Baker’s Cyst Definition : – It is a bag of fluid that appears as a lump at the back of the knee. It causes stiffness in the knee along with pain.
Understanding a Baker’s Cyst
It is a fluid filled sac that is forms a bump at the back of the knee. It is often packed with synovial fluid that is a greasing fluid found inside the knee joint. It is mostly observed in patients who have an underlying knee condition like osteoarthritis.
The cyst is named after William Baker who first discovered and defined the condition in 1877. A Baker’s cyst is also known as a popliteal cyst as it forms on the area behind the knee that is medically termed as popliteal fossa.
The bulge causes stiffness at the back of the knee with pain that can increase when you straighten your leg, stretch it or extend it while walking.
Some Important Terms
The joint capsule is a thick construction that surrounds the knee and provides backing. It is lined by a distinct membrane called the synovium. The synovium produces a liquid called synovial fluid that acts as a greasing agent for the knee joint and protects it during movement.
There are several tissue sacs next to the knee called bursae. It is a small bag of synovial fluid with a thin lining. They help is decreasing the friction and allow free motion of the joints. The bursa at the back of the knee are called Popliteal Bursa.
Size of a Baker’s Cyst
The average size of a Baker’s cyst is approximately 3.2 centimeters. However, the size can vary from a very small size cyst to a cyst as large as a golf ball. In extreme cases, the cyst can grow up to the size a baseball.
Baker’s Cyst Symptoms
The behavior of a Baker’s cyst cannot be predicted and varies from one patient to another. Some cysts are extremely painful, while some cysts show no pain or symptoms. Below are few symptoms that you can experience if you have a Baker’s cyst:
- Swelling at the back of the knee
- A noticeable bulge behind the knee
- Swelling of the knee joint
- Pain around the knee area
- Pain at the location of the cyst
- Pain of stretching or extending legs
- Difficulty in bending the knee
- Sensation of ticking or locking of the knee
- Stiffness in the knee
- Redness in the affected area
Baker’s Cyst Causes
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 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 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.
Who is an increased risk of developing a Baker’s Cyst?
It is mostly observed in children aged between 4 to 8 years and adults aged between 30-65 years. They are more common in young adults than children. If you have an underlying medical condition like arthritis, then you are at a higher risk of developing a Baker’s cyst.
Which doctor do you need to see for a Baker’s Cyst?
Your first point of consultation will be your general physician or family doctor. However, you will be later directed to an orthopaedic that treats underlying conditions of the knees and other bones in the body.
When to see a doctor?
You must visit your doctor straightaway if you notice any of the following:
- A bulge that is growing rapidly
- An extremely painful cyst
- Unexplained redness
- Leakage of fluid from the cyst
Baker’s Cyst Diagnosis
To determine if the bulge behind your knee is actually a Baker’s cyst, your doctor may carry out or recommend the following:
- Perform a thorough physical examination of the bulge and your knee joint
- Compare the affected knee with your healthy knee
- Ask questions related to your medical history and underlying medical conditions associated with the knee
- Shine a light through your swelling to check if it is filled with fluid
- An ultrasound
- X-ray of the knee joint
- Magnetic Resonance Imaging (MRI) for detailed study of the knee joint and presence of injured cartilages.
How to prepare yourself for the appointment?
Your first appointment can take place at your general physician’s or orthopaedics’ clinic. Follow the simple to-do steps below to have a perfect appointment session:
- Note down your symptoms including those which are not directly related to the Baker’s cyst
- Write down a short summary of your medical history and on-going treatment and medications (if any)
- Make a list of questions that you may want to ask your doctor about Baker’s cyst like:
- What caused the cyst to grow?
- What sort of diagnosing testing will I require?
- Is the cyst short lived or permanent?
- Why is the cyst so painful?
- Why am I facing trouble while exercising?
- What is the line of treatment?
- Will there be any side effects?
- Should I cut down on my activity to avoid pain?
- Is the cause of my cyst Arthritis?
- I accidentally injured my knee joint last month, is that the cause of the cyst?
- Meanwhile, also be ready to answer the following questions that your doctor may ask you:
- When did you first notice the symptoms?
- Did you have a knee injury off lately?
- Do you have an underlying knee condition or ailment?
- Do you experience knee locking or ticking?
- What is the degree of stiffness?
- Is the cyst painful?
- If yes, how severe is the pain?
Baker’s Cyst Complications
Complications associated with a Baker’s cyst are uncommon and hardly occur. Some of them are:
- Extreme pain
- Redness of the cyst
- Inflammation in the surrounding area
- Leakage of the cyst
- Continued swelling
These cysts can become severely complicated if the cyst starts leaking and the synovial fluid spreads down to the inner legs near the calf area. It can cause a bruise under the inner ankle which is often painless or swelling of the calf area which is often painful.
Baker’s Cyst Treatment
A Baker’s cyst often subsides and disappears on its own after a certain period of time. However, in some cases, the cyst does not go on its own and requires treatment. It can persist for months or even years. Also, it can rapidly grow and cause severe pain. Based on the symptoms and complications, your doctor may suggest any of the below course of treatments:
Treatment of the Underlying Knee Condition
If the cause of the Baker’s cyst is an underlying knee condition like osteoarthritis, then it is important that you get it treated immediately. This may help in decreasing the size of the cyst and the inflammation. In some cases of osteoarthritis, a steroidal injection is often used to bring down pain and swelling. In case of injury to the meniscal tear, treatment may be administered to help in recovery.
Treatment to provide symptomatic relief
The following treatment methods may be helpful in providing relief from symptoms like pain and swelling:
Medication :- Your doctor may inject a corticosteroid medicine to reduce inflammation. Alternately, NSAIDS (non-steroidal anti-inflammatory drugs) like ibuprofen can be prescribed to bring down pain and swelling of the cyst. These medications help in providing relief from symptoms but do not prevent the cyst from recurring.
Ice Packs :- You can create ice packs by wrapping ice cubes in a towel or plastic case. Apply the pack of 15-20 minutes to bring down swelling and pain. Do not apply ice directly over the cyst as it can result in an ice burn.
Physiotherapy :- A physiotherapist can help you get rid of your knee stiffness and help you in strengthening your joints and keep them moving without much pain or trouble.
Crutches :- Crutches can help you walk freely without pain as they allow putting your body weight on them than your knee joint. During the course of treatment, you can use crutches to walk or move from one place to another.
Treatment to remove the Baker’s cyst
Drainage of fluid
Your doctor may drain the synovial fluid from the cyst using a needle called an aspiration needle. This procedure is performed under the supervision of ultrasounds.
Surgical removal of the cyst
If the cyst is extremely large and painful, the cyst may be removed using open surgery. During the surgery, your doctor may remove the inflamed synovium tissue that is the cause of the cyst formation. This type of surgery is known as an arthroscopic surgery. A keyhole method may also be used to disrupt any connection between the Baker’s cyst and the knee joint.
Baker’s Cyst Home Remedies
Try the home remedies and prevention methods mentioned below to get rid of a sebaceous cyst quickly:
Ice Compress :- You can make ice packs by packaging ice cubes in a towel or plastic case. Apply the pack of 15-20 minutes to bring down swelling and pain. Do not apply ice directly over the cyst as it can result in an ice burn.
Alternating Hot and Cold Compress :- Place a bucket of ice cold water and hot water side by side. Place a towel in both the buckets alternately and place it over the cyst in an alternating fashion for 30-45 seconds each. Continue the hot and cold procedure for 15-20 minutes and repeat 4-5 times a day. Ensure that the water is not very hot or very cold to avoid burning your cyst or the skin.
Apple Cider Vinegar :- It comes handy in eliminating fluid and freeing up the joints. All you have to do is mix a tablespoon of organic apple cider vinegar with a teaspoon of honey in a glass filled with lukewarm water. Consume the mixture 3-4 times a day before each meal for best results.
Cold Pressed Castor Oil :- Soak a cotton ball in castor oil and dab it on the Baker’s cyst gently at least 3 times a day. This will help in reducing the size of the cyst. The only thing to remember that the cold pressed oil should be a branded one and not any local oil.
Turmeric :- Turmeric can help a great deal in breaking open the cyst and healing it naturally. All you have to do is, boil half a teaspoon of turmeric in one cup of water. Drink the mixture every night before sleeping. Continue the remedy for ten days and you will notice changes in the cyst size and formation.
You can also make a paste of turmeric and mint and apply it directly on the cyst for half an hour. Similar remedy can also be used for sebaceous cyst or pilonidal cyst.
Baking Soda :- Prepare a mixture of baking soda, salt and water and apply the paste on the cyst. Baking soda has marvellous pH controlling properties which prevents bacterial growth and helps in keeping bacterial infections at bay.
Epsom Salt :- You can bathe in a lukewarm Epsom salt bath to get help from pain. It contains magnesium sulphate which helps in providing relief from pain.
Tea Tree Oil :- A super anti-inflammatory and anti-bacterial remedy, tea tree oil helps in dealing with bacterial and fungal skin infections and infections of the cyst. You can prepare a mix of tea tree oil and water and apply it directly on the cyst. It should contain the ratio 9:1. You can also apply few drops of tea tree oil on the cyst directly and cover it. It can also be used for treating sebaceous cyst (Click here to know more about sebaceous cyst) and pilar cyst (for more information on pilar cyst Click here).
Fresh Herbs :- Herbs like celery seeds; turmeric, black pepper and cinnamon act as powerful anti-inflammatory natural agents and can help in reducing knee inflammation. Make use of these herbs in your day to day meals as much as possible.
Keep a check on your physical activity
To avoid pain and swelling from increasing, try to rest as much as possible and keep your leg elevated, especially at night.
What is the recovery time for a Baker’s cyst?
Recovery time completely depends on the course of treatment undertaken by you. With the right medications, remedies and treatment, the cyst can heal rapidly within a matter of days or just few weeks. In case of an open surgery, the cyst or the operated area may take 1-2 months to recover.
Baker’s Cyst Pictures
Preview through these pictures of Baker’s cysts to get an idea of how they look.
Image : – Anatomy of the knee joint
Image :- Baker’s cyst in a patient with Rheumatoid Arthritis
Image :- Steroidal injections for a Baker’s cyst
Image :- Location of a Baker’s cyst
Note: None of the images here are owned by me and nor do I have any copyrights over them.