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. Repetitive strain injury of the joints, for example in gymnasts or athletes, or repetitive wrist use in computer users 41 and guitar players 42. 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. Xanthomas, which are lipid deposits in individuals with hypertriglyceridemia (yellowish appearance). 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. You might need to wear a sling or splint for 3-7 days after an operation to avoid an injury to a surgical wound and to give time for swelling to go away 7.
In the first three days after operation, holding an ice pack over the wound dressing (NOT directly on the skin) may reduce swelling 59.
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. A doctor or physiotherapist may suggest you specific exercises to maintain the mobility of the joint and massage of the scar to prevent adhesions. 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. In the United Kingdom (UK) the cost (as of September 2013) may range from 1,300 to 1,750 ? (British pounds) 28.
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. John, first you need to get an exact diagnosis from a specialist (your primary doctor can lead you where to go).
Most primary care offices will be able to aspirate (remove the fluid with a needle) in their office. In my primary care office, this is typically a 30 minute appointment which includes consultation and the procedure together in one visit. 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. Laser treatment might be as effective as aspiration, but I have no real information about this. Kathryn, you get local anesthesia, so it should not be painful more than like getting a vaccine.
During Kim Kardashian’s pregnancy, she had swollen feet that were visibly pinched inside her stiletto shoes.
Unrelated to pregnancy, there are other causes of swollen feet that occur in both women and men.
If you have swelling in the lower extremities, there are some ways to find temporary relief until your appointment.
Normally swollen feet should not be a concern for many of us whose job involves standing or walking for long time. Lymphedema: There will be accumulation of lymphatic fluid when there is some problem in the lymph nodes or lymph vessels. Insufficiency of veins: This is a condition in which blood randomly moves in the veins in the region from legs to feet and up to the heart. Presence of blood clots in the veins of feet may reduce the blood-flow from the legs to the heart. Prolonged use of contraceptives, repeated hormone therapy like estrogen can cause swollen feet. Some doctors prescribe calcium blockers like cardizem, dilacor tiazac and plendil for certain types of hypertension, may cause inflammation.
Do exercise regularly, drink plenty of water, stop using laxatives, cut down salt intake, and avoid standing in the same position for long time.
When the tendons are being repeatedly stretched for long time, it may cause tendinosis and in rare cases, it may rupture. Ankle injury is caused when a person walks on irregular surface and due to repeated sports activities. Compression : You can get help from someone for wrapping the injured ankle with compression for keeping it intact. Your doctor will examine the injured ankle and may ask for X-ray to find out the extent of damage.
For mild form of sprain, first aid treatment of RICE is repeated for many weeks until the swelling subside.
For moderate sprain, apart from compressor or ice application, your doctor may put you on a splint or boot for keeping the ligaments intact.
For severe form of sprain there would be tearing on the ligament and it takes more time for it to heal.
Very often, a person having a sprain will need 3-7 days of rest, after which he will do regular exercise for gaining strength. If there is injury in the tendon, the doctor will use a cast or splint and give anti-inflammatory medicine for reducing pain. Wrist ganglions usually arise from the muscle tendons but sometimes from the wrist bones 7. 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. This fluid may originate from the synovial fluid normally present in the joint, but this is not certain 25.
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. When the obtained fluid is not clear as expected, it can be sent into the laboratory and investigated under the microscope (cytologic investigation) 12. 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.
Nicotine causes narrowing of the blood vessels and may greatly prolong healing of the surgical wound 24.
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. For many women, this is normal because the changing body holds more fluid and circulation to the legs is reduced from pressure on the blood vessels.
Sitting or standing for too long results in swollen feet from blood pooling in the lower extremities, especially if you keep your legs crossed.
Keep your feet raised as much as possible, and place ice packs on your feet for ten minutes at a time while they are raised. You do not have to keep squeezing your feet into shoes that once fit or live with constant pain. There will be continuous movement of lymphatic fluid in the bloodstream and due to any reason, if it gets blocked, it may give rise to lymphedema. Here the veins flow the blood moving in one way direction thus keeping the blood flow insufficient. They would get nerve problem called diabetic neuropathy causing foot infection leading to formation of sores and blisters causing nerve damage.


There is every chance for fluid accumulation in the feet when kidneys are not functioning properly or when there is leakage in liver or when there is sudden heart failure.
Using antidepressant drugs like norpramin, aventyl, amitriptyline, endep and nardil can cause swelling of feet. Earlier it was thought that this type of injury is reserved only for sports personalities but you may get injured by simply walking on uneven surface. A sprain occurs when the ligaments are damaged or stretched beyond their capacity and a strain develops when there is damage to the muscles or tendons. Sometimes it can occur during a fall or a jump in awkward position and due to sudden injury or trauma while driving a bike or car. In case of severe fracture, it might take about 1-2 years for the ligaments and joints to get healed completely. In many cases, the pain will reduce after 2-3 days and you should not put weight on the ankle for few days.
After complete healing, the person will be asked to follow certain exercises for gaining strength on the ankle.
Once the swelling subsides, he will be asked to do physiotherapy or stretching and strengthening the ligaments. For gaining enough flexibility and get back to normal position, it might take several weeks or even months. 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. Swollen feet and ankles may also indicate a potentially dangerous condition known as preeclampsia, marked by sudden swelling in the feet and high blood pressure.
Other serious causes of swollen feet include poor circulation, infections, injury, diabetes, heart disease, reaction to medications, liver problems, kidney failure, or changes in estrogen levels. Ice is especially effective at reducing swelling from an ankle injury such as a sprain or strain. Schedule a consultation with one of our doctors at American Foot and Leg Specialists to help find solutions to your swollen feet.
In case of abdominal pain, nausea or vomiting symptoms, then you should consult your doctor immediately. Sometimes, the ligaments may not sit properly when stretched beyond its limit for some reasons. Due to this process, the valves get damaged and in turn blood drains down the veins causing accumulation of fluid in lower legs, causing swollen feet. They would not feel any sensation in their feet and hence swollen feet during diabetes is truly a matter of concern.
You need to consult your doctor when you have symptoms of fatigue, loss of breath, sudden weight gain and loss of appetite along with swollen feet. After surgery and break period, the patient will be given physiotherapy for strengthening the bones. In case the pain does not get reduced, surgery may be done for reconstructing the ligaments that are torn.
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. Kim’s condition has drawn attention to the pain and possible problem of swollen feet.
A visit to one of our doctors at American Foot and Leg Specialists can provide you with an explanation and treatment of your swollen feet and ankles by addressing the cause.
If you have not experienced an injury in your foot or ankle, moderate exercise can help to improve blood circulation throughout the body, which may prevent or reduce swelling. Sometimes, this condition can become fatal if there is no absolute blood flow from the heart to the feet area. If you are a pregnant woman, whose feet swell more than usual, make an appointment with your obstetrician so that they can check for preeclampsia. Always check with your doctor before beginning an exercise program, particularly if you have ever experienced swollen ankles due to heart disease. You can also apply ice packs or keep the leg in elevated position for reducing inflammation.
A tendon is attached to the muscles of bones and is responsible for movement of foot and ankle. The incision leaves a permanent scar, which can be thick, red and numb, and, in some individuals, a small area around the scar will be also permanently numb 22.
Home treatment for benign causes of leg swelling should be tried before drug therapy under medical supervision. Prevention Avoid sitting or standing without moving for prolonged periods of time. Can an arthritic cyst benefit from laser treatments and if so, about how many should suffice?
And do patients who have surgery to remove an arthritic cyst develop further pain after surgery?



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