What is Ganglion Cyst?
Ganglion cysts are benign lumps and consist of thick, sticky, colorless, jelly-like material. Commonly located adjacent to joints or tendons, the common areas include:
- Top of the wrist (dorsal ganglion cyst)
- Palm side of the wrist (volar ganglion cyst)
- Base of the finger near the
- Top of the end joint of the fingers, knee, foot & ankle
Does Ganglion Cyst Hurt?
Ganglion cysts usually are not painful but when they show the signs of change in size, it creates burning or tingling or shifts the position, then it might hurt and even pain mildly.
Common Locations of Ganglion Cyst
- Dorsal ganglion cyst: This kind of Ganglion cyst is very common and is located on the back side of the wrist above the wrist bones lunate and scaphoid.
- Volar ganglion cyst: The cyst is located on the front side of the wrist and varies from pea to a small sized lemon but sometimes it can be large enough to cover the entire wrist.
Larger ganglion cyst may sometimes cause restriction to the motion of the wrist. People often get confused with the concurrent carpel tunnel syndrome or other problems with the ganglion cyst in the wrist and blame it as a cause of pain.
But the significance is incorrect because a ganglion cyst is never painful. The cyst can be manually removed by compressing and the fluid can drain out, but a more massive cyst which creates more irritation has to be removed surgically.
A ganglion cyst can be present near the first or second interphalangeal joint on the outer surface and might also be present at the base of a finger. Any kind of ganglion cyst, whether small or significant can cause inability to use the hand fluently or result in a faulty grip. In case the cyst is for a more extended period, then it can cause deformity in finger permanently. Hence, such ganglion cysts should be promptly removed.
Usually, ganglion cyst on the foot occurs just below and in front of the ankle. But the ones on the toe cause problem in wearing sandals or shoes with its tip pointed. This place has several small tendons and ankle bones which makes it a highly dynamic area of the foot. Because of no symptoms, they remain negotiated and can only be seen during foot examination for some other case. It can be painful when wearing shoes due as it increases in size. The cause of the cyst on foot can be because of the irritation in the inner lining of the joint or tendons. This is common amongst people who wear boots. The cyst can be removed surgically, and it has 10% chances of reoccurrence.
Earlier it was thought that the ‘Baker’s Cyst’ present on the back of the knee is a ganglion cyst type and similar problems of the knee raised due to the infection and inflammation of bursa around the knee but they are different from ganglion cyst and people should not get confused with it.
The second most common place where the cyst appears is on the elbow. It causes pain and swelling in the anterior part. People who play handball, squash, tennis or racket ball are mostly affected by this type of cyst. Repeated injuries in the elbow can cause the adjacent tissues to exfoliate and swell up. The swollen portion contains a thick, jelly-like fluid which is non-cancerous but can be a reason for mild sprains.
The reason for developing a ganglion cyst in the ankle is unknown, but it has few symptoms which indicate a cyst. Increase in the size of the ankle, burning and a pain while pressing the adjacent tendons indicates towards presence of the cyst.
Causes of Ganglion Cyst
The causes are unknown, but they may appear due to mechanical changes or irritation in the joints or tendons. They can occur in patients of all ages but are common to women aged between 20 to 30 years. Some of the risk factors that can be a cause are:
- Injury to joints or tendon
- Vigorous usage of certain joints (g., female gymnasts)
Symptoms of Ganglion Cyst
- Looks like a bump or mass
- Has a soft touch with size varying from 1-3 cm in diameter and it does not move
- Doesn’t show any symptoms except for swelling but sometimes can cause severe pain
- When connected to any tendon it generates weakness within the affected area
- Presence of pain is usually chronic and joint motion makes it worse
Diagnosis of Ganglion Cyst
During initial stages of a check-up, doctors might press the cyst to check the tenderness or discomfort and even check whether it is fluidic or a solid mass. If the condition is severe, further investigation is recommended by using imaging tests such as X-Rays, Ultrasound or magnetic resonance imaging (MRI) to detect other medical complications such as arthritis or a tumor.
Treatments for Ganglion Cyst
Some ganglion cyst may disappear without any treatment but might take a longer time. Doctors often prescribe ointments and antibiotics as medicine for a ganglion cyst. However, sometimes these cysts can be a great threat and necessary steps need to be taken which may include:
- Immobilization: Cyst size may increase due to movement in the affected area, so the application of brace will stop the movement and will help to reduce the size.
- Aspiration: Removal of fluid within the cyst can remove the cyst permanently. Injecting an enzyme can cause the fluid to drain out of the cyst and later steroids may be injected to stop its re-occurrence. But it does not give an assurance that the cyst might not develop again.
- Open surgery: A small surgery known as surgery for ganglion cyst excision removes the cyst along with a portion of the joint capsule or a tendon sheath.
- Arthroscopic surgery: Also known as the keyhole surgery, it is highly successful and lessens the chances of re-growth of the cyst.
Pain relievers can be applied to reduce the pain, but it is important to avoid popping or squeezing the cyst as it can increase the risk factor. Home remedies such as the application of aloe vera, Epsom salt, black tea bags, arnica oil or frankincense oil can also help in healing and ease the pain.