Synovial Cysts

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WHAT ARE SYNOVIAL CYSTS? A synovial cyst can be described as a fluid-filled sac that develops due to the degeneration that occurs in the spine. This can also be called “joint fluid cyst” or “synovial fluid cyst”. This fluid-filled sac results in the pressure been exerted on the spinal canal creating spinal stenosis of the […] Read More

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Synovial Cysts

WHAT ARE SYNOVIAL CYSTS? A synovial cyst can be described as a fluid-filled sac that develops due to the degeneration that occurs in the spine. This can also be called “joint fluid cyst” or “synovial fluid cyst”. This fluid-filled sac results in the pressure been exerted on the spinal canal creating spinal stenosis of the spine, which is the degeneration of the facet joint of the vertebra of the spine. This could lead to the narrowing or shrinkage of the spinal column.  Synovial cyst grows mostly at the region of the lower spine called the lumbar spine and can be referred to as “lumber synovial cyst”. It occurs when the facet joint in the spine decomposes and produces a lot of fluid than a healthy joint and then this extra fluid may accumulate in the synovial lining of the joint, which provides an ideal environment for the development of a synovial cyst. Most synovial cysts do not produce symptoms and are hardly cancerous. However, they can become very large, pressing into the spine. Since synovial cyst is a degenerative condition, it is commonly seen in elderly people around the ages of 65 and above.  A synovial cyst can grow at any joints of the body. However, studies have shown more than 90 percent of synovial cysts affect the facets joints of the lumbar spine. Other synovial cyst areas include:
  • Wrist
  • Foot
  • Knee
  • Finger
  • Thumb
  • Hand
  • Ankle
  • Toe
  • Shoulder
  • Elbow
  • Popliteal space behind the knee.
Ganglion cysts, which are fluid-filled lumps that grow around the tendon and joint especially the hand and wrist are quite similar to that of synovial cyst abs many refer to it as “ganglion synovial” or “synovial ganglion cyst”. But they are not the same and the major difference between them is that the synovial fluid contains a lining of the synovium and ganglion cysts do not. DIAGNOSIS OF SYNOVIAL CYST The synovial cyst could be detected using magnetic resonance imaging, X-ray scans, computerize tomography scan which allows the doctor to see inside the spinal column to find any cysts or anything causing the symptoms.  When the cyst is detected, your doctor may recommend other scans to ascertain the degree of damage to the spine. You are advised to see the doctor if you notice that you have recurrent lower back pain, or pain in the lower region of the back, unexplainable leg pain, difficulty walking, etc. SYNOVIAL CYST TREATMENT The treatment of synovial cyst could include:
  • The use of pain relievers such as acetaminophen, ibuprofen, etc, to reduce the pain that could affect the quality of your life.
  • You will be advised to reduce strenuous activities or strenuous activities or exercises. Although mild and stretchy exercises could help.
  • The use of cold and heat therapy could be employed in the treatment of synovial cyst.
  • Your doctor may also recommend the use of facet injection in draining the fluid from the cyst through the facet joint, then a steroid is administered after the fluid is removed which aids the swelling and inflammation at the joint.
  • An epidural steroid injection is also used in treating synovial cyst. This procedure involves injecting an epidural steroid injection directly into the pain. Here,  the cyst is removed or reduced rather the injection is injected with aim of reducing the pain. This method is effective when combined with other methods of treatment.
  • Surgery, which involves synovial cyst removal, could be recommended by your doctor, especially when other methods are not productive. The surgery is not a complicated one but it will take recovery time. However, the innovation in technology and medicine has lead to an improvement in the surgical technique of this procedure.
COMPLICATIONS OF SYNOVIAL CYST Although the synovial cyst is not cancerous and hardly produce symptoms, however, when it becomes large and presses into the spine it could lead to serious complications such as spinal stenosis, cauda equina syndrome which could affect the root nerve at the lumbar spine leading to the loss of sensation and inability to move effectively, and sometimes even the functioning of the bladder and bowels.

Symptoms

A synovial cyst hardly produces symptoms until it becomes very large and compresses the spine hence producing symptoms of spinal stenosis.  These symptoms include:

  • Pain in the lower back.
  • Pains in one or both legs.
  • Radiating pain that moves from the back of the leg to the feet.
  • Cramping in the legs.
  • The feeling of numbness or tingling in one or both legs.
  • Increasing pain in the legs and lower back especially when standing and relieves when sitting.

Causes

WHAT CAUSES SYNOVIAL CYSTS?

A synovial cyst is caused by the degeneration occurring in the facet joints of the lumbar spine at the level of the L4-L5 and rarely at L3-L4- which is the lower portion of the back, where the spine curves inward. 

The pain is suspected to arise from the venous blood supply around the nerves that have not been able to drain properly leading to also to irritation. When you sit, the pain may be relieved as the pressure at the lumbar region is reduced. 

The facet joint is characterized by two opposing surfaces that are covered by a smooth slippery surface that allows a joint to move called “cartilage” and a thick capsule that contains a thin film of tissue that generates fluid within the joint called the “synovium”. When the joint degenerates, it produces more fluid.

RISK FACTOR OF SYNOVIAL CYST

Synovial cysts are predominantly found in people within the age of 50 years and above. It is quite rare to find a synovial cyst in young adults or children. Hence, age is a predominant factor in assessing the risk of developing synovial cyst.

Some diseases such as arthritis and other joint diseases could be a risk factor as the rate at which the facet joint degenerates in these people is high, hence, leading to the formation of a synovial cyst.