Lumbar Synovial Cysts form when fluid builds up in the lumbar facet joints which then stretches the tissue surrounding the joint. Any weak area of synovial tissue can balloon up becoming a cyst. If the cyst is inside the spinal canal, it can put pressure on one or more nerves causing pain.
Most people with a synovial cyst have pain in the buttock or hip that radiates down the leg. Some patients have back pain also, but buttock, hip and leg pain are generally the predominant complaints. In addition to pain, numbness and weakness may be present.
Synovial cysts are diagnosed based on the location of the symptoms and confirmed with imaging studies, usually an MRI or CT myelogram.
Treatment for synovial cysts varies widely. Most often, treatment starts with the least invasive and least risky options and progresses from there.
While narcotic pain medications are often given for the symptoms caused by the cyst, rarely do these medicines provide more than short term relief of symptoms, and most of these medications are highly addictive in nature. Instead, anti-inflammatory medications like ibuprofen or naproxen may in some individuals provide more long-term relief without the potential for addiction.
Exercise, physical therapy and chiropractic treatments can sometimes provide temporary relief of symptoms, but most cysts will cause recurrent pain.
Another treatment that has been used is to inject the cyst in the hopes of causing a rupture. Unfortunately, this has not been shown to be widely successful.
The definitive treatment for most synovial cysts is surgical. Surgery can often alleviate the symptoms of leg pain fairly rapidly. The risks of surgery vary depending on the surgery required, but most complications are rare. Most patients experience fairly rapid relief of their nerve pain symptoms after the surgery.