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Baker’s Cyst (aka Popliteal Cyst)

causes, symptoms, treatments, & Other Conditions

A Baker’s cyst can cause knee pain. It is swelling caused by fluid from the knee joint protruding to the back of the knee.

They are NOT a true cyst since it has communication with the synovial sac. They typically arise from degenerative changes or injury to the articular cartilage (arthritis) or meniscus.

At the Centeno-Schultz Clinic, we believe that baker’s Cysts are simply a barometer of the health of the knee joint. In a healthy knee, there are absent whereas with injury and degenerative changes they are common. They arise between the tendons of the medial head of the gastrocnemius and the semimembranosus muscle.

What Causes Baker’s Cyst

The cause of a baker’s cyst is not fully understood, but it’s thought that they may be caused by:

· a build-up of fluid inside the knee joint (known as synovial effusion)

· damage to the lining of the knee joint (cartilage tear)

· a problem with the way the knee joint moves (known as joint instability)

· a meniscus tear

· Knee osteoarthritis

· Patellofemoral dysfunction

Popliteal cysts are sort of like a barometer for the knee’s overall health. If you have a baker’s cyst, it could mean that something is wrong with your knee and you should see a doctor, as there may be an underlying issue that warrants further evaluation. There are other causes of knee pain not related to the knee. For example, a blood clot also known as a deep vein thrombosis can also present as pain on the backside of the knee with swelling. This is a serious medical condition with life treating consequences.

Symptoms

Back of Knee Swollen

Back of knee swollen? Swelling in the back of the knee is not something that is talked about too often. It can be uncomfortable or sometimes painful with the movement of the knee or, even with rest. It often stems from an orthopedic-related issue or, perhaps some other medical condition. Let’s dive in…What’s Causes Swelling in the Back of Your Knee? The back of the knee contains a variety of anatomical structures that can be affected and result in pain, swelling, numbness, tingling, etc. Muscles and tendons behind the knee that could be the source of pain or pathology could be one or more of the following: Gastrocnemius, Soleus…

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Back of Knee Tight

Stiffness in the back of the knee can be a sign that there is damage or inflammation in the joint, arthritis, or a baker cyst. This might be due to an injury, overuse, or medical condition. If you are experiencing stiffness in your back knee, it is important to see a doctor determine the cause and get treatment. Common causes of stiffness in the back of the knee include: tight muscles, tendons, and ligaments, Injury to the joint or surrounding tissue, overuse such as from running or biking for long periods. Stiffness at night can potentially indicate damage to the joint…

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Can’t Straighten Knee

Your knee is capable of moving in a number of directions. The most common are flexion and extension. Flexion is when you bend your knee and the shin bone moves towards the buttock. Knee extension is when you straighten out your knee. The extension is the opposite of flexion. PT, trainers, and physicians alike measure the degree of knee flexion and extension. When lying flat on an examination table or hard surface your knee should be able to extend so that there is no angle between the thigh and shin bone. The inability to straighten the knee is also known as an extension lag and is a reason for concern.

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Knee Pain

Knee pain can be caused by many factors. Overuse injuries, direct trauma to the knee and arthritis are the most common causes of knee pain. Damage to the knee structures may cause swelling, scar tissue formation (fibrosis), and loss of function of the joint. Pain is often accompanied by difficulty walking, weakness, and instability. When the knee is overused, the thigh and shin bones (femur and tibia), cartilage, or tendons may experience stress. This leads to pain and discomfort as well as stiffness in the knee. Overuse injuries are common among athletes who participate in sports that involve running, jumping…

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Knee Popping

Knee popping can be a sensation that something is moving around in the knee. There may also be an audible sound associated with the popping, which in medical terms is called crepitus. This can also cause what we call mechanical catching or locking, which may make the knee feel like it is stuck in an extended or flexed position, and you have to move it in certain ways to get out of that. This knee popping sensation or sound or could be a very simple issue or it could be a sign that more serious damage is going on in the knee, so determining what is causing it is very important. So, the knees may pop and get in a certain position….

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Knee Swelling

Swelling of the knee, also known as water on the knee, is a condition in which fluid collects around the knee joint. Swelling can occur for a variety of reasons and affect patients of any age. Some swelling can be treated with over-the-counter medicines, but persistent and continuous swelling might result in tissue damage, bone softening, and cartilage deterioration. Over-the-counter medicines will assist relieve pain for individuals with a history of osteoarthritis and swelling following physical activity, such as exercise or running. During and after activity, the patient may apply compression sleeves to reduce the inflammation. Ice is another method…

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Outside Knee Pain

What causes outside knee pain? How do you treat it? Let us go over all of this and also review how one patient avoided a huge surgery. What is On the Outside of the Knee? You have a couple of key structures here (1). They include the: Lateral meniscus, Lateral joint compartment, Popliteus tendon, Iliotibial band, Lateral collateral ligament , and anterolateral ligament, and Fibula. The meniscus is a figure-8 shaped fibrous structure (shown here from above) that is a shock absorber for the knee joint. It has an outside part (lateral meniscus) that cushions the joint. The meniscus can become torn or degenerated. If you are young…

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Pain Behind Knee

First off, this is where the hamstrings and calf muscles attach. They have tendons here that are inserted into the bone. So if there’s a problem in the muscle or the tendon, you’re going to feel it right here. This is also where deep muscles like the popliteus and plantaris live. So, if these have issues, you’re going to feel it in the back of the knee. In addition, the tibial nerve is back here. So if there’s an issue with a nerve in your back or a nerve locally, behind the knee, you’re going to feel it here. And the meniscus or the joint spacer lives back here. And the meniscus or the joint spacer lives back here. So a tear in the meniscus could cause pain…

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Treatment Options for Baker’s Cyst

Treatment options for Baker’s Cyst in the knee include rest, drainage, cortisone injection, ice packs, and surgery. Treatment at the Centeno-Schultz Clinic with prolotherapy has been published and continues to be preferred.  Because bone marrow concentrate (BMC) containing stem cells and PRP may be useful for other things, as, again baker’s cysts are sort of like a barometer for the knee’s overall health, the use of BMC or PRP injections can help them indirectly by helping some other portion of the knee.

The recent introduction of ultrasound-guided PRP and prolotherapy will optimize clinical results in the non-surgical treatment of this and other conditions.

NSAIDs

The other day I was evaluating a patient and reviewing the treatment options for their spine condition.  After discussing prior treatments, we got to the topic of medications taken for pain relief. She explained that she mainly utilized anti-inflammatory (NSAID) medications and then she told me to hold much she takes and has been for many years…..she takes close to 2 grams (2000 milligrams) on a daily basis which equated to about 9-10 capsules of medication per day.  I was shocked, considering she was pre-diabetic and with high blood pressure plus the kicker of it is that her PCP (primary care physician) is ok with this…

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PRP for Baker’s Cyst

PRP therapy has been shown to be an effective treatment for baker’s cysts and many of the underlying issues that cause them. PRP stands for platelet-rich plasma. It is a procedure that involves drawing a patient’s blood from their arm, spinning it in a centrifuge thereby isolating and concentrating the platelets. Platelets are rich in growth factors that can increase blood flow, decrease inflammation, and accelerate healing. Treatment of bakers involves identifying the underlying cause and addressing it. The baker’s cyst is often drained under ultrasound guidance. PRP can then be injected to reduced swelling and pain as well as improve joint function…

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PRP Knee Injections

PRP stands for Platelet-Rich Plasma. Platelets are blood cells that prevent bleeding. They contain important growth factors that aid in healing. Plasma is the light yellow liquid portion of our blood. So PRP is simply a concentration of a patient’s own platelets that are suspended in plasma and are used to accelerate healing. PRP is NOT stem cell therapy. Regrettably, blood contains few circulating stem cells. Rich sources of stem cells are bone marrow and fat. PRP is rich in growth factors. There are many different types of growth factors with different properties. VEGF is a very important one as it can increase the blood flow to an area.

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Doctors That Assist with Baker’s Cyst

Christopher J. Centeno, MD

Christopher J. Centeno, M.D. is an international expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate in orthopedics. He is board-certified in physical medicine and rehabilitation with a subspecialty of pain medicine through The American Board of Physical Medicine and Rehabilitation. Dr. Centeno is one of the few physicians in the world with extensive experience in the culture expansion of and clinical use of adult bone marrow concentrate to treat orthopedic injuries. His clinic incorporates a variety of revolutionary pain management techniques to bring its broad patient base relief and results. Dr. Centeno treats patients from all over the US who…

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John Schultz, MD

My passion and specialization are in the evaluation and treatment of cervical disc, facet, ligament and nerve pain, including the non-surgical treatment of Craniocervical instability (CCI). I quit a successful career in anesthesia and traditional pain management to pursue and advance the use of PRP and bone marrow concentrate for common orthopedic conditions. I have been a patient with severe pain and know firsthand the limitations of traditional orthopedic surgery. I am a co-founder of the Centeno-Schultz Clinic which was established in 2005. Being active is a central part of my life as I enjoy time skiing, biking, hiking, sailing with my family and 9 grandchildren.

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John Pitts, M.D.

Dr. Pitts is originally from Chicago, IL but is a medical graduate of Vanderbilt School of Medicine in Nashville, TN. After Vanderbilt, he completed a residency in Physical Medicine and Rehabilitation (PM&R) at Emory University in Atlanta, GA. The focus of PM&R is the restoration of function and quality of life. In residency, he gained much experience in musculoskeletal medicine, rehabilitation, spine, and sports medicine along with some regenerative medicine. He also gained significant experience in fluoroscopically guided spinal procedures and peripheral injections. However, Dr. Pitts wanted to broaden his skills and treatment options beyond the current typical standards of care.

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Jason Markle, D.O.

Post-residency, Dr. Markle was selected to the Interventional Orthopedic Fellowship program at the Centeno-Schultz Clinic. During his fellowship, he gained significant experience in the new field of Interventional Orthopedics and regenerative medicine, honing his skills in advanced injection techniques into the spine and joints treating patients with autologous, bone marrow concentrate and platelet solutions. Dr. Markle then accepted a full-time attending physician position at the Centeno-Schultz Clinic, where he both treats patients and trains Interventional Orthopedics fellows. Dr. Markle is an active member of the Interventional Orthopedic Foundation and serves as a course instructor, where he trains physicians from around the world.

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Matthew William Hyzy, D.O.

Doctor Hyzy is Board Certified in Physical Medicine and Rehabilitation (Physiatry) and fellowship-trained in Interventional Orthopedics and Spine. Dr. Hyzy is also clinical faculty at the University of Colorado School of Medicine in the Department of Physical Medicine and Rehabilitation; In addition, Dr. Hyzy is an Adjunct Clinical Assistant Professor at The Rocky Vista University College of Osteopathic Medicine. Dr. Hyzy also maintains an active hospital-based practice at Swedish Medical Center and Sky Ridge Medical Center. He is also recognized and qualified as an expert physician witness for medical-legal cases and Life Care Planning. He is published in the use of autologous solutions including…

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Brandon T. Money, D.O., M.S.

Dr. Money is an Indiana native who now proudly calls Colorado home. He attended medical school at Kansas City University and then returned to Indiana to complete a Physical Medicine and Rehabilitation residency program at Indiana University, where he was trained on non-surgical methods to improve health and function as well as rehabilitative care following trauma, stroke, spinal cord injury, brain injury, etc. Dr. Money has been following the ideology behind Centeno-Schultz Clinic and Regenexx since he was in medical school, as he believed there had to be a better way to care for patients than the status quo. The human body has incredible healing capabilities…

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Other Resources for Popliteal Cyst

Free Download: The Knee Owner’s Manual

This e-book by Dr. Chris Centeno examines the knee and its role in the human musculoskeletal system and the body as a whole. The Knee Owner’s Manual provides a series of tests and clearly defined exercises that you can perform on your own to assess and monitor your own knee health. It will allow you to look for trouble spots where your own body may be having difficulty with stability, articulation, symmetry, and neuromuscular function. You’ll be able to see how these deficits in other regions of the body relate to the knee.

The Knee Owner’s Manual also discusses how Regenexx is pioneering the development of interventional orthopedics, a new branch of medicine that employs regenerative biologic therapies such as adult bone marrow concentrate and platelet-rich plasma to help repair and strengthen damaged tissues in other areas of the body.

This is contrasted with invasive knee surgeries, which often remove important tissues or replace the entire knee itself when it becomes damaged. With hyperlinks to more detailed information, related studies, and commentary, this book condenses a vast amount of data, images, and resources into an enjoyable and informative read. This is the first edition of The Knee Owner’s Manual, a companion book to Orthopedics 2.0.

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  • How To Heal A Torn Meniscus Naturally

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  • How to Avoid Knee Replacement: A Quickstart Guide

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  • How to Read a Knee MRI for Meniscal Tear

    Dr. Chris Centeno discusses how to read a knee MRI for meniscal tears and what you need to know about such tears. Transcript Hi, this is Dr. Centeno. And I’d like to go over today How to Read Your Knee MRI: Focus on the Meniscus. I have a whole series of these and reading a … Continued


  • 7 Most Common Symptoms of a Loose Knee Replacement

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  • How Likely Is a Second ACL Tear On the Same Knee?

    Anterior Cruciate Ligament Injuries and Treatments The ACL (anterior cruciate ligament) is an important knee stabilizing ligament. It prevents the tibia from moving too much frontward (anterior translation) and twisting too much (internal rotation).  It is under most stress with landing from a jump, or a planted foot with twisting, and this is how it … Continued


References:

Centeno CJ, Schultz J, Freeman M. Sclerotherapy of Baker’s cyst with imaging confirmation of resolution. Pain Physician. 2008 Mar-Apr;11(2):257-61. PMID: 18354718.

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