DEAR DR. GOTT: I was bothered by a large Baker's cyst after an injury to my left knee. I needed surgery to repair my knee, and my doctor said the cyst would disappear on its own after my knee got better. Well, my knee improved, but the cyst got worse. My doctor tried to drain it, but nothing came out. I was still advised against surgery unless it was absolutely necessary owing to the area and length of recovery time. Some days, the pain was so bad I could hardly walk. I didn't want the surgery, so I just dealt with the pain and hoped it would go away as the doctor said.

Well, one day, a year and a half later, I was enjoying playing with my grandchildren in the lake. I twisted my knee a little, felt it pop, experienced enormous pain, and fell into the shallow water. I couldn't get up for about 30 minutes, but my grandchildren eventually helped me into my car.

I thought I was in big trouble and was going to have the surgery for sure. I felt the pain all that night, but to my surprise, it was gone the next morning. Eight months later, I remain pain-free, and the knot on the back of my knee is gone as well.

I believe when I twisted my knee, it ruptured the cyst and staying in the cool water helped.

DEAR READER: A Baker's cyst, also known as a popliteal cyst, is often the result of a problem with the knee joint, such as a tear or arthritis. When this occurs, too much synovial fluid is produced, resulting in a cyst. By way of explanation, synovial fluid is a lubricant that circulates throughout the knees, passing through various tissue pouches known as bursae. A mechanism within the joint and back of the knee regulates the amount of the fluid passing in and out. A bulge forms when the bursae fill and expand. That bulge is called a Baker's cyst.

In some cases, no treatment is necessary. In others, however, help from a primary-care physician, physical therapist, medication, drainage or surgery to repair the torn cartilage might be appropriate. A physician should be consulted when pain and swelling are observed behind the knee. Noninvasive testing such as MRI or ultrasound can be performed for proper diagnosis.While rare, there are instances in which fluid can leak into the calf. This appears to be what happened to you. Usually, medical attention is necessary to help evaluate the symptoms of a ruptured cyst, because they can be similar to those of a blood clot in your leg. However, your cyst did rupture, and you were unable to see a physician before the condition resolved on its own.Lifestyle changes will go a long way toward relieving pain for many sufferers. They include a reduction in physical activity; over-the-counter aspirin, ibuprofen, naproxen or acetaminophen; rest, compression and elevation of the knee area; and icing of the joint. A substitute for an ice pack in the middle of the night just might be a bag of peas from the freezer wrapped around the joint.We have to give your physician the benefit of being correct. The cyst did go away by itself without surgery. I'm not sure that he would have expected it to burst while you were immersed in water, but all's well that ends well. Congratulations.To provide related information, I am sending you a copy of my Health Report "Managing Chronic Pain." Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a check or money order for $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.