Question from Falk S.: I have had knee pain for about four weeks. The medical examination revealed a Baker's cyst. What treatment options are there to be free of pain again?
Dr Merkl: Baker's cyst is a fluid-filled blister, usually on the inside of the posterior knee joint. It is always a secondary syndrome, i.e. the result of damage to the knee joint. This can be a meniscus problem, weakness of the joint cartilage, arthrosis or an inflammatory rheumatic disease. As a result, the knee joint produces more fluid, which moves into the hollow of the knee at the point of least resistance and collects there. As the fluid can go there but cannot flow back easily, the cyst exerts increasing pressure on the tissue structures, nerves and vessels at the back. This can lead to pain in the hollow of the knee as well as numbness, paralysis or circulatory problems in the lower legs and feet. Occasionally the pressure becomes so high that the cyst bursts and thrombosis-like symptoms develop.
If the cyst is not too large, it does not usually need to be surgically removed; this is usually not even advisable due to the risk of infection and possible new growth. Instead, the therapy should address the cause of the actual possible diseases mentioned above.
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