Our knees get a constant workout day in and day out. Whether we are standing up, sitting down, getting in and out of the car, or crouching over second base, our knee joints are on call constantly to perform. So, it’s no wonder that, on occasion, they have to rebel.
This rebelling can happen one morning when you wake up and feel stiffness in one leg. Reaching around behind your knee, you suddenly feel a lump. You may experience slight pain and find you are unable to extend your leg completely or bend your knee at all. If so, you may have a Baker’s Cyst.
What Is a Baker’s Cyst?
A Baker’s Cyst is a distinct fluid-filled sac that forms in the popliteal space, that shallow depression at the back of the knee. In most instances, pain may be minimal or non-existent, and you may experience only minor discomfort.
But where does the fluid come from that forms that bulge in the back of your knee?
Within the knee, there is fluid, called synovial fluid, which lubricates the knee joint and allows it to bend and extend when you need it to. Production of excess synovial fluid means the fluid has to go somewhere, so it is pushed out into the popliteal space, causing a Baker’s cyst. Actual causes for the excess fluid can vary, including overuse of the knee joint, a cartilage tear, or arthritis.
Symptoms of a Baker’s Cyst
With a Baker’s Cyst, the symptoms may be minor or cause considerable discomfort. These symptoms may include any of the following.
Swelling Behind the Knee
Swelling behind the knee or a noticeable lump or bulge protruding from the back of the knee can be alarming when first noticed. As excess synovial fluid accumulates, it is squeezed out into the space behind the knee and resembles swelling. When you touch the swollen area, you may feel a water balloon-like lump, and as you press gently, the slightly squishy feel confirms that fluid is involved. The swelling will be most noticeable when you stand and compare the back of one knee to the other.
Knee Pain
Another symptom of a Baker’s Cyst is knee pain. This pain may be slight or more pronounced and may spread down into your calf muscle. It can also increase when you bend your knee or attempt to straighten it out. You may find it painful to walk as well. However, if you suddenly experience a sharp pain in the knee area, there is a possibility that the cyst has burst, leaking the fluid into the calf area. This may be accompanied by redness and swelling. If these additional symptoms occur, see your doctor immediately.
Tightness or Stiffness Behind the Knee
A Baker’s cyst may cause tightness of the knee joint and stiffness behind the knee. Due to its location, the Baker’s Cyst may be large enough to prevent bending of the knee or even straightening out your leg fully. A decrease in the knee’s range of motion is another tell-tale symptom of a Baker’s cyst.
Treatments and Remedies
You can attempt to relieve the symptoms of swelling, pain, and stiffness at home. However, you will most likely need to see a doctor at some point for more involved remedies. Below are the most common treatments and remedies available for a Baker’s cyst.
At-Home Treatments
RICE Method
With the swelling, stiffness, and pain you are experiencing, your first potential remedy is the RICE method, which includes the actions of Rest, Ice, Compression, and Elevation. The combination of these four actions will usually reduce inflammation, which is often what leads to the actual swelling, pain, and stiffness.
- Rest the knee by staying off of it as much as possible. If you must move around, try using a crutch or cane to relieve some of the pressure on your leg.
- Apply a cold compress to the space behind the knee. Make sure you have a cloth between the cold pack and your skin.
- Use a compression bandage, such as a lightweight sleeve. This can help the body reabsorb the fluid in the cyst more quickly. A compression sleeve or bandage will also help support the knee joint. Be sure the sleeve is snug but not overly tight, which can disrupt the blood flow to the area. Remove at night.
- Elevate your knee above your heart level, especially at night. Elevating the leg will not only reduce the strain on the knee joint but also reduce the excess swelling.
Anti-Inflammatory Medication
Since symptoms of swelling, stiffness, and pain can be attributed to some type of inflammation in most cases, an over-the-counter anti-inflammatory medication may help. Options for this include
- Aspirin
- Ibuprofen (Advil, Motrin)
- Naproxen (Aleve)
This remedy may relieve the symptom fully or only provide temporary relief of the pain and inflammation. Heed the instructions on how long to take these before seeking the advice of a doctor.
Doctor-Recommended Treatments
When you’ve tried at-home remedies, and they haven’t provided relief of all the symptoms, it’s time to see your doctor. With an initial exam of the knee, your doctor may recommend any of the following treatments.
Corticosteroid Injection
One remedy offered by your doctor may be a corticosteroid injection. Examples of corticosteroids include prednisone, cortisone, and methylprednisolone. The doctor will inject the corticosteroid directly into your joint to help relieve the inflammation and the pain. While this treatment can result in quick relief, it will not prevent a reoccurrence of a Baker’s cyst.
Aspiration
Another remedy for Baker’s cyst is to drain the fluid sac by way of needle aspiration. The procedure involves the insertion of a needle into the cyst, while the doctor is most likely guided by ultrasound. As a result of removing the excess fluid in this way, the symptoms of swelling, stiffness, and possibly even the pain will be relieved instantly. Again though, as with the corticosteroid injection treatment, it will not prevent a reoccurrence.
Physical Therapy
Physical therapy is another potential treatment for Baker’s cyst. Movement and exercises, as well as stretching, can help ease the swelling, the pain, and the overall stiffness caused by the Baker’s cyst. Recommended therapy may include any or all of the following:
- Slow, gentle exercises to help improve the knee’s range of motion
- Strengthening exercises for the hamstring muscles, which are often found to be weak in many who suffer from Baker’s cysts. This may be because weak hamstrings put pressure on the popliteal space where Baker cysts occur.
- Stretching of the hamstring muscles to loosen them up. Tight hamstrings are also common in those who suffer from Baker’s cysts.
- Low-impact exercises, including walking, yoga, or Pilates.
Surgery
When all other remedies fail to provide relief of the swelling, pain, and stiffness, and the cyst still remains bulging out the back of your knee, surgery is the next step. Your doctor may also recommend surgery in specific instances where you are experiencing severe pain or if the size of the cyst makes it difficult for you to move your knee at all, causing discomfort as well as mobility issues.
The surgeon may only need to make a small cut on your knee. However, if extensive knee joint damage is discovered, possibly from an injury, the cyst may need to be removed and repairs made to the joint itself. For this, the doctor inserts a thin, flexible, fiber-optic tube called an arthroscope through a small incision into the knee joint.
Treat the Source of the Cyst
As mentioned previously, a Baker’s cyst is more likely than not the result of another condition within the body. This cause could be a type of arthritis, such as osteoarthritis or rheumatoid arthritis, damage to the knee, such as a ligament tear, inflammation, gout, or trauma. If not treated, Baker’s cysts may reoccur again and again.
Wrap-Up: Avoid a Reoccurrence by Solving the Mystery Behind the Baker’s Cyst
As we have seen, a Baker’s cyst is a fluid-filled sac formed in the back of the knee in the popliteal space due to an accumulation of excess synovial fluid. Although there are various at-home and doctor-recommended treatments to relieve the symptoms of pain, swelling, and stiffness, determining the cause of the fluid accumulation which resulted in the Baker’s cyst is key to preventing a reoccurrence.
If you are experiencing a Baker’s cyst, contact your doctor and be on the way to relief and also to solving the mystery behind that lump in the back of your knee.