Frequency

Symptoms

Patients with a Baker cyst report recurrent knee and upper calf pain located on the back of the leg. In some cases, only an uncharacteristic feeling of tension in the hollow of the knee is reported. However, the extent of the complaints depends on the degree of activity of the fluid formation.

After exertion, a Baker’s cyst typically swells up considerably and, if left untreated, may no longer be detectable after a few days. Accordingly, the symptoms usually fluctuate with the degree of stress, corresponding to the tension of the fluid-filled cyst. Once the Baker’s cyst has reached a certain size, the pain can also occur completely independent of stress.

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Baker cyst symptoms
Acute knee pain – This may be the cause

In most cases, affected persons feel a feeling of pressure in the hollow of the knee. Depending on the size of the Baker’s cyst, from about 2 cm upwards, it can be felt well in the hollow of the knee. The symptoms also depend on the physical activity.

The more active the affected person is, the more pronounced and severe the complaints are. Pain can occur especially when bending the knee. In addition, a strong pain can be provoked by pressure in the hollow of the knee.

Depending on the size and displacement of the surrounding tissue, Baker cysts can simulate lower leg thromboses by compressing vessels. If the cyst compresses nerves in the hollow of the knee, sensory disturbances such as numbness or paralysis may occur in the lower leg or even in the foot. In addition to palpation, ultrasound or magnetic resonance imaging can also help to confirm the diagnosis.

If a rupture in the Baker’s cyst occurs in the course of the symptoms, the fluid from the cyst can spread into the surrounding tissue and the pain becomes worse. In addition, the fluid from the cyst may spread to the muscles of the lower leg. This causes a strong inflammatory reaction, which is accompanied by severe pain and swelling. These are symptoms that can resemble deep vein thrombosis. Therefore, it is important to exclude differential diagnoses such as thrombosis during the closer examination.

Diagnosis

The diagnosis of a Baker’s cyst can generally be made relatively easily, if the physician considers this diagnostic option, from a combination of medical history, symptoms, clinical and diagnostic examination. In pronounced forms, the Baker’s cyst protrudes into the hollow of the knee, medium sizes can usually be palpated in the classic position, small Baker’s cysts can usually only be visualized with diagnostic methods. The following diagnostic methods can help to confirm the diagnosis:

An ultrasound examination (sonography) of the popliteal fossa can detect a Baker cyst and show its location and size.
Conventional x-rays can reveal arthrotic changes (wear and tear as the cause of the cyst) in the knee joint. – A magnetic resonance imaging (MRI) of the knee can also show the exact anatomical location and the connection to the joint capsule. However, Baker’s cysts sometimes cause diagnostic problems due to unusually bizarre, even very long tubular configurations in bleeding with and without ruptures.

An MRI is certainly not necessary for the detection of a classic Baker cyst. However, since the cause of a Baker’s cyst must always be treated, the MRI provides helpful additional information about concomitant injuries, such as meniscus tears or the degree of arthrosis. – Thigh (Femur)

Kneecap (patella)
Knee joint (Articulatio genu)
Shin bone (tibia)
Baker’s cyst (politeal cyst)

If the Baker’s cyst does not cause any symptoms, treatment is not necessarily required.

If the mobility of the knee is restricted by the cyst or if pain occurs, there is the possibility to undergo conservative therapy and surgery. This depends on the extent of the swelling and the symptoms it causes. If symptoms occur, anti-inflammatory drugs such as diclofenac or ibuprofen can be given.

In very acute, painful cases, a cortisone injection can also be helpful. However, the method with cortisone is not the method of first choice due to the side effects. Furthermore, additional measures such as physiotherapy or physical therapies can help to improve the symptoms.

However, it is important to note that the cause of a Baker’s cyst is often an underlying disease of the knee joint, which is accompanied by chronic joint effusions such as cartilage or meniscus damage. For this reason it is essential to repair the causal damage. If this underlying disease is successfully treated, a Baker’s cyst can regress on its own during the course of therapy.

You can find more on this topic here: Baker’s cyst treatmentWhen the size of a Baker’s cyst increases and functional impairment is caused by disturbance of surrounding structures such as blood vessels and nerves, surgery should be considered. In this case the Baker’s cyst is removed surgically. On the one hand, the cyst can be removed surgically, in which an incision is made in the hollow of the knee, the cyst is freed from surrounding structures and after constriction at the stem of the cyst is removed completely.

The joint capsule is then closed. In this way, one tries to avoid recurrences. In addition, it is also possible to puncture the cyst and aspirate the fluid.

With this procedure, however, it is likely that the cyst will come back, i.e. a relapse will occur. In addition, the underlying disease should be removed before the cyst is removed, because otherwise there is a possibility that the Baker’s cyst will reappear. You can find more about this topic here: Baker cyst surgeryThe puncture is an important part of the treatment options for a Baker cyst.

In this procedure, the treating physician inserts a needle into the cyst and uses it to remove the fluid contained in the cyst. Besides a purely conservative or surgical therapy, puncture represents a kind of compromise of these strategies. However, it should be noted that puncture is only a treatment for the symptoms of a Baker’s cyst and cannot treat the inflammation, and thus the cause of the cyst’s formation.

For this reason, other therapies are often combined with the puncture of a Baker’s cyst in order to achieve the best possible treatment success. The aim of these therapies is to prevent the cyst from refilling. For example, anti-inflammatory drugs can be taken, or the deflated cyst can be flushed with cortisone.

A bandage which is wrapped around the knee joint can also contribute to a successful treatment. The puncture of a Baker’s cyst is not without complications and for this reason should only be performed after an intensive medical consultation. If the puncture is unsuccessful, surgical removal of the cyst may be considered.

You can find more about this topic here: Baker’s cyst punctureIn addition to a variety of available therapies to treat a Baker’s cyst, the use of homeopathic remedies is a popular way for patients to treat the cyst themselves. It should be noted that the therapy of Baker’s cyst with homeopathic remedies cannot be recommended from a medical point of view as there is no evidence that the available homeopathic remedies have a healing effect on the cyst. Therefore, the attending physician should always be consulted to explain the individual therapy options and to confirm the safe use of homeopathic remedies, if necessary with simultaneous conservative or operative therapy.

As a rule, no complications are to be expected when taking homeopathic remedies. Nevertheless, it should be noted that the progression of the disease and the inflammation associated with the Baker’s cyst are given in the absence of therapy and that later treatment may be associated with complications. The application of a tape bandage is very popular for knee joint complaints.

Especially when it concerns complaints of the muscles or ligaments, the elastic tape can help to increase stability in the knee joint and reduce pain under load. The Baker’s cyst is usually based on an inflammatory process of the knee joint and cannot be successfully treated by applying an elastic tape dressing alone. Nevertheless, tape bandages can be a useful addition to the therapeutic options of a Baker’s cyst.

Whether the use of a kinesio-tape bandage makes sense in individual cases can be discussed with the treating physician or physiotherapist. Especially if the Baker’s cyst was removed by means of a puncture or surgery, a tape bandage can prevent the recurrence of a Baker’s cyst. In addition to taking anti-inflammatory medication and a classic physiotherapy with lymph drainage, the bandage can be a useful aftercare measure.