Baker's cyst medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Baker's cysts usually require no treatment unless they are symptomatic. Often rest and leg elevation are all that is needed. If necessary, the cyst can be aspirated to reduce its size, then injected with a corticosteroid to reduce inflammation. A ruptured cyst is treated with rest, leg elevation, and injection of a corticosteroid into the knee. Recently, prolotherapy (in use at the Mayo Clinic since 2005) has shown encouraging results as an effective way to treat Baker's cysts and other types of musculoskeletal conditions.[1][2]
Baker's cysts in children, unlike in older people, nearly always disappear with time, and rarely require excision.
Symptomatic relief
Cryotherapy
Ice pack therapy is believed to be an effective way of controlling the pain caused by Baker's cyst. Ice must not be applied directly onto the skin but be separated by a thin cloth. Alternatively cooling packs may be used, but the total application time for any product is for no more than 15 minutes at a time.
Medication
Medications bought at pharmacies may be used to help soothe pain. Painkillers with paracetamol aka tylenol (acetaminophen) or with the additional anti-inflammatory action (such as ibuprofen or naproxen) may be used. Stronger non-steroidal anti-inflammatory drugs may be required by prescription from one's general practitioner.
Heat
Heat is also a recognized treatment. The application of a heating pad on a low setting for 10-20 minutes may relieve some pain, but only if instructions are followed carefully.
Bracing
A knee brace can offer support, but relieve pain by stimulating nerve fibre, giving the feel of stability in the joint. If only support is necessary, a simple elastic bandage is recommended; however, braces compress the back of the knee, where it is most tender, and can cause pain.
Rest and specific exercise
Many activities can put strain on the knee, and cause pain in the case of Baker's cyst. Avoiding activities such as squatting, kneeling, heavy lifting, climbing, and even running can help prevent pain. Despite this, some exercises can help relieve pain, and a physiotherapist may instruct on stretching and strengthening the quadriceps and/or the patellar ligament.