Baker's Cyst or Popliteal Cyst

What is Baker's Cyst or Popliteal Cyst?

A swelling that is prominent at the back of your knee could be a Baker's cyst or popliteal cyst. When you are active and fully flexing the leg or when you extend your knee is when the symptoms of the baker's cyst or popliteal cyst worsen.

The problem of the knee joint gives rise to baker's cyst or popliteal cyst. Conditions like tear of the cartilage and arthritis are examples. Baker's cyst or popliteal cyst can occur due to the production of too much fluid by the knee.

Relief is attainable when the underlying problem causing baker's cyst or popliteal cyst is treated properly despite the uncomfortable swelling caused.

Baker's Cyst or Popliteal Cyst

Facts about Baker's Cyst or Popliteal Cyst

Baker's cyst or popliteal cyst condition generally arises as a result of some other medical disorder which has resulted in swelling of the knee joint. Since the communication with the synovial sac is generally maintained, the baker's cyst or popliteal cyst is not considered as a "true" cyst. If swelling is present behind the joint, then there is resultant bursal swelling too. As a result of a medical condition, the synovial fluid present within the knee joint increases and gets into the bursa posterior to the knee which results in the increased size leading to formation of baker's cyst or popliteal cyst.

  • Any condition giving rise to joint swelling like arthritis can commonly cause baker's cyst or popliteal cyst.
  • Fluid protrudes towards the back of the knee from the knee joint, causing a swelling of baker's cyst or popliteal cyst.
  • Symptoms might not be caused by a baker cyst also knee pain and tightness at the posterior part of the knee during full flexion and extension.
  • If the baker's cyst or popliteal cystrupture it results in complications owing fluid spread downward the leg between muscles at the leg's calf (dissection).
  • Medication can treat baker's cyst or popliteal cyst also cortisone injection and aspiration and not forgetting surgery which is often arthroscopic surgery.
  • In children, Baker's cyst resolves on its own.
  • There is approximately 40% chance that Baker's cyst may recur in children who undergo surgery.

Why is Baker's Cyst or Popliteal Cyst Given Such a Name?

A development behind the knee which is fluid-filled is called a baker's cyst. The doctor who described the condition in 1877 was called William Baker and hence the name. Because the side of the knee that is affected is called the popliteal fossa, baker's cyst is called popliteal cyst in some instances.

Where is the Location of Baker's Cyst or Popliteal Cyst?

Baker's cyst or popliteal cyst affects the location behind your knee forming a swelling of the part called popliteal bursa.

Is the Prevention of Baker's Cyst or Popliteal Cyst Possible?

You can only minimize any disease that can be contributing to baker's cyst or popliteal cyst like arthritis because no prevention is available.

What Causes Baker's Cyst or Popliteal Cyst?

Friction between the parts of the knee that moves can be reduced by the use of synovial fluid which lubricates the leg and smoothen its swinging.

Too much of synovial fluid is produced by the leg sometimes. The fluid accumulates behind your knee forming a swelling (popliteal bursa) which leads to baker's cyst or popliteal cyst. The reason for this occurrence is:

  • The knee joint is inflamed, just like in many arthritis incidents.
  • Injury to the knee like tear of the cartilage.

The main cause of the baker's cyst or popliteal cyst in young athletes can be a torn cartilage meniscus. In athletes, who are much older, arthritis and cartilage tear can be a potential cause. Any sort of injury or trauma to the knee joint can result in swelling and formation of a baker's cyst or popliteal cyst. There can be baker's cyst or popliteal cyst present in children but that does not necessarily point to an underlying joint disease. Majority of the baker's cyst or popliteal cyst have direct contact with the synovial cavity of the knee. A ruptured baker's cyst or popliteal cyst results in acute pain behind the knee which radiates to the calf causing swelling of the calf muscles.

What are the Signs and Symptoms of Baker's Cyst or Popliteal Cyst?

No pain is caused by baker's cyst or popliteal cyst symptoms in most cases and thus noticing can be difficult. The signs and symptoms if you have them may include:

  • Rear part of the knee swells and also the leg, in some instances.
  • Pain in the knee
  • Inability of flexing the knee and stiffness.
  • Round shaped, golf ball sized, swelling.
  • Pressure sensation in the back of the joint which radiates into the muscle of the calf.
  • Reduced joint flexibility.
  • Pain and tenderness with physical activity.
  • If the lump is observed in the dark with the help of a torch, then it is noticed that there is a red colored glow to it indicating that the cyst is fluid-filled.
  • A ruptured Baker's cyst results in acute pain in the calf with swelling and redness. An affected individual can get symptoms resembling a thrombophlebitis or a DVT which poses a potential threat to the life of the individual. These conditions need to be ruled out by blood draws and ultra-sonogram. It is very rare where Baker's cyst is shown to compress vascular structures resulting in leg edema and DVT.

What are the Complications for Baker's Cyst or Popliteal Cyst?

Although it is rare for baker's cyst or popliteal cyst to leak and spread to the calf region, and cause:

  • Sharp knee pain
  • Calf swelling
  • You will feel water run down your calf and sometimes redness of the calf.

The symptom that results closely resembles a blood clot that has happened in your leg. In order to rule out complications that are more serious which might be causing the symptoms, you will require prompt medication.

What Tests are Conducted to Diagnose Baker's Cyst or Popliteal Cyst?

A detailed knee examination is conducted to determine the exact cause of the swelling. Physical examination can also confirm a diagnosis. Baker's cyst or popliteal cyst is easily visible if the affected person stands with the knees fully extended. It can also be palpated easily when the knee is partially flexed. Ultrasonography and MRI gives a confirmatory diagnosis. To aspirate the synovial fluid, it is necessary to rule out a popliteal artery aneurysm.

Asymptomatic baker's cyst or popliteal cyst generally do not require treatment till the time they become symptomatic. Rarely, an individual gets symptoms from the cyst. In majority of cases, the symptoms are produced due some other knee disorder such as arthritis, meniscal tear, etc.

A physical test is often conducted for the diagnosis of baker's cyst or popliteal cyst. A noninvasive imaging test can be ordered by your doctor if the symptoms of baker's cyst or popliteal cyst resemble those of a condition that is more serious, and it includes:

  • X-ray tests
  • Ultrasound tests
  • Magnetic Resonance Imaging (MRI)

How is Baker's Cyst or Popliteal Cyst Treated?

What is the Cure for Baker's Cyst or Popliteal Cyst?

Baker's cyst or popliteal cyst might disappear sometimes, on its own. The following treatments can be recommended by your doctor if you are having pain and the baker's cyst or popliteal cyst is large:

  • Medications: Corticosteroid medications like cortisone can be injected into the knee, by your doctor, to minimize inflammation. The baker's cyst or popliteal cyst recurrence cannot be prevented by this but pain will be relieved.
  • Drainage of the fluid to Treat Baker's Cyst or Popliteal Cyst: A needle can be used by your doctor in order to drain the fluid from your knee. The procedure is known as needle aspiration and is performed with the guidance of an ultrasound in most cases.
  • Physical Therapy Treatment for Baker's Cyst or Popliteal Cyst: The swelling and the pain can be reduced by compression wrap, crutches and icing. The preservation of the knee function and the reduction of symptoms can be achieved through the muscle strengthening exercises and a range of motion that are gentle.

The underlying cause regarding your baker's cyst or popliteal cyst can be treated by doctors. If the cause of the flow of the synovial fluid is the cause of cartilage tearing surgery might be recommended by the doctor to repair or replace the damaged cartilage. Treatment of arthritis helps in treating baker's cyst or popliteal cyst that is linked with osteoarthritis. It is rare to need surgical intervention.

When is Surgery Recommended for Baker's Cyst or Popliteal Cyst?

Surgery is always performed when the baker's cyst or popliteal cyst is especially painful and vary large and considering the inefficiency of the treatments that have been tried. Keyhole method is sometimes used in closing the bridge between the knee joint and the baker's cyst or popliteal cyst. Open surgery is sometimes used to remove the baker's cyst. An underlying problem can be treated at the same time when the surgery is done, such as the repair of a torn meniscus.

What is the Treatment of Ruptured Baker's Cyst or Popliteal Cyst?

Fluid leak can result owing to a burst (rupture) of the baker's cyst or popliteal cyst. Tightness, pain and redness occur in the calf as a result. It will take a few weeks for the body to reabsorb the fluids. Rest and elevation (raising the affected calf) is the treatment that is recommended for a Baker's Cyst or Popliteal Cyst that is ruptured.

Painkillers prescription like paracetamol and codeine combine often can control the pain when used and thus seek a prescription from your general physician (GP).

Home Treatment for Baker's Cyst or Popliteal Cyst

If arthritis is causing your baker's cyst or popliteal cyst after the doctor determines, the following steps might be the best home treatment for bakers cyst or popliteal cyst:

  • Best Home Treatment for Bakers Cyst or Popliteal Cyst Would be Following the R.I.C.E. principles: Rest, ice, compress and elevation are what these letter stands for.
  • Rest the leg, ice the knee, use a wrap, brace or sleeve to compress the knee. Whenever possible elevate the leg, particularly at night.
  • OTC (over the counter) medication is worth trying. Ibufren (Advil, Motrin IB others) acetaminophen (Tylenol, others) aspirin and naproxen sodium (Aleve, others) are such drugs. Adhere to the instructions that are stated in the package and avoid overdosing.
  • Reduction of physical activity. Your knee will be less irritated when you do so. The duration of which you will be required to relax will be obtained through the guidance of the doctor and alternative forms can be suggested by him or her in which you can engage in, in the meantime.
  • Prolotherapy is shown to be effective in treating baker's cyst or popliteal cyst.
  • The affected knee joint needs to be rested adequately and the leg needs to be elevated.
  • A compressive wrap can be used to help support the knee and reduce the swelling associated with Baker's Cyst or Popliteal Cyst at home.
  • Physical therapy can be of help with stretching and strengthening the quadriceps and/or the patellar ligament.
  • Using ice packs can also be effective home treatment for Bakers Cyst or Popliteal Cyst.
  • Heating pads are also useful for pain relief associated with Bakers Cyst or Popliteal Cyst.
  • Activities that need to be restricted are squatting, kneeling, heavy lifting, climbing and running in order to prevent pain.
  • A knee brace when used gives support and stability to the joint.
  • Analgesics such as paracetamol who also have additional antiinflammatory action like ibuprofen or naproxen can be effective.
  • Patient should not do any physical activities for about 12 weeks after surgery.
  • Although any lump behind the knee usually is a baker's cyst or popliteal cyst but there is a possibility that it can be a tumor or aneurysm, so it is imperative that the patient seeks medical attention immediately for a definitive diagnosis.

What Exercises are Recommended for Baker's Cyst or Popliteal Cyst?

Knee injury or arthritis causes baker's cyst or popliteal cyst most commonly. The swell is due to fluid build ups at the joint which flows and collects causing at the bursa.

Various treatment options are available for a baker's cyst or popliteal cyst like ice, medication and injections but exercise is the most effective more so to the prevention of recurrence problem.

Baker's cyst or popliteal cyst is most commonly contributed by the muscle tightness. Tightening of the hamstring (muscle behind the thigh) aggravate a popliteal cyst because extra pressure is placed on the bursa. This is an indication that more pressure is put on the any time when the knee moves which will lead to increased swelling and owing to inflammation and thus baker's cyst or popliteal cyst is aggravated and as a result pain is caused behind the knee.

A physical therapist (PT) is the person to be sought in order to conduct careful analysis and to allow you discern if the tightness of your muscle is the main contributing factor to the pain in your knee due to baker's cyst or popliteal cyst. Nevertheless, you can discern any tightness by using test that are simple and can be tried at home. You can find these tests in our stretches section below.

You can help the knee affected with baker's cyst or popliteal cyst through several ways that differ of hamstring stretching. Different position is taken when doing each that is sitting, standing and lying down and thus, it is wise for you to use that suits you best because there is no need of doing all three, a couple of them are enough.

Standing Hamstring Stretch Exercise for Baker's Cyst or Popliteal Cyst

The first step is to get a chair or stool which is supposed to be approximately one and a half feet in height. One foot should be left on the floor and lay the other foot at the stool at and the knee must be bent slightly at an angle of 15 degrees.

Now, lean down and forward, while your back is straight, until you feel that you have stretched the center of the back thigh. Repeat three times twice every day before exercise and after.

An alternative approach is, if you cannot feel enough stretch, in the leg that is being stretched, lean forward as well as to the side slightly and more stretch can be felt.

Lying Hamstring Stretch Exercise for Baker's Cyst or Popliteal Cyst

Start with lying flatly on your back. In order to be stretched, bend the knee while holding the back of the thigh with one hand and use the other hand to hold the calf.

Now, bent the knee in a 20 degrees position and use the hands to pull it towards you. Do it until a stretch emanates at the middle of the thigh (at the rear). Do this for 30 seconds. Repeat this, three times twice daily prior to and after exercise

An alternative approach would be to hook a towel around the leg if you are unable to reach the leg. Pull it instead until the same stretch is attained.

Seated Hamstring Stretch Exercise for Baker's Cyst or Popliteal Cyst

Firstly, bend your leg while you have seated on a chair's edge. Slightly been the knee while the bad foot is in front.

While you have kept the head up and the back straight, lean forward until you experience a stretch in the back of the thigh. Do it for 30 seconds. Repeat this exercise thrice at a time and do it twice daily.

In order to achieve the best results from the exercise of the knee with baker's cyst or popliteal cyst, keep this in mind. You must be uncomfortable moderately when you stretch effectively, but it is only muscle stretch which stops as soon as one stops stretching.

The stretch must be felt in the middle of the thigh following each of the baker's cyst or popliteal cyst exercise and it must not be at the knee. This can be achieved by bending the knee slightly. An effective stretch is the target of the muscle belly rather than the tendon at the knee's rear.

What is the Prognosis for Baker's Cyst or Popliteal Cyst?

The general outlook is good basing on the baker's cyst or popliteal cysts' cause. Recurrence is prone to happen regarding those accruing from chronic arthritis.

Prognosis for surgery. Whatever that might be behind the cause of the swelling, a surgeon might be needed to operate in order to correct it, which include, foreign bodies, bursa or cartilage meniscus which needs removal. The healing of the surgery might take 8-12 weeks.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: November 4, 2015

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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