Ganglion cysts are the non cancerous and the most common mass or lump growing mainly in the hand. Though such cysts usually grow in the back side of the wrist, they can however grow in various other locations. Ganglion cysts are normally not harmful. However; if the cyst gets painful or interferes with the bodily function or if it grows to an abnormal appearance then it is required to be treated in the most effective way. In this current article we will talk about the ganglion cysts and will present a detail note on the best possible treatments for the same.

Ganglion Cysts

Ganglion Cyst: An Overview!

  • Ganglion cysts are the most common lumps growing within the hands and mostly growing out of the tissues surrounding a joint like the tendon sheaths, ligaments etc.
  • These are the cysts made of synovial fluid or a thick jelly like fluid and they can quickly appear, disappear or change in their size.
  • Mostly ganglion cysts are not harmful and do not require treatments. However some can be painful or grow abruptly to unacceptable size and shape which might require treatments.
  • There may be one large cyst or many small cysts appearing in ganglion cysts.
  • Ganglion cyst are not cancerous and do not spread to nearby areas.
  • Mostly these cysts are common in women. About 70% of the ganglion cysts occur in the age group of 20-40 years. However children below 10 years also get encountered with ganglion cysts.
  • Back of the wrist is the most common site where these ganglion cysts occur.

Which Body Parts can Get Affected by Ganglion Cyst?

Let us see below the sites in the body which can be affected by the ganglion cyst.

  • Mostly ganglion cyst occurs on the back side of the wrist, however they can also grow on the palm face of the wrist.
  • Ganglion cyst can also be on fingers on the palm side, fingertip just below the cuticle etc are some other places in hand where ganglion cyst can occur
  • Ganglion cyst are also likely to occur on the top of the foot
  • Outer side of the knee and ankle can also be affected by ganglion cyst.
  • Ganglion cysts are also reported to be occurring on the shoulder joints.

Notable Symptoms of Ganglion Cysts:

Here below are some of the notable symptoms which can be helpful while knowing about ganglion cysts.

  • Ganglion cysts usually appear as a mass or a bump which change their size.
  • Usually they are soft and range anywhere from 1 cm to 3 cm in diameter.
  • Up to 35% of the ganglion cysts exist without symptoms, however most of them show symptoms and some of the cysts can be painful at times.
  • If the ganglion cyst is connected to a tendon one might be feeling a sense of weakness in the finger affected by the cyst.

Causes of Ganglion Cysts:

Though it is not very much known about how ganglion cysts occur, they may be linked with the ageing or any injury to the joint or tendon. Ganglion cysts occur when the synovial fluid surrounding a joint or tendon leaks out and gets collected beneath the skin.

Diagnosis of Ganglion Cysts:

"Diagnosis is the first step to treatment". So let us look on the diagnosis procedure for ganglion cysts.

  • Medical history and Physical Examination: So, it first starts with an initial consultation where doctor would ask you about any medical history of yours and know about the symptoms from you. This would be followed by a physical examination where the doctor would apply some pressure to check for any tenderness in the cyst. He may also shine a penlight up to the cyst so as to see if light shines through.
  • X-Rays: These X-ray tests can create clear pictures of the dense structures like bones. These tests are done so that other conditions like arthritis or bone tumor can be ruled out, making it simpler to diagnose further for the condition of ganglion cyst. However it must be noted that X-ray tests cannot show a Ganglion cyst.
  • MRI( Magnetic Resonance Imaging) Scans or Ultrasound: Soft tissues like ganglion can be better seen with the MRI/ultrasounds. These imaging tests can be used to distinguish the cyst from other tumors and sometimes required so as to find an occult ganglion which is invisible.

Treatments to Get Rid of Ganglion Cyst

Let us now switch into the treatment procedures that can help get rid of Ganglion cyst. We will be studying about the treatment under following two prime categories, i.e. the Non-surgical treatment and surgical treatment for ganglion cyst.

Non-Surgical Treatment for Ganglion Cyst:

Before proceeding to surgery, doctor will go for the non-surgical treatments. Here let us look at the non surgical methods to treat ganglion cyst.

  1. Immobilization: The size of the ganglion and pain might be reduced with the help of a prescribed wrist brace or a splint. It is so because in ganglion cyst more of physical activity can cause the ganglion to grow in size and also increases the pain which can be checked by a brace on the wrist or the splint.
  2. Exercising: Once improvement is seen, once pain gets reduced by the initial treatment of immobilization, you might be prescribed with some exercises by your doctor so as to strengthen the wrist and enhance the range of motion.
  3. Active Release Technique (ART): Active Release Technique is a particular technique recommended for treating the tendon-sheath ganglion cyst which is caused due to a short, or injured tendon or muscle. Here in such a technique, the ART practitioner applies a manual pressure on the tendons, muscles and other soft tissues, while the target tissues are put through their natural ranges of motion. By applying such a pressure to the tissues during the time they are in motion, it becomes possible to help promote the maximum range of motion of the target area and also the healthy soft tissues in the area via an increased flow of blood.
  4. Aspiration Procedure for Ganglion Cyst: The procedure to drain out the fluid from the ganglion cyst so as to reduce the pain and get relief from limited activities; is called as aspiration. Here, the area around the ganglion cyst is first numbed and the cyst is then punctured with a sterile needle so as to withdraw the inner fluid. These procedures are mainly recommended for the ganglion cysts located on the wrist top. It must be informed that most of the time aspiration fails in eliminating the ganglion cyst because the connection to the joint or tendon sheath or the "root" of the cyst is not removed with this. So, it can grow back or recur once again.

Surgical Treatment for Ganglion Cyst:

You might be recommended for a surgery of your ganglion cyst in case the symptoms do not get reduced or relieved by the non-surgical procedures or if the ganglion cyst recurs after aspiration. The surgery which involves the removal of ganglion cyst is known as Excision. It not only involves the removal of the cyst but also the part of the involved joint capsule or the tendon sheath, which are taken as the root of the ganglion cyst. It must be noted that that are chances that even after the surgical treatment, the cyst may return.

Complications of the Treatment for Ganglion Cyst:

Now you can ask if there are any possible complications of the treatment in Ganglion cysts. Well! There are certain complications, which include stiffness in the hand or in the site and formation of scar. There are also possibilities for recurrence of the lesion which is more common following excision of a volar ganglion cyst over the wrist. There are also chances that in case of incomplete excision (where it fails to include the pedicle/stalk) may also lead to recurrence.

Recurrence of Ganglion Cyst Despite Treatment:

In case of aspirated cysts, the recurrence rate is comparatively higher than the excised ones. It is found that in about 12% to 41% patients, there has been recurrence of Ganglion cyst following the surgical treatment.

After Surgery Care of Ganglion Cyst:

"It is not all over. It is the aftercare that decides the complete recovery!" Let us take a look at the after surgery care for the ganglion cyst in this section below.

Though the wound after surgery won't get pain, yet you will be prescribed with some painkillers by your surgeons to take in case necessary to eradicate the discomfort after the operation. There will be a bandage over the wound after the stitching so as to keep the area clean and reduce the risk of infection. You will also be prescribed with some exercises/physiotherapies for keeping your motion in the area and help keep the connected joints flexible. There are also possibilities that you might experience some bruising in the area after the surgery to remove ganglion cyst. However this would fade down in a quick time. Scar formation can also be seen after surgery in ganglion cyst. You will be prescribed with lotions, medicines etc for getting relief. You will have to visit the doctor after 10-12 days of surgery so as to have a check-up and get confirmed about the healing.

What not to do at Home in Case of Ganglion Cysts:

There is an old home remedy for treating ganglion cyst. There is a belief that "thumping" on the cyst with a heavy object can help get rid of it. However it must be noted not to do the same, as it can cause damage the surrounding structures of the cyst because of the force applied. It is also advised not to try piercing the cyst at home with needle which can cause infections in the area.

Conclusion:

As the prime cause for the occurrence of a ganglion cyst is still unknown, so one cannot take the respective preventive measures for keeping away from its encounter. However an early diagnosis after the notable symptoms arise and immediate treatment of the ganglion cyst is always recommended. Again, though there are treatments for the painful ganglion cysts, yet how well you take care of your wound after treatment decides the recovery.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: June 12, 2015

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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