From the Research
Treatment for a Baker's cyst should prioritize conservative measures, including rest, ice, compression, and elevation, as well as addressing the underlying knee condition, with aspiration and corticosteroid injection considered for persistent or painful cysts, as supported by the most recent study 1. The initial approach to managing a Baker's cyst involves conservative measures aimed at reducing symptoms and addressing the underlying cause. This includes:
- Rest, to avoid exacerbating the condition
- Ice application, to reduce swelling and pain
- Compression, using an elastic bandage to support the knee
- Elevation, to reduce swelling by improving venous return Over-the-counter pain medications such as ibuprofen or naproxen can help manage pain and inflammation. Physical therapy exercises are beneficial for strengthening the knee muscles and improving range of motion. For persistent or painful cysts, a doctor may perform aspiration, using a needle to drain the fluid, sometimes combined with a corticosteroid injection to reduce inflammation, as demonstrated in a case report 1. Surgery is rarely needed but may be considered if the cyst causes severe symptoms or complications like rupture. Since Baker's cysts typically result from underlying knee problems like arthritis or meniscus tears, treating these primary conditions is essential for preventing recurrence. Other treatment options, such as low-dose radiotherapy 2, may also be effective in reducing the volume of the Baker's cyst and improving symptoms, but the most recent and highest quality evidence supports the use of aspiration and corticosteroid injection 1. It is also important to note that horizontal therapy combined with corticosteroid injection may be beneficial for patients with knee osteoarthritis complicated with Baker's cyst, as shown in a randomized controlled trial 3. However, the most recent study 1 provides the strongest evidence for the treatment of Baker's cyst, and its findings should be prioritized in clinical practice.