Synovial cysts develop when the facet joints in your spine, those between the bony projections, develop abnormal sacs filled with fluid. Medical experts have connected these cysts to the degenerative changes that happen as you age. They are most often found in the lower back but can develop anywhere along the vertebrae. Synovial cysts are not typically cancerous, and their symptoms vary depending on location and size. Many people feel intense back and leg pain that lessens in an upright position and worsens when standing. Treatments for synovial cysts vary based on symptoms and severity.
Symptom: Pain in the lower back
Pain in the lower back could indicate a number of issues that involve the spine, the most common being a torn ligament or a pulled muscle. When the issue is a synovial cyst, your back pain will increase each time you stand up and try to walk. Back pain is not present for everyone with cysts.
Symptom: Pain in the legs
Leg pain is one of the most common symptoms of synovial cysts. Many people expect some pain following excessive exercise or walking. However, the leg pain associated with cysts can be more serious. While some measures can ease the pain, both the patient and doctor should closely monitor its progression.
Symptom:Pain radiating to the feet
The leg pain can move down the back of the leg to the feet. Doctors diagnose this as sciatica, and it can also radiate through the buttocks. Sciatica happens when something is compressing the sciatic nerve in the lower spine. This issue can make the legs weak or numb and make it difficult to move.
Symptom: Leg cramping
In most cases, leg cramps are harmless. However, they create sudden discomfort because the contractions that happen are nearly impossible to ignore. Most people grasp the muscle and just endure the cramping until it stops. Drinking water to improve can also ease the sensation. If leg cramps are caused by a synovial cyst, however, this is only a temporary measure.
Symptom:Pain lessens when sitting
Pain caused by a cyst often eases when the individual is sitting because this position takes the pressure off the spine and gives the spinal joints a break. Standing and walking make the pain more intense. People with synovial cysts and these pain symptoms need to find a way to manage it since sitting all the time is usually not feasible.
Treatment: Surgery
Surgery is not a right or necessary option for everyone with synovial cysts, but a doctor may consider an operation if the pain becomes unbearable. The goal of almost any surgical treatment is removing the cyst to make more room for the spinal cord and nerves. The surgery to treat synovial cysts is similar to that of relieving herniated lumbar discs: the surgeon removes part of the disc to ease some of the pressure on the spinal nerve column. After the surgeon removes the cyst, he or she may need to fuse the joint to stop any movement in the affected area and prevent the cyst from coming back. Doctors evaluate each case of synovial cysts and determine the best treatment based on the overall medical situation.
Treatment: Pain medication
Medications for synovial cysts have the primary goal of helping manage pain. The prescription will depend on the patient’s medical history and other medications he or she is taking.
Treatment: Observing the cyst
Sometimes, a doctor may choose to treat a synovial cyst by leaving it alone and simply observing. This gives the doctor a chance to document changes over time. This is a logical first response if the cysts are not growing and not causing problems. If issues arise, the doctor will know the full history of the case and can make an educated decision about future treatment.
Treatment: Modified activity
Knowing which activities most aggravate a cyst can help a doctor determine treatment and recovery plan. Using this knowledge, he or she may prescribe mild exercises and stretches, as well as hot or cold compresses. It is also probable the doctor will point out activites the patient should avoid until recovery is complete.
Treatment: Injections
Doctors may choose to use two types of injections to treat synovial cysts. Facet injections are meant to help drain the fluid from the cyst through the facet joint. After the fluid is gone, the doctor will inject a steroid to reduce swelling and inflammation. The second type of injection treats pain temporarily, and patients may need multiple injections each day.