Bakers Cysts And Back Of Knee Pain: What Does It Mean?

Bakers Cyst: A Potential Cause Of Pain In The Back Of Knee

As a physio seeing patients who are complaining of back of knee pain is not as common as having patients attend your practice complaining of anterior knee pain (front of knee pain). One potential cause of back of knee pain is due to the presence of a popliteal cyst, which is more commonly known as a Bakers cyst.

• A Bakers cyst is the more commonly used name for swelling in the behind the knee. This swelling is a result of a collection of synovial fluid being pumped inside the bursae at the back of the knee.
• Synovial fluid is the joint fluid that lubricates and nourishes the joint. A bursae is a sacs of fluid that are found throughout the body and generally are there to help cushion and reduce local friction in the area.

Generally this swelling associated with the diagnosis of a Bakers cyst is in the popliteal bursa, on palpation of the knee the swelling can be felt or seen between the two heads of the calf muscle at the back of the knee, with the swelling often being the easiest to visualize when standing.

Bakers Cysts As A Rule Typically Only Cause Quite Mild Symptoms

Back of knee pain resulting from a Bakers cyst is typically fairly mild pain, this is unless the swelling behind the knee becomes particularly enlarged or if there is a rupture of the Bakers cyst. Large Bakers cysts can restrict movement of the knee, causing pain and aching and a ruptured Bakers cyst can cause acute back of knee pain and as the fluid drains down the leg it may cause swelling in the calf and or ankle area . However, a lot of the time Bakers cysts are relatively asymptomatic and may just be a visual or palpable swelling in the back of the knee associated with a sensation of tightening behind the knee, and at times patients may be totally unaware they have this swelling in the popliteal bursa until someone points it out. 

Not  Secondary Symptom

A Bakers cyst is caused by inflammation from within the knee joint and can be associated with any condition causing inflammation and swelling in the knee. Hence Bakers cysts are really a secondary symptom resulting from an underlying knee condition. Meaning it is not a complete diagnosis in itself but assessment should be undertaken to highlight the underlying cause. Meaning highlighting that someone has a Bakers cyst on imaging like ultrasound imaging or by palpation or visualising the cyst is not actually the diagnosis, there will be an underling reason behind this swelling being present and getting to the root cause of this will be the key to fixing the back of knee pain.

Some Common Causes Of A Bakers Cyst

A couple of common knee conditions that can result in the presence of a Bakers cysts can include knee osteoarthritis and meniscal (cartilage) tears. Bakers cysts may be present as the result of an acute injury or from a more chronic condition. Physical assessment by a skilled physiotherapist, sports medicine specialist, orthopaedic surgeon may sometimes need to be combined with medical imaging such as an ultrasound scan to view the cyst, other investigations like an MRI or X-ray can help look for underlying causes such as the presence of arthritis or other pathology that could be a potential cause of the inflammation/swelling in the knee. There are also medical reasons that potentially can causes back of knee pain or what appears to be the presence of a Bakers cyst henceforth it is always a good idea to have things assessed and if appropriate investigations with some medical imaging.

Back Of Knee Pain Treatment For A Baker’s Cyst

Treatment of a Bakers cyst should always look at addressing the underlying cause, hence assessment and accurate diagnosis of the knee is vital to managing this and any cause of back of knee pain. A Bakers cyst is seldom removed surgically as they will inevitably just return if the underlying causes is not first solved. Solving any underlying cause will almost always lead to resolution of the Bakers cyst.
For more immediate relief of back of knee pain resulting from a Bakers cyst, treatment can be based on the principles of R.I.C.E (rest, ice, compression, and elevation) this coupled with short term use of anti-inflammatory medication will often provide relief while any underling cause is examined/treated.

The take home here is, if you have back of knee pain you suspect is from a Baker’s cysts then always seek medical advice, as it is almost always a representation of some underlying knee condition that would benefit from assessment and professional management.

Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance on Back Of Knee Pain should consult his or her general practitioner or physiotherapist or otherwise appropriately skilled practitioner.