What conservative measures can be advised to patients with asymptomatic Baker's cysts?

Conservative management options for patients with asymptomatic Baker's cysts include no active treatment and reassurance. If the cyst is asymptomatic and diagnosis is confirmed by ultrasound, no treatment is required as primary Baker's cysts often resolve without intervention. Patients should be reassured about the benign nature of the cyst in this context. Treatment should focus on identifying and managing any underlying joint pathology, such as osteoarthritis or inflammatory joint disease, which may contribute to cyst formation. Direct aspiration of the cyst in primary care is not recommended. If symptoms develop or become troublesome, simple analgesia (such as paracetamol or ibuprofen) and physiotherapy may be considered. Referral to a specialist (rheumatologist or orthopaedic surgeon) is advised if symptoms persist despite conservative measures, the cyst is very large, or the diagnosis is unclear.

These recommendations are based on expert opinion and review articles, emphasizing that excision of the cyst is generally not recommended due to high recurrence rates and that treating underlying joint conditions can lead to cyst resolution.

NICE CKS