Feeling a little lump on the wrist or on the foot? Could be ganglion cyst! A fluid filled lumps which are benign and not cancerous. They grow in size, and can be very painful but they are not contagious.
How they are formed is not known, but theory has it that the fluid in between the joints are leaked out that forms pouches moving towards the outer skin. When these pouches or cyst pressurize the nerve passing through surrounding tendon it becomes painful and restricts movement of that joint. It may also be caused due to trauma / injury or it indicates an early sign of arthritis. The cyst is normally formed on the wrist. Those who give a lot of pressure on their hand are most prone to this disease, like tennis players or a typist. They mainly affect women. A ganglion cyst may be formed on the front of the wrist (volar wrist ganglion), at the back of the wrist (dorsal wrist ganglion), on fingertip, at the base of the finger, on top of the foot or on the ankle.
The doctor should perform the necessary tests before deciding on the method of treatment to be used. After a through physical examination of the cyst an X-ray or in certain cases a MRI scan could be requested to detect any small cysts which are not visible to the naked eye.
Needle aspiration is an effective, quick and inexpensive way of treating ganglion cyst. But the chances of reoccurring aremore. In this procedure (ganglionectomy) the cyst is punctured with a hypodermic needle and the fluid is drained from it, after the area around it is numbed. The lining of the cyst cannot be removed through this procedure hence the chances of ganglion cyst to reappear are almost 50%. A more comprehensive and sure procedure is to remove it through an open surgery. In this procedure the cyst fluid along with its lining and the roots are removed surgically. Though many doctors opt for this procedure there is still a 5-10 % chance of the cyst to grow and reappear. It takes about a month to resume normal routine life, after taking proper precaution and ritually following the exercises.
Arthroscopic surgery is among the latest treatment available that can remove the cyst from its roots effectively. The chances of reoccurrence are minimum though not eliminated. Under this procedure two small incisions are made around the area. A camera (arthroscope) is inserted to receive the complete view of the cyst and smaller ones which otherwise goes unnoticed. Then it is removed through the laser incision. The scars are very small and the healing time is also short. A compressed dressing or a hard wrap or splint is applied to the joint to prevent it from moving.
It should be noted that not all cyst require surgery. Some of these cysts may disappear by themselves. Especially if they do not change in shape and are not painful. In a few cases only the splint or a support may be given to the joint to reduce swelling and the lump decreases in size. A Nonsteroidal anti-inflammatory (NSAID) medicine may also be given to reduce pain. Few patients have also tried homeopathic treatment with varying results. As homeopathic treatment takes a long time, in this case about 5-6 months, to show results most patients do not go for this method.
There were many home remedies which had been tried in ancient times, like topical plaster, heat or the most bizarre “the Bible Therapy”. The bulge is actually hit hard by a heavy book, mainly with the Bible, for it to subside down. This method naturally was not effective because the cyst would reappear and worsen the condition.
The most common risk after an aspiration or a surgery is an infection to the affected area or inflammation. Hence physical activity is dissuaded for a period of time and periodical checkup is necessary. After surgery there may be some stiffness of the joint or scars may form which is normal. In very few cases the patient may be allergic to the injections given or there is a risk of the nearby blood vessels or nerves being damaged.
There are very few cases where the cyst is completely removed but in most cases a single treatment may not be enough.