Synovial Cysts can develop at joint lubricated by synovium, but it is most common in the spinal cord and is one of the reasons for spinal stenosis.2 An individual suffering from Synovial Cysts will have back pain when standing as this increase the pressure on the nerves and is relieved by sitting down. It is believed that Synovial Cysts develop due to this extra buildup of synovial fluid which is formed due to degeneration of the joints. The cyst itself is not a cause of worry as it is fairly benign but it may be a cause of various neurological problems like spinal stenosis, cauda equina syndrome, or bowel or bladder disturbances.
What Are The Symptoms Of Synovial Cyst?
The symptoms experienced by a patient affected with Synovial Cyst are variable and depend on the size of the cyst. Some of the symptoms experienced are:
- Low back pain which increases with activity and eases off with rest
- Back pain radiating to the legs is another symptom of synovial cyst 3
- Narrowing of the spinal cord in people having synovial cyst
- Neurological issues like numbness or tingling, muscle weakness in the lower extremities, and footdrop are associated with synovial cyst
- In some cases among people suffering from synovial cyst, there may also be presence of neurogenic claudication.
How Is Synovial Cyst Diagnosed?
In order to confirm the presence of Synovial Cysts, the treating physician will first take a history as to when the symptoms started and if there are any other symptoms observed by the patient. After that, the physician will order radiologic studies in the form of an MRI confirmatively diagnoses a Synovial Cyst.3 The physician may also order x-rays to check the stability of the spine, as spinal degeneration usually causes instability of the joint. If joint instability is present along with a Synovial Cyst then the treatment for it becomes that more complex.
How Is Synovial Cyst Treated?
The mainstay of treatment for Synovial Cysts is activity modifications, injections, pain medication for relieving pain. If the Synovial Cysts are quite small and is not causing a lot of hindrance to the person while performing daily activities then the treating physician may adopt a wait and watch approach to see if the symptoms may improve on its own. The physician will also recommend activity modifications in the form of limited standing and bending so that there is not much stress put on the nerves of the spine. Adequate rest periods will also be recommended to people suffering from synovial cyst. The physician will also recommend application of heat alternating with ice for about 15-20 minutes at the affected region. Pain medications may also be prescribed in the form of Naprosyn or tramadol to control pain associated with synovial cyst. Exercises will also be recommended for the back to strengthen the back and increase its stability. The patient will be advised to walk about a mile a day if possible on a regular basis.
Most of the symptoms of synovial cyst will go away by following the above treatment method. In some cases if the symptoms do not improve by conservative treatment then surgery will be recommended to remove the synovial cyst in its entirety and relieve pressure on the nerves. If back instability is also present along with Synovial Cyst then surgery will also be done to restore stability of the back.
By following the above nonsurgical methods diligently and following the physician’s recommendations more often than not all the symptoms will go away caused by Synovial Cysts.