The cyst is the result of injury to the joint or tendon lining, which creates a soft or spongy build-up that can harden over time. A ganglion cyst is basically a sac which is filled with fluid that arises from either a joint (space between two bones) or from a tendon (structure which attaches a muscle into a bone). Ganglion cysts do vary in size, may get larger or smaller as well as may even vanish totally, only to return later. A majority of these cysts do cause some amount of pain, frequently following an repetitive or acute trauma, but as many as 35% have no symptoms, except for cosmetic appearance. When the cyst is linked to a tendon, you can feel a sensation of weakness in the affected foot.
Whether or not you have any symptoms, medical evaluation of a ganglion cyst is a positive option.
A careful examination by the doctor is usually all that is required in order to make a diagnosis of a ganglion cyst. The physician can get additional verification by taking a syringe and drawing out a portion of the fluid inside the cyst – needle aspiration – or by using an ultrasound.
Your primary care physician may refer you to a surgeon if the bump is solid or if the bump involves an artery. Patients that are susceptible to ganglion cysts can be asked to wear shoes which are prescribed by the doctor, or at least pads for anti-pressure that can line regular shoes.
If an individual is suffering from problems using the foot or considerable pain or if the treatment options have not worked, the physician may make a referral to a surgeon to eliminate the cyst. With the majority of the cases, the surgery is performed as an outpatient meaning the individual will go home on the same day after the surgery.
The cyst as well as the stalk which fastens the cyst to the tendon or joint, together with a portion of the tissue in the surrounding area will be removed. Dependent on the cyst location, the doctor may mention in the meantime using a brace or a splint to help with minimizing post-operative pain. Unfortunately, there is no assurance that a ganglion cyst will not return, even with surgery. Ganglion cysts grow due to accumulation of fluid within them and not because of uncontrolled cell growth, like benign tumors (lipoma, for example) do 3. Bible cyst or bump, because they were used to be treated by slamming with a heavy book, such as Bible 4 or Gideon Bible (and hence Gideon’s disease). Synovial cyst arises from the joint synovial sheath and is a true cyst (covered by epithelium on the inner side), so it is not the same as ganglion cyst, but the appearance and treatment for both is similar, so they are often used as synonyms 29,45,65.
Bursal cyst arises from the bursa; its inner side is covered by epithelium, so it is not the same as ganglion cyst, but the two are often used as synonyms 11,64,65. Wrist ganglion cysts most commonly appear on the dorsal (back, top) side, but also on the volar (palmar) side of the wrist 5. Ganglion cysts can appear on the fingers or thumbs, either on the base of the finger (palm side) or on the end knuckle (back side) — in the later case it is called mucous cyst 3,5. Some ganglion cysts are hidden within the joints (occult cysts) and are not visible or palpable and may or may not cause symptoms 3. A cyst can cause stiffness and limited motion, snapping, catching or locking of the affected joint and may affect hand gripping or walking 3. When a cyst is attached to a tendon, it may cause muscle weakness in the affected finger or toe. A ganglion cyst arising from the hip joint may appear as a groin mass, which may pulsate, and when it presses upon the femoral nerve, it can cause groin pain or tingling 50,51.
Rarely, ganglion cysts develop within the bones (intraosseous cyst), most commonly in the wrist bones 7, but also in the femur 6 or humerus 32,  cartilaginous discs in the spine 8, muscles (mainly in the calf) 15,33,34 or nerves 17,35. The fluid from the joint may move into the cyst but not vice versa, so this is why a cyst can grow larger with the joint activity 25.
The wall of the cyst is made of collagen (the predominant molecule in the connective tissue) and fibrocytes (cells that produce collagen) 25.
In a 25 year old footballer who was hit into the peroneal muscle on the outer side of the calf, a ganglion cyst with bumpy swelling developed in the muscle 38. Some orthopedicians believe wearing shoes with high heels increases the risk of injury that can result in formation of a ganglion cyst 54. A doctor observes and palpates the cyst and shines through it by using a penlight (transillumination) — most ganglion cysts are translucent (Video 1) 3,7. In doubtful cases, a doctor may check the content of the cyst by aspiration a small amount of fluid using a needle and syringe. Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) can reliably show a ganglion or mucous cyst, but are rarely needed and are expensive 3,5,13. X-ray does not show a ganglion cyst, but can rule out dense structures, such as tumors and bone spurs 3.

A Lump in the neck is rarely a ganglion cyst; it is more likely an abscess (after infection in the mouth or throat), enlarged lymph node (gland) or a thyroid nodule, goiter or cancer. Ganglion cysts are translucent when you shine a light through them, but cancers and benign tumors are not.
When a cyst hurts, over-the-counter (OTC) painkillers, such as aspirin or ibuprofen, may help. Wrist brace or splint prevent wrist mobility and may reduce pain and may, eventually, lead to reduction of the cyst size 3.
A puncture (acupuncture) of the cyst is rarely performed nowadays; a doctor pushes a suture perpendicularly into the wrist and the cyst is allowed to drain for several days 7,25,70.
Aspiration is mainly used to treat cysts on the back of the wrist (Video 2) and in the foot 21. A primary doctor or orthopedic surgeon cleans the skin above the cyst, injects a local anesthetic near the cyst and drains the cyst fluid by using a needle and a syringe. In about half of the cases, after aspiration the cyst will be filled with fluid in some time 3. Cyst excision, which is usually an outpatient procedure, which lasts about 15 minutes, involves removing the cyst, its stalk and often a part of the tendon sheath or joint capsule from which the cyst originates with the scalpel 3 or laser 56,70. In an open surgery, an orthopedic surgeon makes about 2 inches (5 cm) cut through the skin and removes the cyst (Video 3) 3. In an arthroscopic or keyhole surgery, an operator pushes a thin endoscope with a camera and instruments on the end through a small incision in the skin into the joint and removes the cyst 3.
A surgery can be performed under local or regional anesthesia (you are awake during the procedure) or general anesthesia (you fall asleep) 68. Recovery time after wrist ganglion removal may range from few days to six weeks, depending on how extensive the surgery was and how much you use wrists during work 3,4,23. After removal of a cyst from the top of the foot or big toe you may be able to walk straight away 24. After removal of a cyst from the bottom of the foot, you might need to wear an offloaded surgical shoe for 2-3 weeks 24. The cost of ganglion cyst removal surgery may vary greatly and depends on the hospital, the type of anesthesia used and the difficulty of operation. Recurrence of the cyst in 10-48% of cases, much more likely after the removal of the volar than dorsal wrist cysts 37. Arthroscopic surgery results in less pain and a smaller scar than open surgery, but the recurrence rate is about the same in both types 7,36.
Do not pop a cyst with a needle, since you may not be sure if it is a cyst at all, and because you can cause a cyst infection 2. Do not try to burst a cyst by slamming it with a heavy object like a book because you can cause damage of the nearby nerves 2. There is a lack of scientific evidence about effectiveness of homeopathic or holistic methods in curing ganglion cysts. The exact cause of ganglion cysts is not known, so currently no prevention guidelines exists 58.
A surgery is currently the most effective cure for a ganglion cyst, but it leaves a scar, stiffness and pain in the joint may persist or even worsen, and the cyst may return in 4-48% cases. Most cysts can be aspired–in this case only the fluid is removed, but the membrane and the stalk are still there, so aspired cysts often recur. Characterized by a sac filled with a jelly-like liquid, a ganglion cyst forms on a tendon or joint and forms a lump or knot that sits below the skin’s surface. Your foot doctor will use a number of tests in order to properly diagnose a ganglion cyst, including a physical examination and asking a serious of questions about your medical history. Once your doctor determines that a ganglion cyst is present, he can begin talking with you about the process of ganglion cyst removal.
Additionally, you can place pads around the ganglion in order to cut back on friction and pressure while you are walking and wearing footwear. Finally, if there is no sign of improvement with other methods, or if your inflammation and pain is severe, your foot doctor might choose to treat your symptoms with certain medications.
The term comes from the word ‘ganglion’ translated to ‘knot’ recounting the lump of cells which is knotted and grow beneath the surface of the skin of the foot.
A cyst may become bigger with joint activity and smaller with joint rest; a cyst disappears spontaneously in up to 58% cases 3,4,25,26. There is no epithelial cells on the inside of the cyst wall, so ganglion cysts are not true cysts but pseudocysts 25.
The prevailing opinion is that ganglion cysts are caused by degeneration of the connective tissues in the joint, probably due to chronic irritation or minor trauma, such as pressure from the shoes or landing on the hand with an extended arm 7,11. In most cases, a doctor can make a diagnosis of ganglion cyst on the basis of a physical exam alone without further investigations 25.
Holding an ice pack (wrapped in a cloth, not directly to the skin) over the cyst for 20 minutes few times a day may also provide pain relief 60.

After aspiration, a doctor may inject a steroid into a cyst — this is supposed to reduce the chance of the cyst recurrence, but this has not been proven 25. Arthroscopic surgery usually results in less pain after a procedure and a shorter scar than open surgery 3,36. Surgical removal of a ganglion cyst from the top of the wrist: preparation, excision, sutures, bandage.
When the associated part of the synovial sheath from which the cyst arises is removed as well, the recurrence rate may be as low as 4%. According to one study, a volar wrist ganglion cyst can recur as early as in one month or as late as after 12 years 49. Doctors don’t know exactly what causes ganglion cysts, but they might form as a result of trauma to your foot. They can also make it difficult for you to wear shoes comfortably, so it is best to talk to your doctor about treatment for ganglion cysts. During the physical exam, he might shine a light through the cyst in an attempt to find whether it is filled with fluid or a solid mass. Ahmadi is a Board Certified Foot Surgeon and a Fellow of the American College of Foot and Ankle Surgeons. Ahmadi specializes in reconstructive surgical and non-surgical care for children and adults as well as a wide variety of foot and ankle diseases and disorders. Causes for these cysts are not certain, but are often attributed to trauma around the area. A ganglion cyst is a non-cancerous fluid-filled sac that arises from the muscle tendon, tendon sheath, joint capsule or ligament, most commonly in the wrist or foot 3.
In most cases, a ganglion cyst is not dangerous, but may cause stiffness or pain in the affected joint 3.
A cyst may rupture when you hit it accidentally; this usually causes no problems, but the cyst often returns.
The fluid within the cyst is made predominantly of water, hyaluronic acid, glucosamine, mucin and proteins 25,46. Cysts on the palmar side of the wrist may be guided by an ultrasound to avoid injury of the radial artery 25.
Splinting the wrist after the cyst aspiration has not been proven beneficial and may actually prolong the stiffness of the wrist 25. If the cyst is the cause of your pain, its removal would result in pain relief, but your surgeon can tell you some statistics about this. In general, conservative (non-surgical) treatments of ganglion cysts are not very effective. You may notice that the cyst grows or shrinks in size, disappears, and then returns at a later time. A needle aspiration method might also be utilized, which involves the use of a fine needle to remove liquid from the cyst for examination and testing. Your foot doctor might recommend icing the affected area for 15 to 30 minutes in order to temporarily relieve pain and inflammation. Matt Ahmadi might utilize fluid removal in order to treat the ganglion and minimize symptoms. He places emphasis on educating patients about the function and dynamics of the foot and ankle in order to prevent future problems.
Ahmadi strives to help his patients understand these connections and develop useful ways to maintain a healthy functioning of the foot and ankle in relation to movement and posture. NOTE: Ganglion cysts have nothing to do with neural ganglions, which are clusters of neural cells inside the body. According to one study, immobilization after cyst aspiration does not reduce symptoms or prevent cyst recurrence 48.
Sometimes, a cyst heals spontaneously, but I can’t say if this can happen in your case. Matt Ahmadi of Orange County Foot and Ankle performs ganglion cyst removal procedures, among other podiatric treatments.
Ahmadi is a leading foot and ankle doctor, who has earned the Doctor of Podiatric Medicine degree from Barry University School of Podiatric Medicine and Surgery.
The first step in receiving treatment is getting confirmation that you have a ganglion cyst, and that the growth is not caused by another condition. He completed his post graduate training in Podiatric medicine and reconstructive foot and ankle surgery at the Washington Hospital Center.
Ahmadi?s residency consisted of three intense surgical years at a level one trauma center where he performed advanced procedures in reconstructive foot and ankle surgery.

Dr schuster
The ball of my foot hurts and is swollen
Shoe stretcher for boots
Category: Swollen Feet

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