Baker's cyst, also known as popliteal cyst, refers to a bulge in the kneecap that consists of synovial fluid. In adults (typically 35-70 years old), Baker's cyst usually occurs in connection with or after damage to other structures of the knee. Such damages include spiral injuries, cartilage damage and various ligamentous injuries. A cyst can also arise as a result of rheumatism or arthritis. Cysts can also be found as lateral findings. Unlike in adults, Baker's cyst in children/young people is not usually caused by damage to other knee structures, but the cyst can be congenital, for example. (1,2)
Baker's cyst symptoms
The most obvious symptom of a Baker's cyst is a lump/bulge in the kneecap. The cyst can also be small and found as a side finding when imaging the knee. The cyst can cause a feeling of "tightness" in the kneecap and pain, although Baker's cysts are often asymptomatic. Swelling of the kneecap usually appears especially when standing, while when bending the knee the swelling decreases or even disappears completely. Pain can be provoked by movement and also limit bending and/or extension of the knee. If the Baker's cyst is large, it can press on nerve structures and veins, and if it bursts, the symptoms can be reminiscent of a venous blockage. If there is reason to suspect a venous blockage, you should see a doctor immediately. When the cyst bursts, the symptoms can be sharp pain in the calf and knee and swelling. It may also feel as if water is running inside the calf. (1,2)
Management
If Baker's cyst is asymptomatic, no special treatments are usually needed in addition to self-care. The cyst can also disappear on its own with time. However, adults often have other damage to the structures of the knee in addition to the cyst, which can cause pain. These possible other knee problems should be evaluated separately.
In the early stages of the problem, it may be reasonable to reduce the load on the knee so that the area calms down. The mobility of the knee should be maintained so that it does not stiffen. Anti-inflammatory drugs can also be tried to relieve the pain. If the symptoms do not improve with self-treatment, the cyst can be drained by a doctor. A cortisone injection can also relieve the symptoms. The last straw in cyst treatment is surgery. However, in some patients, the cyst may reappear even after surgery. (1,2)
The author of this article is also currently enjoying an anterior cruciate ligament injury and a subsequent Baker's cyst.
Ilari Keckman
Osteopath, sports massage therapist & educator
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