How to to Live with a Baker's Cyst

If the surgeon reviewing my pre-surgery knee MRI noted that the radiologist saw a Baker's cyst, he didn't say so. Following repair of a meniscus tear - a procedure I thought would return life happily to normal - this little cyst turned into what doctors call a complex Baker's cyst. Eight months later, I've finally learned how to live with a Baker's cyst.

Overview

According to MedicineNet.com, a Baker's cyst is a swelling that occurs when synovial fluid from the knee joint protrudes into the back of the knee. Doctors sometimes call it a popliteal cyst because it arises in the popliteal area of the knee.

When excessive fluid from problems like osteoarthritis or a torn meniscus develops, body weight compresses the fluid between the bones of the knee joint. If it gets trapped and separates from the knee, a sac of fluid known as a Baker's cyst forms.

While some people with Baker's cysts have no symptoms, the Mayo Clinic says most experience some signs. The most common are swelling behind the knee and and/or leg, stiffness, pain in the knee and tissue that feels like a water-filled balloon.

These cysts often disappear on their own. However, if a Baker's cyst is large and causes considerable pain, orthopedic surgeons typically recommend physical therapy, aspirating the cyst to drain fluid or injecting a corticosteroid to reduce inflammation and pain.

While surgery to correct an underlying condition like osteoarthritis might cause the cyst to disappear, this doesn't always happen. Unfortunately, most orthopedic surgeons are somewhat reluctant to remove a Baker's cyst because it often recurs. Corticosteroid injections are far less effective in relieving problems associated with complex Baker's cysts than with the standard variety.

Learning to Live With a Baker's Cyst

After surgery for a meniscus tear, I underwent 20 physical therapy sessions. The affected leg still swells. Injections aren't on the horizon. Just as I was digesting information on Baker's cysts, I developed one in the other leg. Both of them throb 24/7. The post-surgical knee also stings and burns.

Patients such as myself who have exhausted standard treatment options are essentially left with learning how to live with a Baker's cyst. When an injury such as a cartilage tear is the cause, there are two options: live with the pain of the injury or have surgery and accept whatever the result is.

The most common cause of a Baker's cyst is osteoarthritis. If the physician determines that arthritis is the culprit, he or she will usually advise the patient to take certain steps at home to learn to live with the cyst:

Follow the P.R.I.C.E. principle. It's an acronym for protection, rest, ice, compression and elevation. Icing and elevating the affected leg to a level higher than the heart have been the most effective remedies for me.

Use NSAIDs or acetaminophen. NSAIDs like aspirin, ibuprofen and naproxen (brand names: Advil, Motrin, Aleve) are anti-inflammatory drugs. They also relieve pain. However, for individuals like me who have Crohn's disease, they're off limits. We're left with acetaminophen (Tylenol), which reduces pain but has no anti-inflammatory properties. For patients who can tolerate them, doctors sometimes recommend prescription NSAIDs.

Re-evaluate physical activity. The objective is to reduce inflammation in the knee joint. While doctors recommend alternative ways to get exercise, it's sometimes necessary to experiment to see which types are most easily tolerated. Running and jogging are no longer a part of my life. Forty-five minutes at the supermarket means immediate icing when I get home. I've been told to avoid climbing stairs.

Ask about compression stockings. They help reduce swelling for some patients but aren't right for others. A physician should be able to provide a prescription for these stockings or recommend an over-the-counter product if either is likely to help the patient. Wearing them has helped reduce swelling in the leg on which I had surgery.

For a patient without a resolution of this disorder, learning to live with a Baker's cyst probably won't make life pain-free. However, it can make it manageable.

Sources:

http://www.medicinenet.com/baker_cyst/article.htm

http://www.mayoclinic.com/health/bakers-cyst/DS00448