Baker’s Cyst Removal – 5 Ways to Remove a Baker’s Cyst

A Baker's cyst, also known as a popliteal cyst or popliteal bursitis, is a fluid-filled sac that forms behind the knee. It's caused by a buildup of synovial fluid, the lubricating fluid that helps reduce friction within your joints.

When the body produces too much synovial fluid, it can lead to swelling and the formation of a Baker's cyst. The excessive fluid production can be due to various conditions such as arthritis or a knee injury, such as a cartilage tear or more commonly, a meniscus tear.

Symptoms of a Baker's cyst can vary. Some people may not have any symptoms at all, but many people complain to Surrey Physio about the following:

Tightness in the back of the knee.
Swelling behind the knee, which can become more noticeable when the individual fully extends their leg.
Knee pain.
Knee stiffness.
In some cases, a Baker's cyst may burst, leading to fluid leaking down into your calf, causing swelling and redness in that area, and often sharp pain in the knee.

Treatment for a Baker's cyst often involves addressing the underlying condition that led to its formation. This can involve physiotherapy, medication for pain and inflammation, and in some cases, surgery. It's also possible for the cyst to disappear on its own without treatment. However, it’s best to get the knee assessed as often there are “other things” going on with the knee, and at Surrey Physio we will be able to examine the knee.

Let’s look at 5 Ways to Remove a Baker’s Cyst

1. Baker’s Cyst Aspiration

A Baker's cyst aspiration is a procedure done by our team at Surrey Physio (price at time of writing this article: £140.00) to drain the fluid from the swollen area at the back of the knee. Tim, Peter and Ben perform this procedure.

Preparation: Before the procedure, our physio will examine your knee and confirm the diagnosis of a Baker's cyst. They will explain the procedure and answer any questions you may have.
We clean the area and carefully and gently insert a needle into the cyst. Ultrasound guidance may be used to help accurately place the needle. The fluid inside the cyst is then drawn out through the needle. Sometimes we may need to re-position the needle to get to the reservoir.
Steroid Injection: In some cases, after the fluid is removed, some people request an injection of steroid into the joint. This can help reduce inflammation and prevent the cyst from recurring. This is optional and has an additional cost of £40.00.

After the Procedure: after the aspiration, the area is cleaned if needed, and a plaster is put on. It is best to take things easy and over the next 24-48 hours. It is fine to drive home.

Aspiration is a safe procedure, but as with any procedure, there are potential risks, including infection and bleeding (especially if you are on blood thinners/medication). We use sterile equipment and have not yet had a single case of a knee infected over many thousands of injections/aspirations. There's also the chance that the cyst may reoccur but, in many cases, it does not.

2. Baker’s Cyst Surgery

At Surrey Physio, we’ve never sent anyone for a Baker’s cyst surgery. This is because they can easily be drained from an aspiration, and the aspiration is effective and affordable (£140.00). Surgery on the other hand is more complicated, and if performed on the NHS would have long waits, and performed privately it would be expensive.

Surgery is not something we are too familiar with. However, we strongly recommend conservative treatment approaches.

3. Ice for Baker’s Cyst

Applying ice to a Baker's cyst can help to reduce inflammation and relieve pain. Here are some general guidelines for using ice to treat a Baker's cyst. Never apply ice directly to your skin as it can cause skin damage or an ice burn. Always wrap the ice or ice pack in a thin towel or cloth before applying it to the area. Place the wrapped ice or ice pack on the cyst for about 10 minutes at a time, and use once to twice per day. Repeat daily for up to three months. It does take time to work.

Also keep in mind that while icing can provide temporary relief from symptoms, it may not cure the cyst or address the underlying issue causing the cyst. Always consult one of our Surrey Physio team members for advice tailored to your specific circumstances. If the cyst is causing significant discomfort, you probably need to get it aspirated.

4. Exercises for Baker’s Cyst

Exercises can be helpful for Baker’s cysts. Range of movement exercises can help reduce swelling in the knee. Strengthening exercises can help stabilise the knee to reduce any instability. Exercises basically help to improve the function of the knee. The main function of the knee is to bend and straighten, flexion and extension. This is to allow us to move, to walk, to run, our gait. Exercises improve mobility, improve function, and this can help reduce swelling. Find more exercises for a Baker's Cyst here.

Here is an example of a mobility exercise:

And a hamstring stretch:

5. Steroid Injection

Aspirations are, in my opinion, much better for a Baker’s cyst. However, steroid could be used at the back of the knee to reduce inflammation. This could be the case if the cyst cannot be drained for whatever reason. Also, some people like to have the knee aspirated and then injected with a steroid. This is possible, and we do this if patients request it. The steroid is a strong anti-inflammatory that works locally, and has an anaesthetic to help reduce pain. This differs from oral non-steroidal anti-inflammatories that it works directly on the area. We do steroid injections, but are always cautious and use a shared decision-making process with patients.

If you are a therapist and like the exercises and information in this article, please go to www.rehabmypatient.com to check out this amazing exercise prescription software.

If you are a patient and need some advice about a Baker’s cyst, or want to get your Baker’s cyst drained, please call us on 02086856930. We will need to see you face-to-face for a Baker’s Cyst draining and book you specifically with one of our trained injection therapists.