Treatment of a Baker’s cyst

The treatment of a Baker’s cyst is usually initially carried out with medication. Anti-inflammatory drugs are used to dampen the inflammation and thus stop the formation of too much synovia. The Baker’s cyst can regress.

Drugs from the field of non-steroidal anti-inflammatory drugs (NSA) are used (e.g. Diclofenac, Ibuprofen) or aspirin (COX inhibitors). In case of long-term use, a doctor should be consulted to clarify any side effects. The use of pain and anti-inflammatory ointments may also be advisable.

A relief of the knee joint is necessary to improve the inflammation. In severe cases, a medication containing cortisone (ointment, tablet, injection) can also be used to treat a Baker’s cyst. Furthermore, a mobilizing and stabilizing physiotherapy can be useful to prevent overloading of the passive structures (cartilage, bone, ligament, meniscus) by increasing muscular support and to counteract further inflammation. In the case of systemic diseases such as rheumatism, arthritis or metabolic diseases as the cause for the development of a Baker’s cyst, it is necessary to proceed causally and treat the underlying disease. More detailed information about the therapy can be found under Baker cyst therapy.

Burst Baker cyst

If a large Baker’s cyst is filled up to the brim, it may burst. This causes synovial fluid to leak into the surrounding tissue. This causes severe pain due to the mechanical space requirement of the fluid.Furthermore, the synovial fluid causes severe inflammation in the tissue, resulting in further swelling, increased blood circulation and further pain.

The movement in the knee joint is massively restricted, the pain is strong, diffuse and can also be felt in the calf region. The general swelling and the additional space requirement of the synovial fluid in the tissue can lead to compartment syndrome. This is when the fluid in the joint cavity compresses other tissue so severely that an adequate supply is no longer available.

Nerves and vessels are squeezed and can die in the worst case. The tissue that should actually be supplied by the vessels is less supplied (ischemic). This leads to severe pain.

In the event of long-term undersupply, the tissue can perish (necrosis). Numbness or paralysis in the area supplied by the compressed nerves is also possible. Long-term compression can lead to irreversible nerve damage.

If left untreated or detected too late, compartment syndrome can result in the loss of the lower leg. Compartment syndrome requires immediate relief of pressure in the tissue. Surgery is usually performed immediately.