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Synovial Cyst

Synovial cysts are fluid-filled sacs that form in the joints of the spine, most commonly in the lumbar (low-back) region, due to age-related bone degeneration. These cysts may cause cramping, tingling, or pain in the lower back or leg, or no symptoms at all.

Treatment may include injections, medicines, and, rarely, surgery.

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  • Neurosurgery.
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On this page

  • What Is a Synovial Cyst? 
  • What Are the Symptoms of a Synovial Cyst?
  • How Do You Diagnose a Synovial Cyst?
  • How Do You Treat a Synovial Cyst?

What Is a Synovial Cyst?  

Synovial cysts are fluid-filled sacs that occur in the spine. They can form in the cervical (neck), thoracic (upper back), or lumbar (lower back) areas, but most develop in the lumbar spine.

This type of cyst results from age-related degeneration of the facet joints of the vertebrae (spinal bones). They are always benign (noncancerous).

Most synovial cysts are asymptomatic, meaning they do not cause symptoms. Asymptomatic synovial cysts often went undiagnosed until the last decade, when improvements in imaging began revealing more of them.

What causes synovial cysts?  

The facet joints of the spine are small connector bones that link two vertebrae together and allow you to bend and twist your upper body. They also limit over-rotation and keep the vertebrae from slipping out of place.

Facet joints are made up of cartilage, a fibrous capsule of connective tissue and ligaments, and synovial fluid, which lubricates the joints and decreases friction. As spinal facet joints break down, they can produce more fluid to protect the joint than a healthy joint needs. This extra fluid can build up in the synovial lining of the joint, causing a cyst to form.

The fluid in the cyst is not dangerous on its own. It is not under any pressure within the joint and will not cause problems unless it pushes on the spine. Even the largest spinal synovial cysts rarely cause problems.

Do synovial cysts need to be removed?

Since most synovial cysts do not cause symptoms and are benign, they do not have to be removed. They may be treated with nonsurgical approaches first if they cause mild symptoms. Surgery is only performed when nonsurgical approaches fail to relieve symptoms.

What are synovial cyst risk factors and complications?  

Synovial cyst risk factors  

The risk factors for synovial cysts include:

  • Being female.
  • Being in your 60s or older.

Complications of synovial cysts

Although these cysts are uncommon and don’t often produce symptoms, they may cause issues with your spine.

Spinal stenosis, or the narrowing of the spinal column, is one of these issues. As the open spaces within the spinal column compress, pressure can increase on the spinal cord and nerves, causing pain and cramping in the back or legs. Standing may worsen the symptoms.  

Very rarely, synovial cysts can cause cauda equina syndrome (CES) to develop — a serious condition that may require emergency medical attention. CES is when there is a bundle of spinal nerves and nerve roots in the lumbar or sacral (tailbone) area. Its name means “horse tail” in Latin because the bundle of nerves resembles a horse’s tail.

How can I prevent a synovial cyst?

Although you cannot prevent a synovial cyst, you can lower your risk by taking care of your spine.  

For example:

  • Avoid prolonged positions, whether sitting or standing.
  • Incorporate abdominal exercises into your routine to keep your core strong.
  • Lift heavy objects with proper form — bending from the knees and using your legs, not your back.
  • Maintain a healthy weight to prevent additional pressure on nerves.
  • Stay active by walking or getting regular exercise.
  • Take periodic breaks if you engage in repetitive activities to avoid nerve and muscle overuse.
  • Use good posture when sitting, standing, or sleeping to reduce pressure on your nerves.
  • Work ergonomically by adjusting your workstation to reduce body strain and keeping your computer screen at eye level.

How common is a synovial cyst? 

Synovial cysts are uncommon. According to the National Institutes of Health, their incidence is thought to be less than 0.5% of the general population with symptoms.

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What Are the Signs and Symptoms of Synovial Cyst?

Synovial cysts usually cause no symptoms until they become large enough to put pressure on the spinal cord or nerves within the spinal column. When they have grown to that point, spinal stenosis, or narrowing of the spinal column, often results, and you may begin to have symptoms.

Synovial cyst symptoms might include:

  • Cramping or pain in one or both legs.
  • Lower back pain.
  • More pain when standing that improves when sitting.
  • Numbness or tingling in one or both legs.
  • Sciatic nerve pain radiating down the back of the leg to the feet.

When should I see a doctor about my synovial cyst symptoms? 

If you experience symptoms of a synovial cyst that make it hard to complete your activities of daily living, talk to your doctor.

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How Do You Diagnose Synovial Cyst? 

Synovial cysts can best be seen with imaging. Specifically, an MRI enables your doctor to see inside the spinal column to find cysts or any other issues that may be causing your symptoms.

If an MRI reveals a cyst, your doctor may order additional tests, such as x-rays or ultrasound, to check for spine and spinal column damage. A surgeon may also use these images to look for instability issues before cyst-removal surgery.

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How Do You Treat a Synovial Cyst?  

Your doctor may recommend nonsurgical treatment options for your synovial cyst.

Lifestyle changes for synovial cysts

If certain activities make your symptoms worse, such as exercising or standing at work, your health care provider can help you find ways to modify your activities to lessen symptoms. Easy stretching and heat or cold therapy may reduce discomfort, but ask your doctor first.

Injections for synovial cysts

There are two types of injections used to treat a synovial cyst:

  • Epidural steroid injection — Temporarily treats pain caused by the synovial cysts. Additional injections may be needed to sustain the effects.
  • Facet joint injection — Drains fluid from the cyst through the facet joint and then inserts a steroid to reduce inflammation and swelling.   

Medicine for synovial cysts

Over-the-counter (OTC) pain relievers like acetaminophen and ibuprofen can reduce synovial cyst pain. If they do not help, your doctor may prescribe a stronger pain medication.  

Watch-and-wait approach for synovial cysts

If your cyst does not cause your problems, your provider may recommend not treating it. They may recommend a watch-and-wait approach to see if the cyst grows.

Surgery for synovial cysts

If nonsurgical synovial cyst treatments do not provide relief, your provider might recommend surgery to remove the cyst. This surgery is not difficult but requires recovery time. Your doctor may be able to use a minimally invasive surgical procedure to remove the cyst, which may lessen your pain and recuperation time. 

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By UPMC Editorial Staff. Last reviewed on 2025-06-26.

  • Medical News Today. Synovial cyst: Symptoms, causes, and treatment.
  • PMC. Spinal lumbar synovial cysts. Diagnosis and management challenge.
  • HealthLine. Synovial Cyst: Symptoms and Treatment.
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