KNEE ARTHRITIS - Arthritic swelling and Baker's Cysts :
can someone help me? - - Posted by jodie (jodie), 2 July 2003
Hi I am new to this site. And yep i have no idea where to go.
My story is that I have been diagnosed with a "bakers cyst" (without scan, having one tmw) after being on my feet constantly with pregnancy no 3.
I am looking for information on this and info from anyoine who has had the "surgery" to remove this fluid etc, I have no idea what im in for, recovery time etc.
I am quite nervous as I have never had any surgery before and only been in hospital to have 3 uncomplicated births. I am 29 yrs old and live in Australia.
Thanks in advance!
Jodie.
Posted by Lizzie (Lizzie - UK), 2 July 2003
Hi Jodie
Welcome to the KNEEguru board.
I've had a look in a few of my books on knees and most of them say that there really is requirement for surgery on a Baker's cyst.
A Baker's cyst is described as a pouch of fluid commonly found at the back of the knee. The liquid is normal knee-joint fluid that in some people seeps through a small opening and collects in this pouch.
The pouch varies in size from person to person. It ranges from being invisible to feeling like the size of a table tennis ball.
The swelling can come and go as the fluid moves back and forth from the cyst to the knee joint. Unless the cyst is extremely large, it is usually asymptomatic and requires no treatment.
Fluid tends to build up in the knee and thus into a Baker's cyst - when something is irritating the knee. The reason behind this can be any number of conditions, including arthritis or a torn meniscus (cartilage)
Usually the body absorbs the fluid that builds up making the Baker's cyst. In some cases the fluid does not completely get absorbed by the body and leaves a jellylike substance which can harden with time. The doctor may place a needle in the cyst to aspirate it. It may even recur.
A Baker's cyst will show up on a MRI scan. It might be wise to go back to your OS and ask for a MRI scan to see what is causing you to have a Baker's cyst.
Most of the books say that the Baker's cyst should disappear spontaneously and that surgery is seldom required. However, the joint should be investigated to exclude gout, rheumatoid arthritis or an internal derangment and any underlying cause treated. It says that the patient should be warned that the cyst may rupture. If the cyst does rupture, rest and analgesics are all that is needed.
I hope that has helped you. I remember when I was younger that I would suffer from bursae on the front of my knee, which was known as housemaid's knee - it is similar to a Baker's cyst in that where your build up of fluid is at the back, mine was in the front. I did not require any surgery or any aspiration of the knee. The fluid just disappeared after a while. I think I was told to RICE it, ie, rest, ice, compression and elevation.
So Jodie, make sure that you are not on your feet constantly, let other people around you take some of your burden off you.
Wishing you well and when is your baby due? Do you know what sex it is?
Take care
Lots of love
Lizzie xxx
Posted by Lizzie (Lizzie - UK), 2 July 2003
Jodie
In the main forum there is a section called Arthritic swelling and Baker's Cysts - have a look on there for some more feedback.
Take care
Lots of love
Lizzie xxx
Posted by Janet (Janet), 2 July 2003
A lady I work with has a very large Bakers cyst behind her knee. She takes Celebrex for it, but both her GP and an OS have told her there is no surgery for it. The OS said that if they drain it, it will just come back. He said there are too many nerve endings and blood vessels there to surgically remove it. It does bother her and affects her gait, but she lives with it. She was told to wear good cushioned shoes (she hates wearing them with her good clothes to work, but what the heck!). I don't know if you were thinking you would have surgery or if your OS told you, but I would find out more before thinking about surgery.
Janet
Posted by Iona_-Uk (Iona), 2 July 2003
Hi Jodie and welcome to the board, we're glad you found us!.
Bakers cysts are normally apparent on an MRI, I assume this is the scan that you are having done tomorrow, so the results of the scan should show conclusively whether this is a bakers cyst or another time of swelling.
I know that some people have their cysts removed but others choose not to because of the risk of recurrence.
Your OS will best advise you on how they intend to manage your particular cyst.
Best of luck
Iona
Posted by hmaxwell (Heather M.), 2 July 2003
It's important to keep in mind that the Baker's cyst is often a symptom of an underlying condition, such as meniscal or articular cartilage damage. Therefore, it's not often recommended to just address the cyst for a number of reasons--as Janet said, the area behind the knee is highly vascularized and full of nerves and blood vessels. Also, the chances of recurrence are excellent if the cyst is being caused by some underlying condition.
However, if you have a torn meniscus, serious chondral damage, or even osteoarthritis and bone spurs, then addressing these would be logical, and would result in the Baker's cyst being resolved (theoretically).
I also have some bad news...I have a palpable Baker's cyst in my 'good' knee, it is a hard knot the size of a walnut that gets bigger and more painful if I spend a lot of time on my feet. This cyst has never once appeared on MRI--three of them and counting. However, the cartilage damage that is producing the cyst does show up on the MRI. It's very strange, and no one has an explanation for me....
Heather
Posted by jodie (jodie), 3 July 2003
thanks everyone for your warm welcome and advice. I had an ultrasound today which found nothing, it is suggested that i have an mri. What does this involve?
I am currently not pregnant, have had my baby, he is 14 weeks old. And yes, a boy, after having 2 girls, so a great suprise!!
Hoping they find something, the pain is on inside of left knee, more like in the fatty part, if you know what i mean, and is a dull ache all day and worse with excersise, ie, walking too much, hehe, not that i can avoid that. it sometimes makes my leg tingle right to the foot so i am syumped as to what it is. I have NO pain behind the knee which is where I have a small swelling. I diddnt notice this swelling, the doctor did and suggested a bakers cyst which was not found to be the case so now im guessing! They also checked for dvt but not that either thank heavens! Any ideas?
Thanks again!
Jodie.
Posted by Helen_uk (Helen uk), 3 July 2003
Hi Joddie dont know much about bakers cysts but just wanted to congratulate you on the birth of your son.
Love H xxx 
Posted by Linds (Linds), 3 July 2003
Congratulations , on your child number 3, that's awesome. 
, Also welcome to the board and hope you get the help you need here. 
I have never had a bakers Cyst but my Dad did. It is caused by a tear in the meniscus of the knee, and fluid leaking out of the knee capsule. His was easily repaired with removal of the offending piece of meniscus and draining of the cyst. His pain after surgery was minimal, he was on crutches for a couple of days and was playing hockey again a week later. I am sure they aren't all this easy....but...hopefully yours will be. When I had my knee surgeries I was more concerned about the going to sleep /waking up part...more than the surgery itself. It isn't all that bad...the only bad part is the fasionable hospital green johnny shirts and hair nets. Not so fun, trapsing around the hospital...trying to keep the draft from blowing open the backside of your gown. But if that's the worst part...guess its' not all that bad. Good luck and hopefully everything goes good for you. LEt us know,
Take care, hugs n' HOrse slobber
Linds
Posted by PhatCat (PhatCat), 25 February 2004
ALSO correct is there being an underlying cause for it.... My OS said mine was Osteoarthritis..
I can't believe it--- I just lost my entire post I spent an hour writing.
Is anyone still there..? I wish I'd found this last July when everyone was posting.
I have the B.C....and my OS (Head Surgeon of an NFL team), said "NO surgery"....a BS is like a blister (blood/water),,,if you 'pop' it, it will just refill and come back. First he had me undergo an M.R.I. ("Magnetic Resonence Imagery") He offered "asperating" or "cortesone"...but I'm a chicken with needles; then, he INSISTED I start physical therapy at least twice a week with "Modalities" (Ultrasound; & Deep Tissue Massage, and various exercises) with repetitions of the exercises at home with bands and weights.
RPT...(Physical Therapy) is an absolute MUST. I'd neglect it, and the pain would hit hard...I'd do them, and the pain would go away and mobility would come back. I stopped RPT 3 months ago, and continued the home therapy,,,but stopped the home therapy about 3 weeks ago, feeling like it was gone---GUESS WHAT? It's still there---just moved down into the calf of my leg.
I start RPT (registered physical therapy) again tomorrow. And I started the DAILY home exercises LAST WEEK.
My Orthopod also said, a BCyst is a sports injury too (but, yes, with underlying causes...mine which happened to be Osteoarthritis..,and can be triggered by a sports---and is prevelent with little kids! (the feet in one direction and the body goes in a different one ---like skiing, snow-boarding, running from your car like I was---a myriad of ways.
Glucosimine/Chondroitin helps too. A lot.
I hope someone is out there..Now I've copied this so I don't lose it...
Jodie---how's the baby? Over 6 months old now.
Fondly,
.........Cat
Posted by PhatCat (PhatCat), 25 February 2004
It's just me........Cat......again,,,
I forgot something...
Mine never had a "Pouch"...!
Has anyone else ever had theirs without the pouch? The fluid from my joint...SHOT out (I FELT it...and I HEARD it---it sounded like a RIFLE SHOT!and it stunned me---no pain right away).
Then my OS told me the noise was loud for me, because the sound reverberated up my skeletal frame to my inner ear.
Anyway, the fluid never went into the "Baker's" pouch---mine seeped into the ligaments and muscles behind and down the side of my knee...Not places fluid is supposed to be---and believe me THAT hurts (and my RPT said it probably hurts worse when IN the tissues then IN the pouch.
AND NOW IT'S GONE DOWN INTO THE CALF muscle.
Did you all know that the name "Baker's" did not come from a "Baker" (being on your feet)...but from the Doctor who discovered the injury...DOCTOR BAKER. 
It' is actually caused from the feet and the body going in opposite directions (like I said in the last post)---and that's the reason it happens so often in sports like skiing or snoboarding, track and field, etc.) --- Caused by strenuous and quick movements,,,NOT from standing.
SO SLOW DOWN EVERYONE...WE ARE NOT BIONIC!
and keep up (or START) the stretching and weigh-lifting exercises.
............Cat
Posted by bchesney (bchesney), 30 March 2004
Hi everyone ; 
I have the same problem most of you do. I've had 3 baker cysts in the back of my lft knee for 2 years!!
I've really suffered with them as I can't do impact exercises and they really hurt when I'm on my feet. I do physical therapy 2 X week- sonography, massage, exercises like stairmaster 10 minutes, and calf raises and toe lifts. They have gotten smaller and are a little more manageable but still hurt when I walk. I do have arthritis in that knee. It clicks all the time too.
Can anyone tell me what exercises have helped you and if these really do go away? I'm thinking of having a baby soon, but wanted to wait till these are more manageable.
Can you tell me your experiences/treatments that would help me? Thank you so much and thanks for this nice forum! Please write me...
Beth
Posted by PhatCat (PhatCat), 30 March 2004
Hi Beth,
When did you post that? 
I'm not an OS, but I will say that if you're on your feet that much, I'd wrap the knee (lightly) with an ace bandage. You want to be very careful you don't apply it tight at all...because the pressure will increase as you have normal swelling come into your tissues, which would not be comfortable at all--and could even cut off the circulation.
As far as what to do, Beth, you are going to PT 2Xweek... I'd keep that up as long as your OS wants you to...and at home, EVERY day, I'd be sure to do at least a 10 minute set of work outs. If you don't own, go purchase a set (pair) of ankle weights/wraps (with velcro); 2 pounds minimum, and 2-1/2 pound max. With one on each ankle, and one knee bent with that foot flat on the floor, raise the other (straight) leg about 2 feet off the floor and lower it; repeat 10 times to start...work up to 20 (do the other leg too, to just keep your muscles balanced).
Then, if you can lay on your tummy, raise the legs alternately up BEHIND you...about 10-12 inches (same reps as the first);
Also, turn on your side and with your hands, pull the top leg up as close to your waist level as possible; raising the lower leg (straightened) UP...about 10 inches; 5 to 10 reps, working into 10-20;.
Then, try to do at least 10-15 "wall crunches", working into 15-30.
"Ice" your knee as often as you have pain...try to limit the Ibuprofin, so as not to damage your kidneys. Moist heat can sometimes be used, just to give a 'warm & fuzzing' feeling...I mean what can be wrong with that,,,when with the BC there's so few, eh? Just be sure that you always end up with at least 5 minutes of icing.
For quick relief from pain and swelling, use an 'ice massage'; to do this, buy some paper 'dixie cups'; fill with water and freeze several; when frozen, tear off the paper from the BOTTOM of the cup, (have a towel nearby to catch the melt-off) and massage the swollen/painful area (the BC) with the "ice-cup", adding as much pressure as you wish.
I wish I could add some drawings for the exercises; but if you can't understand what I've described please feel free to email me directly at lftmsg@yahoo.com.
I can't stress enough how[flash=200,200][/flash] important it is to do these "weighted" exercises DAILY. I know it hurts to get down on the floor, and to get back up again...but please find a way to do it...if you do, you'll be very happy you did (a chair close by to use for support getting up and down, helps.)
I see I can attach something. So, if anyone needs a diagram of these work outs...please write me privately, or post here...and I'll scan them and send them to you. (They came from my RPT. An "outpatient PT of the Seattle Swedish Hospital group).
Posted by PhatCat (PhatCat), 30 March 2004
Hello All,
& Beth...
It seems I have to add to my post again. I just browsed through the menu on the upper right...and when I clicked on "The REHAB GYM"...ALL THE EXERCISES I'M TALKING ABOUT AND ALL THE OTHERS I DO...ARE ALL THERE...PHOTOS! not just drawings...but actual photos.
I also forgot to mention using the 'band'...(which is also shown.) The link is here:
http://www.kneeguru.co.uk/html/gym/general/middle/principles.html
or just click on that in the menu above.
Sry...
I guess I thought you all had seen that. Maybe not. It is wonderful...
PhatCat
Posted by bchesney (Beth VA), 30 March 2004
Hi Cat
Thank you so much for the tips and exercises you gave me. I'll definately add these to my PT routine.
(I posted the message yesterday).
My PT is using iontophoresis to get rid of my "housemaid knee bursitis" on the front inside of my knee. But she isn't using it on my b cysts in back of my knee.
Has anyone used the iontophoresis for the bakers cysts? Has it helped at all with the swelling?
Please tell me of your experiences...
Thanks
Beth
Posted by PhatCat (PhatCat), 30 March 2004
Hi Beth,
I've never heard of that...
but I'm going to ask my RPT; and if she doesn't know, I'll ask my OS's assistant.
Did you click on "The REHAB GYM" on the upper right menu?
very very helpful exercises. Just remember to allow 20 minutes to do them every single day---especially if you're not able to walk outside or do anyother exericses. These will keep you strengthened to protect from further injury. The knee has 'bands' of tendons and muscles that protect it...that if allowed to atrophy, will put you at risk without a doubt.
As I said, have a stabilizing piece of furniture nearby to help you get down and then up again, if it's difficult.
As Niki says, "JUST DO IT"
I'm trying too...and it's really hard because I just had surgery on my left foot...and as soon as it heals, I go in for the right foot...and I sure don't want the knee weak when I get ready to move normally again.
Thanx for your support---you have mine.
......Cat
Tues, March 30th
Posted by bigcrazywoman (bigcrazywoman), 30 April 2004
Hi....I am a 42 year old woman that has been diagnosed with Rheumatoid Arthritis 5 years ago...at the time I had insurance and they put me on aggressive therapy to try and put it in remission...they actually give you chemo medicine....well in mean time insurance lapsed....so no more remission meds....but i seemed to have been doing better...then just recently i have gotten highly active again which they call flare ups....but as I said I have no insurance so I have been just living with the pain killing my kidneys with ibuprofens...I noticed one weekend about 3 weeks ago the back of my knee was swollen and hurt...but that is not the first time I that had happened to me so I just chalked it up to my RA....well...I work as a Cook...I woke up Wednesday morning following that weekend and couldnt hardly get out of bed....my knee hurt me so so bad....it hurt all the way up to my hip and down to my toes....well....with RA you learn to live with that so I went to work in pain...by the end of day my knee was pretty swollen in the front this time...NOT in the back....well...everybody was worried I had blood clot or something so I went to ER that evening after work....I told him how it had started that previous weekend with a lump on the back of my knee....he said stop right there....He said sounds like you had a Bakers Cyst that might have just ruptured although usually when they rupture the calf will swell...but to rule out a DVT (deep vein thrombosis) or simply a blood clot he wanted me to come back to hospital in morning and have a venous doppler done...which I did....When the results got sent to my Dr. he wanted to see me immediately....the result showed I still have a Bakers Cyst...but of course mine is not that simple....Mine is under my knee cap being protected and probably wont rupture on its own...and not only that but it is right on top of all my nerves including the Sciatica...which in turn is making my whole leg hurt bad....Mainly my hip hurts worse....I have no idea what to do? I was wondering if anyone else has ever had one under their knee cap that could give me some advice.....I cant stay on my leg long which keeps me from working and I cant make payment arrangements to even see a OS without working....My husband works but we are barely getting by...we have 2 children still at home....I would mainly like to know if somebody out there has had one under their knee cap in between the leg bones and cap like mine and what they have done and what the surgery involves....I would like to know more about my options here....like I said....I have RA anyway...so I know it is a result from that....I just feel so distraught and dont know what the surgery would be like cause I cant see an OS right now....any input would Greatly be Appreciated.....
Posted by bchesney (Beth VA), 4 October 2004
Hi "Bigcrazywoman" (don't know your name!)
I'm sorry that you have all that pain with the cyst where it is in the kneecap. Atleast you have a diagnosis and it's great they see it on the scans. (Mine aren't seen at all!) I'm not familiar with anyone whose had this in that location and with RA. Good luck with your research and hope you feel better soon.
Beth
Posted by bigcrazywoman (bigcrazywoman), 21 October 2004
Thank you Beth for your concern. I was just wondering if you had a ultrasound done on your legs to find out. I have had numerous mri's and nobody has ever noticed it but then they did the ultrasound on my leg to rule out DVT and that is when they found it. I know how frustrating it can be without a diagnosis. I went for years without one. Now I am being diagnosed with too many things wrong.....and then no insurance to boot. But such is life.
Updated Tue Dec 2 2008