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Q: Can a Baker's cyst cause cervical muscle spasms? The cyst was caused by an injury 18 years ago, confirmed by arthrogram. I was told to ignore it, that it probably would not require surgery. The knee swells, and the cyst can be seen. I have received physical therapy and do exercises for the back spasms, but nothing short of pain meds really helps. It's getting real old.
A: A Baker's cyst is, by definition, the presence of a detectable amount of fluid within the tendon sheath of the knee. In general, the cause for such cysts is unknown. However, trauma may be an inciting factor in causing them. Furthemore, they appear more frequently in patients who also have rheumatoid arthritis or osteoartritis. Frequently, these cysts disappear on their own after some time. If the cyst does not rupture, patients typically present with swelling behind the knee without any or with only mild pain. If the cyst ruptures, a large inflammation of the leg can occur, with possibly severe leg swelling and pain. In these cases, the cyst can be confused with the disease referred to as thrombophlebitis, i.e., a sudden narrowing of a vein by clot formation within it. Correct diagnosis of the cyst can then be established by a negative venogram, to demonstrate the absence of a vein clot, followed by a knee arthrogram that demonstrates the cyst. By definition, a venogram consists in the injection of a dye in the veins in order to allow them to be visualized them when X-rays are used. Also, a venogram is said to be negative when it does not show any clotting in the veins. A knee arthrogram is a test which consists in the injection of dye and or air in the knee in order to better evaluate the joint by means of X-rays. In addition, knee fluid is also usually aspired for evaluation whwn an arthrogram is performed. Alternative to an arthrogram, either an ultrasound examination or a magnetic resonance imaging examination may also be carried out for evaluation of the knee. In most cases, however, the tests just mentioned do not need to be performed since the cyst does not rupture and diagnosis can easily be made on physical examination.
Treatment of a Baker's cyst is not usually necessary, since they tend to disappear spontaneously. However, when they rupture, treatment consists in leg elevation and injection of steroids within the knee.
In your case, it appears that trauma was a precipitating cause of the cyst. Furthermore, it also appears that you have osteoarthritis of the spine. As mentioned above, cysts tend to often occur in individuals with osteoarthritis. However, the back pain you refer to above, does not, per se, have anything to do with the cyst, since Bker's cysts may be associated with osteoarthritis but are not a causative factor for this disease.
Updated: 07/09/99
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