Therapy
In principle, conservative and operative measures are available for the treatment of the Baker cyst. As already mentioned, the form of treatment depends on the cause of the Baker cyst. Many Baker cysts cause only moderate symptoms. These can certainly be treated conservatively. However, it is important to note that conservative measures do not treat the cause of the cyst.
The alternative treatment of Baker’s cyst
The alternative treatment is not primarily directed against the cause of the Baker’s cyst, but against the wear and tear of the knee joint. Only if there is an improvement in the function of the knee joint can a permanent improvement in the complaints in the hollow of the knee be expected.
The conservative treatment of Baker’s cyst
1. Drug treatment of the Baker’s cyst: Anti-inflammatory (antiphlogistic) drugs from the group of non-steroidal (without cortisone) anti-rheumatic drugs (NSAIDs), such as ibuprofen and diclofenac are used. Recently, COX 2 (cyclooxygenase) inhibitors have also been used as therapeutic agents.
Cyclooxygenase is a key enzyme in the production of pain-producing substances (pain mediators), with the advantage of having fewer side effects on the stomach lining in particular. However, the efficacy of this group seems to be inferior to classical drugs. The use of preparations containing cortisone in the case of a Baker’s cyst is not without danger due to the numerous side effects, but it is very effective.
If one decides to use them, the cortisone preparation can be administered directly into the knee with the help of a syringe to stop the inflammatory process locally. In order not to let the cortisone-related risk become too great, cortisone should not be administered more than three times a year. In recent years, hyaluronic acid therapy has become particularly effective in the treatment of Baker’s cyst.
This is a body-own substance that can improve the quality of the remaining cartilage. This can reduce “water formation” and ideally, the Baker’s cyst will regress. The hyaluronic acid treatment is not carried out directly on the baker’s cyst but on the knee joint, where the water for the baker’s cyst is produced. 2. puncture of the cyst: The contents of the cyst can also be sucked out with a syringe. However, a recurrence of the cyst must be expected since, to describe it metaphorically, “the lake is pumped out, but the inflowing river continues to flow”.
Drugs
The treatment of a Baker’s cyst can also be done by the administration of various drugs. In principle, mainly anti-inflammatory (antiphlogistic) drugs are used. Due to the fact that active ingredients from the group of so-called non-steroidal anti-inflammatory drugs (in short: NSAIDs, i.e. drugs without cortisone) have both pain-relieving and anti-inflammatory properties, they are particularly suitable for the treatment of Baker’s cyst.
Typical drugs in this group of active ingredients are ibuprofen and diclofenac. With these drugs, however, it must be taken into account that long-term use can lead to considerable damage in the area of the gastrointestinal tract. For this reason, the duration of use should be kept as short as possible.
In addition, taking proton pump inhibitors at the same time can help to prevent any stomach problems that may arise. For some time now, special inhibitors of cyclooxygenase 2 (COX 2 inhibitors) have also been used in the treatment of Baker’s cyst. Cyclooxygenase is the key enzyme in the synthesis of various pain mediators.
The advantage of selective inhibition of cyclooxygenase 2 is that the side effects in relation to the stomach mucosa can be significantly reduced. In terms of efficacy in the treatment of Baker’s cyst, however, the selective inhibitors of cyclooxygenase 2 appear to be inferior to non-steroidal anti-inflammatory drugs. Cortisone containing drugs are usually not administered orally (in tablet form) in the presence of a Baker’s cyst.
The reason for this is that the numerous side effects of cortisone-containing drugs should not be underestimated. However, in patients suffering from a Baker’s cyst, cortisone containing drugs can often be applied locally. In order to prevent the inflammatory processes from spreading, these drugs are applied directly into the affected knee with a syringe.
Nevertheless, even with this method there is a risk of serious side effects. For this reason, local application of the cortisone-containing drugs should be carried out no more than three times a year. Furthermore, hyaluronic acid is particularly suitable for the treatment of Baker’s cyst.
The term “hyaluronic acid” refers to a substance that can improve the quality of cartilage tissue. The regular use of these drugs can reduce water retention in the area of the Baker’s cyst. Furthermore, the application of hyaluronic acid can even lead to the complete regression of the baker’s cyst.
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