Baker’s Cyst: Symptoms, Causes and Diagnosis
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This condition is not linked to the baking profession, but it was in the late 1800s that the surgeon, Dr. William Morrant Baker, first describe this condition and that is how it gained its name. Nowadays, it is also known as a popliteal cyst after its location or a synovial cyst due to the anatomy. The popliteal fossa is a diamond shape space at the back of the knee, made by the muscles that attach above and below the back of the knee, many structures pass through this space including nerves and blood vessels. The synovium is the connective tissue that lines the inside of joints such as the knee. With a Baker’s cyst, this connective tissue gets stretched and forms a bulge at the back of the knee.
A Baker’s cyst presents with similar signs and symptoms as a blood clot of the leg, known as a deep vein thrombosis or DVT. Both will cause heat, redness, swelling and a tight feeling at the back of the knee or calf, and have pain when walking or standing. A Baker’s cyst may be mistaken for a DVT and vice versa, the close link between these two conditions have been widely known for a long time. In 36% of patients with a DVT, a Baker’s cyst was also present, and 31% of patients with a Baker’s cyst, a DVT was also present (Simpson et al, 1980).
A Baker’s cyst can also increase the risk of a DVT, as the swelling at the back of the knee can compress the deep popliteal vein and increase the chance of developing a clot. Careful and thorough assessment is needed when these symptoms arise to ensure a correct diagnosis is given, and the correct treatment is provided. A missed DVT is potentially life-threatening as the clot can move and cause serious illness such as pulmonary embolism.
Finding a comfortable position to sleep in can be difficult with a Baker’s cyst. Knee flexion or pressure at the back of the knee can make the pain worse. Two good options for finding a comfortable position to sleep in are lying with a straighter knee, or providing soft cushioning behind the thigh and calf with a space behind the knee, to avoid any direct pressure.
A Baker’s cyst is caused by damage and irritation in the knee joint. Some exercises will further irritate the knee joint and enlarge the cyst, making it more painful and the knee joint flexion further restricted. However, this is more commonly exercises with repeated knee flexion, such as squatting. If you run and monitor your response to it, and if there is no greater swelling or pain after, then you should be able to continue running. Bear in mind that changes in speed, terrain, shoes and distance can aggravate the Baker’s cyst, so make small and gradual changes, if any.
Cycling is a good exercise that rarely irritates a Baker’s cyst, so it is a good option to keep active. However, if your bike set up or fit is poor, it can aggravate your symptoms. A low saddle will increase the angle of knee flexion, and clip in shoes with a poorly set angle, may both irritate and enlarge the cyst.
The significant swelling of a Baker’s cyst can cause compression on the nerves that pass through the back of the knee. When nerves are compressed the fine blood vessels that provide circulation to the nerve also get compressed and the nerve’s function is compromised resulting initially in numbness, and if compression is further maintained it can lead to loss of muscular power. This feels like your foot has fallen asleep, similar to it you sit on your leg for a period of time then have a numb foot on getting up. The nerves that pass through this area include the tibial, common fibular, sural and posterior femoral cutaneous nerves. These are responsible for providing sensation and muscular power to the foot and lower leg.
Some food types are known to increase inflammatory levels in the body, such as saturated fats and sodium. Other foods such as fibre, antioxidants and omega-3 fatty acid are linked with reduced levels of inflammation (Hess et al, 2021). Keeping a healthy, varied and balanced diet is the best way to maintain a healthy body, and that will help recovery from injuries such as a Baker’s cyst.
While a health, balanced diet is good to promote injury recovery and healing, there is limited evidence to suggest any specific vitamins or diet supplementation to help with the recovery of a Baker’s cyst. There has been suggestion that vitamin D can help reduce joint effusion with conditions of osteoarthritis. However, there has been no evidence that synovitis, such as Baker’s cyst, is affected by this supplementation (Perry et al, 2019).
This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments for £45.