A ganglion cyst is a small tumor-like lump of tissue filled with a clear, odorless, jelly-like liquid. Ganglion cysts can form either on a joint capsule, which is the connective tissue between two bones, or on a tendon, which is the connective tissue that connects bone to muscle. Although ganglion cysts are most common around the wrist area, they can occur on the top of the foot and the ankle.
The exact cause of ganglion cysts is unknown, but injuring the joint or tendon is thought to be the main contributing factor. These injuries can be internal, such as spraining or straining the foot, or external, such as dropping an object on the top of the foot or wearing shoes that are too tight. Ganglion cysts can often form where there is no injury or the injury was so slight that you did not even notice.
The most obvious symptom of a ganglion cyst is a small lump ranging in size from approximately one to three centimeters. The cyst can change in size, getting larger and smaller throughout the duration of the affliction. There can be some swelling, especially if the ganglion cyst is pressing against a sensitive area. Ganglion cysts that form on tendons may cause weakness in the surrounding area.
A ganglion cyst by itself does not typically cause pain. The pain associated with ganglion cysts is actually the cyst putting pressure on the tendons, joints, and nerves. This can be especially troublesome when ganglion cysts present on the top of the foot, as most shoes will push the cyst into the foot.
Ganglion cysts that do not cause pain are more of an annoyance than anything else. Eventually, the cyst should go away on its own. However, ganglion cysts often return in the same spot regardless of treatment method. The focus of at home treatments is on preventing the cyst from putting pressure on the surrounding areas.
When ganglion cysts occur on the top of the foot, a change in footwear is the first step in relieving the pain that occurs when the cyst presses into the tendons and nerves. Shoelaces can be loosened or even laced in such a way to avoid crossing the laces over the cyst. Leave shoes that aggravate the condition in the closet while the ganglion cyst is present. Placing foam padding or lamb’s wool cut in a horseshoe or do-nut shape over the cyst will ease the pressure on the cyst.
If at home treatments do not work to alleviate the pain, or where an individual would like the cyst gone more quickly, there are two types of medical intervention that can remove the cyst. Aspiration, or draining of the liquid filling the cyst is one treatment. With aspiration, a needle is inserted into the cyst and the liquid is drawn out. An injection of steroids is then used on the cyst. The other medical treatment method is to surgically remove the cyst by cutting it off, and removing the capsule and ensuring that the connection is severed. While surgical removal ganglion cysts have the lowest incidence of re-occurrence, there is still a possibility that the cyst can return.
One treatment which is not used so often is rupturing the cyst by hitting it with an object such as a book. It is how ganglion cysts became known as bible cysts, as most people had a bible and were thus able to treat it. It is important that this is discussed with a doctor, and that an accurate diagnosis has first determined that it is indeed a ganglion cyst.
orthoinfo.aaos.org, merckmanuals.com, emedicine.medscape.com
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