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What Is a Baker’s Cyst? Symptoms, Causes and Treatment Options
A Baker’s cyst (popliteal cyst) is a fluid-filled swelling located at the back of the knee. It typically forms when excess joint fluid accumulates and extends into the popliteal space. In most cases, it is not an isolated condition but a result of an underlying knee problem.
The size of the cyst may vary significantly. While some patients have small, painless cysts, others experience large swellings that cause tightness, pain and difficulty bending the knee.
Symptoms of a Baker’s Cyst
The most common symptoms include:
- Swelling or a noticeable lump behind the knee
- Tightness and stiffness when bending the knee
- Knee pain, especially during walking or squatting
- Discomfort after prolonged standing or activity
- Swelling that extends down toward the calf
- Sudden calf pain and swelling if the cyst ruptures
When a Baker’s cyst ruptures, symptoms may mimic a deep vein thrombosis (DVT), making accurate diagnosis essential.
What Causes a Baker’s Cyst?
The cyst is usually caused by conditions that increase fluid production inside the knee joint, such as:
- Meniscus tears
- Cartilage damage and osteoarthritis
- ACL and other ligament injuries
- Inflammatory or rheumatologic knee conditions
- Knee effusion (excess joint fluid)
These conditions increase joint pressure, pushing the fluid toward the back of the knee where the cyst forms.
Diagnosis
Physical examination is often sufficient to diagnose a Baker’s cyst. If further evaluation is needed, the following imaging studies may be used:
- Ultrasound
- Knee MRI to detect meniscus tears and cartilage defects
Treatment Options
Treatment focuses on addressing the underlying knee problem rather than the cyst itself.
1. Medication and Activity Modification
- Anti-inflammatory medications
- Avoiding activities that strain the knee
2. Physiotherapy and Exercise
Strengthening and stretching exercises help reduce joint pressure:
- Quadriceps strengthening
- Hamstring stretching
- Hip and knee stability exercises
3. Intra-articular Treatments
- Corticosteroid injections for inflammatory conditions
- Hyaluronic acid or PRP therapy for cartilage problems
4. Aspiration
The cyst may be drained under ultrasound guidance. However, it commonly recurs if the underlying issue remains unresolved.
5. Surgical Treatment
Direct surgery on the cyst is rarely required. Instead, arthroscopic treatment of the underlying knee condition (such as a meniscus tear) usually leads to significant improvement.
Does a Baker’s Cyst Come Back?
Yes — if the underlying meniscus tear, cartilage damage or inflammation is not treated, the cyst may recur. Long-term relief requires treating the primary cause.
When Should You See an Orthopedic Specialist?
Seek medical evaluation if you experience:
- Rapidly increasing swelling behind the knee
- Severe calf pain and tightness
- Difficulty walking or bending the knee
- Persistent knee pain
