Baker's Cyst Information

What is a Baker's Cyst and What Causes it?

A Bakers Cyst is a term that is used to describe a buildup of fluid in the back of the knee. Typically, people notice pain and a lump in the back of their knee. For some people, the lump isn't noticeable, just the pain. Others notice more lump and little pain. Both situations are a Baker's Cyst.

Sometimes you will hear the word "popliteal" when talking about a Bakers Cyst. "Popliteal" is just a medical term that generally refers to that empty space at the back of your knee - it's not an important term.

The fluid building up in your knee is collecting in a little sac called a "bursa". Your body has lots of bursae; their purpose is to hold 'excess' fluid around joints. Anytime any of these sacs get overfilled with fluid and swell up, we call it "bursitis". In your case, this sac in the back of your knee (the bursa in your popliteal) has a BIG buildup of fluid. This exact situation is so common it has a special name, a "Baker Cyst".

That 'fluid' we're talking about is called "synovial fluid". The interesting thing is that synovial fluid is not bad. Synovial fluid is really good for your knee, you just have a big buildup. Your body produces synovial fluid to keep your knee healthy. It lubricates the joints so the parts slide smoothly over one another. Think of it as a natural oil for your knee joint. Synovial fluid carries oxygen and nutrients, and everything the living parts of your body need in the knee joint. It also removes waste and damage from the cells. Synovial fluid replaces the role of blood in your inner knee (the synovial joint) and much more. And, it works as a kind of hydraulic shock absorber in your knee so the meniscus cartilage doesn't have to take all the abuse.

Synovial fluid is a thick fluid. It fills the space between the parts in your knee, and acts as liquid padding or a shock absorber to reduce damage from sudden movements. There are sizable spaces in your joints where living tissue exists, like cartilage and bones, but you don't have blood in the area (like where bones meet). The synovial fluid feeds these cells by bringing what is needed from areas with blood supply.^43x It also moves waste from the area back to your blood stream which is critical for your knee's health. That fluid is important and your body is producing it for a good reason.

Your body produces this fluid to keep your knee healthy. The inside of your knee, though, is constantly in motion and undergoing constant changes in load. With every step your whole body weight gets transferred off and onto your knee joint. The purpose of the bursa, the sac, is to provide a place for the fluid to escape to when the joint is under a lot of pressure. As the pressure subsides, the synovial fluid moves back into the joint from the bursa.^47x Bursitis occurs (a bakers cyst when we're talking about the knee) when more fluid gets squeezed into the bursa than gets returned during the off-loading cycle. It's just a tiny, tiny, wee bit every time, but over time it builds up.

So why is this happening? It's happening because in some other place in your knee - not in your bursa - there is some injured tissue.^{28x 29x} In response to that injury, your body is producing more and more synovial fluid to try to lubricate it, and cushion it, and nourish it, and clean away the dirt. It is because your inner knee injury hasn't healed for a long time that your body keeps producing more and more fluid to the point where the bursa becomes really big. As long as that inner injury doesn't heal, the problem will persist.^33x

What is the Underlying Injury Causing the Problem?

What is the underlying injury that is causing you to have a Baker's Cyst? Most people with a baker cyst don't realize their knee is actually injured. That's why they are looking for information on a baker cyst, instead of the real problem in their knee. This is very common.

The most common underlying injury is a small meniscus tear.^{28x 29x} The meniscus is a piece of very tough tissue called cartilage between your two knee bones. It is a rubbing pad, a protector, between your knee bones so they don't actually rub on each other. You may have heard the term 'bone on bone'. Bone on bone is not a good thing which is why there is always cartilage between bones. Bones are separated where they would 'touch' by cartilage, and in your knee that sheet of cartilage is called your meniscus.

Sometimes that meniscus gets a bit of a tear in it. Sometimes it just gets a bit frayed on the outsides. When the tear is significant you feel it in your knee long before a baker cyst develops.^33x When the meniscus damage is minor though, you may not feel it. Your body produces more synovial fluid to help do all those good things for your meniscus that we discuss above. If your meniscus heals you never know there was a problem. But if your meniscus doesn't heal (typically because of small repetitive reinjury) your synovial fluid can build up to a point where a baker cyst develops.

The next most common cause is Osteoarthritis. People often don't realize there are two kinds of Arthritis: Osteoarthritis and rheumatoid arthritis. Rheumatoid arthritis is the bad one because it's a disease-like condition and it is a problem that doesn't go away. But most arthritis is actually osteoarthritis which is a problem coming from overuse - overactivity in a joint.^44x Osteoarthritis can go away if you let up on the activity and let the joint heal.^47x Often, active people develop osteoarthritis in their joints that they don't even realize is there. And the body's response to osteoarthritis is, again, to start producing synovial fluid to help the joint heal. When it is mild enough that you don't notice it, but it persists for a long time, then that can cause a baker cyst to develop.

There are other much less common inner knee injuries that can result in a baker cyst. Suffice it to say that if some part of that knee has an injury that you don't know about and your body is trying to resolve it for a long time, a baker cyst can result.

What Doesn't Cause Knee Damage Behind the Baker's Cyst?

Overuse or Repetitive Strain. It is not usually the cause of a knee injury. It may be the reason you're not healing now, but it probably didn't start the problem.

Your knee is designed to move. It's made to handle walking, running, and regular physical activity. That is not even abuse - that's just normal use.

Once the knee is injured, regular activity can keep retearing it, but normal use likely did not cause the original injury. There are a few people who do push too far, though. If your knee is repeatedly under heavy strain, that could be the underlying cause.

When your knee is under long-term excessive strain, it usually leads to osteoarthritis - not a meniscus tear. If you have both a meniscus tear and a diagnosis of arthritis, it probably means your knee was under constant stress and then one day you had bad luck.

If you have a torn meniscus, there is no reason you cannot have a very active lifestyle again one day. Just do what you need to do to heal your injury properly. Remember, though, once the pain goes away, you are not fully healed. When the pain goes away your meniscus is probably only 30% healed. So, however long it took to get rid of the pain, go twice that long with your treatment plan, and going easy on your knee. Most people need to go easy on their knee for several months after the pain is gone so the underlying injury can heal properly.

How Long Does a Baker Cyst Last?

Some people get to this point and realize what may be the root cause. Perhaps it was an increase in activity level or a new activity. Perhaps it was that you have always maintained a fairly high activity level, but as you age or gain weight (we almost all do a bit with age), maybe your body can't keep up as well. In many, many cases, you did something once that caused you to have an injury in the moment, and it didn't have a chance to heal, and the injury has persisted ever since. That's the best scenario, because if that's the case, if you can allow your body to heal and get past that injury, you are likely to be able to return to the same activity level as before and never have the problem again. No matter what the cause, though, you have an underlying injury and you need to let it heal. If you heal your injury, regardless of the reason it started in the first place, your bakers cyst will go away and you will likely be able to resume normal life. That is, if this whole ordeal is dealt with properly...

What Not to do when you have a Baker's Cyst

The internet is full of bad advice about treating your knee. Here's a short list though: It's not your shoes. Draining it doesn't solve the underlying problem. Anti-inflammatories don't help - it's not that kind of swelling.^25x Pain killers probably make it worse.^50x Driving through the pain will just make it worse.^33x

For a full list of things to avoid check out our Bakers Cyst Myths page.

What You Should do when you have a Baker's Cyst

For a little while - not forever - it is really helpful to give your knee a rest. In many cases, resting your knee for a few weeks will give it time to heal to a point that your body gets ahead of the healing / reinjury cycle. It's important to realize that once the cyst goes away, your underlying injury may not be healed completely so take it easy and go back to regular life gradually once the pain and swelling are gone. If you want to be more proactive about healing the problem, you can click here to visit the Recommended Treatments page.

Rest & Use Conservative Treatments

If you want your Baker's Cyst to go away as quickly as possible, you need to rest the affected knee. Avoid any physical activities that could cause further injury to your knee. If your Baker's Cyst developed from a knee injury or condition, do your best to avoid the activity that caused this knee injury or condition. Consider using crutches to keep the weight off your injured knee and avoid re-injury.

Do regular ColdCure^® treatments to control the pain and swelling in the back of your knee. The compression during each treatment helps gently move the synovial fluid back into your knee from the bursa sac.

You can also focus on healing your underlying knee injury with regular BFST^® treatments. This combination will work to finally get rid of your Baker's Cyst.

Around the 4-6 week mark you can start doing some light stretching and strengthening exercises. Slowly work your way back to your regular level of activity. Continue doing BFST^® treatments long after the pain and lump disappear to maintain the healing you've done. Do a ColdCure^® treatment if you experience any flare-ups of pain and swelling and after any significant activity.

Surgery Should Be a Last Resort

You don't have to undergo surgery in order to get rid of your Baker's Cyst. ^28x You can get rid of your Baker's Cyst with conservative treatments. However, it's possible that your underlying knee condition or injury requires surgery. These are very rare cases.

Meniscus surgery usually involves the removal of part of the meniscus and that is not what you want. That's a path to an eventual full knee replacement, it's just a temporary fix.^29x You want to do everything you can to let your meniscus heal on its own.^42x

Only in rare cases is it required for the Baker's Cyst to be drained or removed. If it's an option, you want to keep the synovial fluid and just move it back into your knee joint where it belongs, where it can help. In order to remove a Baker's Cyst, arthroscopic surgery must be performed.

If surgery is necessary for structural repair, focus on rehabilitation and controlled recovery rather than a rapid return to activity. If surgery is your only option, make sure your post-surgery recovery goes as smoothly as possible by using BFST and ColdCure.^33x Use a ColdCure^® Leg Wrap to reduce the inflammation and relieve the pain for the first few days following surgery. Once the inflammation has gone down, promote blood flow to the injured area using a BFST^® Knee Wrap. This will improve your circulation and help you heal faster.

There is also a possibility that the Baker's Cyst could rupture, causing fluid to move into the calf and result in further swelling and pain in the calf. A ruptured cyst isn't great, but it's not the worst situation either. Until the underlying injury is dealt with, in some circumstances, it becomes difficult for the Burst Baker's Cyst to heal. You want a functional bursa to keep capturing the synovial fluid and return it back into your knee. Symptoms of a Burst Baker's Cyst are similar to those of a blood clot, so if you're not certain that your Baker's Cyst has ruptured, please see your doctor.

Dealing With Pain

Painkillers are risky.

Painkillers mask the pain, often causing you to continue to stress and injure your knee. This can make your condition worse. It is understandable that people need relief from the pain, so if you have to take painkillers, restrict them to times when you are off your feet. You can use painkillers to help you sleep. Using them when you are active is increasing the risk of permanent damage. Your choice of pain killers is important. You can give us a call to discuss which ones are best.

The ColdCure^® Leg Wrap is designed to relieve the pain associated with Baker's Cysts.^26x This safe and effective pain reliever is also great at bringing down swelling and inflammation.^27x The ColdCure^® Leg Wrap is incredibly soothing and provides support and protection for your Baker's Cyst.^51x The painkilling element is incredibly powerful and it works instantly - there's no 20 minute wait like with pills.

Baker's Cysts can be extremely painful and debilitating. NSAIDs such as ASA, acetaminophen or ibuprofen are often used to treat the pain but these drugs do nothing to treat the actual condition.^25x In fact, NSAIDs are known blood thinners and make the bleeding worse for fresh tissue injuries.^50x Cortisone injections are used in extreme cases but these too are intended to address the pain.^{35x 37x} They do not promote healing of the injury itself and they put you at a very high risk of further injury.

Knee Gel Injections

Knee gel injections are also called "viscosupplementation". This is a process where hyaluronic acid is injected into the knee capsule to make up for a shortage of synovial fluid.

It is possible, that after years of abuse, or just as a function of the aging process, our knees get 'tired'. In this case, the amount of synovial fluid in the joint isn't just what it used to be. If you can take care of your knee and improve it's overall health, your knee may recover. In the meantime, hyaluronic acid injections replace some of the missing synovial fluid with a substance that is FDA approved and demonstrated to help. It doesn't heal any underlying injuries, but it can give your knee joint some relief while you try to help it heal. It does not block pain, like cortisone, which is good.

It's not for everyone though. If your synovial capsule is not showing signs of collapsing, then it won't help you at all. In fact, if you over-pump that capsule, you can increase your risk of a baker's cyst as the surplus fluid drains out into the bursa at the back of your knee. You don't want your baker's cyst to rupture either. If you already have a baker's cyst, this really could aggravate your cyst more than any benefit you get otherwise. Talk to your doctor. Any injection into your knee comes with risks, so don't sign up unless you are highly likely to benefit from the procedure.

Lastly, while viscosupplementation may help, there are many other injections that won't. Be certain about what injection you are getting. If it is not just a hyaluronic acid injection, it's very wise to seek another opinion. If you already have a baker's cyst, even this injection may aggravate your swollen bursa. Talk to your doctor. Choose wisely.

Blood Flow is Essential for Healing

There is no doubt about it, for healing most tissue injuries in the body, blood flow is the most critical element in rapid recovery. Blood brings the building blocks for new cell growth. It carries away waste and damaged tissue. It delivers antibodies to protect against infection. Your circulation supplies the cells with everything they need and removes much of what needs to be taken away.

While your heart ensures a sufficient supply to the body as a whole, the amount that reaches a specific area like your knee depends on many factors. Motion in local tissue can play a major role in circulation, but when you are injured, motion is reduced, and so is the trigger to bring blood to the area. ^43x People often do not realize that gentle motion alone is enough to encourage circulation. That does not mean putting a heavy load on your knee. Simple, light movements without pain are all that is needed. Adding weight or stressful activity does not improve the flow further, and the added loads can result in reinjury. ^33x Find light, gentle motions you can do with no pain at all and repeat them several times each day. For example, sitting with your leg dangling, swaying it gently is all you need. It is definitely much better than going up a flight of stairs when you're in pain. Just motion - not load. Move only as much as you can without causing more pain.

Diathermy is a medical process to promote blood flow in tissue at rest. ^7x It works by sending energy deep into the body to stimulate blood flow far below the skin. ^{1x 2x} An example of diathermy is ultrasound treatment, which is often used in physiotherapy. ^13x The challenge with ultrasound is that diathermic effects last only about 4 hours, while most people only receive treatment once every few days. It also carries more risk, as ultrasound can damage tissue if misused, and it must be performed by a trained technician in a clinic. That means you cannot do it at home.

The good news is that you have an option for this painful condition other than ultrasound. ^9xBFST^® devices from King Brand are diathermic devices that you can safely use at home to promote healing. ^{1x 2x} With a home diathermic device, you can treat yourself multiple times each day, which greatly improves blood flow and accelerates recovery. ^{7x 20x} They are also more powerful, providing deeper stimulation than clinic-based ultrasound treatments. ^13x

Unlike ultrasound, which treats only a small focused area and must be moved constantly, BFST^® devices treat up to 70 square inches of tissue at once. This means your knee injury can be treated more completely, with better safety and far less effort. ^{1x 2x} They are typically up to 10 times more powerful than ultrasound and completely safe for home use. ^13x

BFST^® brings extra oxygen and nutrient-rich blood to your knee - something the body must have to heal itself. ^1x Unfortunately, an injured body at rest often has restricted circulation, which greatly slows recovery. ^33x With a King Brand^® BFST^® Knee Wrap, blood flow can be stimulated in the area of injury while you are at rest. With improved circulation and reduced strain, you lower the risk of reinjury and you can recover from your knee injury and the related Bakers Cyst at an optimized rate.

For more in-depth information about how an injury heals click here for our Healing Page.

How We Can Help You with the Pain of a Baker's Cyst:

Protect Your Knee All Day Long

Your knee works all day long. It supports your body when you walk, stand, and climb. When you have a bakers cyst, you can feel every step. You cannot pause life while you heal, so you need a way to protect your knee without losing your range of motion.

KB Support Tape™ is designed to support your tendons, ligaments, and muscles through the day and help prevent further damage while you move. It does this while still allowing full mobility.

Our skin is soft and elastic and can stretch far more than the tissue underneath. When you apply KB Support Tape™, it makes your skin a more rigid surface, which supports the damaged tissue below and helps prevent reinjury. ^24xThat is why we call it armor for your injury.

Support Tape™ - Protection from reinjury

Too busy to slow down but still want to heal faster? Then Support Tape™ is your must have. Constant reinjury is a big reason a bakers cyst does not get better. Your knee may improve at rest, but once you get moving again the irritation can come back. Taping adds daytime protection so you can move safely while healing.

Athletes are always taped to reduce the risk of reinjury while they are active. King Brand Support Tape™ is made for that purpose. Taping is very underappreciated and very effective. If you have to keep moving, you should tape.

There is one big difference between King Brand Support Tape and regular kinesiology tapes or athletic tapes you find in drug stores. King Brand tape is medical grade; the others are athletic-grade. Medical grade tape is designed to be worn all day long, day after day, which is exactly what you need when treating a chronic knee injury. They may look the same, but the materials are entirely different. Athletic tape is designed for occasional, temporary use - maybe an hour or two at a time. The materials in athletic tape can be toxic to your skin with prolonged exposure. Some are even carcinogenic. King Brand medical tape is designed for long-term, repeated use - the way you will use it while treating your knee. Choose wisely and stay safe.

Color is just your style choice. The Continuous Roll gives you the most control over placement and usually provides the most use from a single roll. The precut strips offer a bit more convenience.

Click here for a detailed guide on using medical support tape for protection of underlying injuries

What Does the BFST Feel Like?

The BFST treatments are very comfortable and soothing. The BFST^® uses Electromagnetic Energy to stimulate blood flow underneath the surface of the skin. It is warm, but not hot. It does not vibrate like a massager. (You shouldn't use a massager on soft tissue injuries) It does not cause your muscles to tense in jolts like with a TENS machine. (TENS machines are very bad for soft tissue injuries) The BFST^® isn't supposed to do either of those things. Rather, it is soothing and sometimes gives you a gentle tingling sensation in the treatment area. BFST treatments are very pleasant and enjoyable.

Don't be confused, while the treatments feel gentle, they are still very powerful. Think about an X-RAY or an MRI. Even though you don't feel the energy during those procedures, a lot of energy is definitely going deep into your body. If you put your ear close to the BFST when it is on, you can actually hear it going through the cycles. It's not loud, but you can hear it if you listen. It isn't just delivering one energy level at one frequency. Just like an MRI machine, the BFST buzzes and hums and gets louder and more quiet as it goes through the treatment cycle. It sounds just like a mini-MRI machine. Over the 20 minute treatment period it goes through a treatment cycle to deliver the most energy in the most effective way. It is designed to help give you the fastest healing time possible, in the comfort of your home.

During each BFST^® treatment you will only feel a mild warming sensation. If it feels hot, you are using it on too high of a setting. Over time, after several treatment sessions, the treatments will feel like they are getting less and less warm. This is your body responding to the BFST^® treatments by increasing your subdermal blood flow. The more BFST treatments you do, the less warmth you're going to feel. This is a good sign. Your tissue is becoming healthier. Your body is getting stronger. This means that your circulation through your injury is improving, and your injury is improving. When the feeling of warmth during a treatment is almost all gone, this is the signal that it is time to move up to the next level. People usually move up to the second level after a few weeks of treatment.

Additional Baker's Cyst Information

We have briefly covered the most common reasons people struggle with a Baker Cyst. There is much more information available. You can explore the Quick Links menu at the very bottom of the screen - each link contains more information about the condition. Here are some of the popular pages:

To learn about common mistakes made by people with a Bakers Cyst, click here.
To learn about what people have been saying from their own experience using BFST and ColdCure, click here.
For in-depth information on how the injury process works, click here.

To be more proactive about healing your underlying problem, you can click here to visit the Recommended Treatments page.