The Yeargain Foot & Ankle medical team specializes in treating and removing ganglion cysts. Even though ganglion cysts are usually painless, they can cause pain if the cyst presses on a nerve.
Applying pressure on an affected tendon or on the cyst can also cause pain. You may experience tingling or a burning feeling in severe cases. Even if the cyst is still small, it can still cause muscle weakness, numbness and pain.
Learn about ganglion cysts, how they form, what they look like, their causes, diagnosis and how we treat them at Yeargain Foot & Ankle to minimize further injury.
What are Ganglion Cysts?
Ganglion cysts are noncancerous, sacs filled with jellylike fluid that originates from a tendon sheath or joint capsule. Ganglion cysts are the most common benign soft tissue masses that typically occur in the hand or wrist but can also present in the foot and ankle region. These cysts are typically harmless, and the word “ganglion” means a knot and is used to describe the knot-like mass or lump felt below the skin’s surface.
Ganglion cysts can vary in size and location on the foot and ankle and may get larger and more prominent over time. These cysts can disappear on their own and can reoccur randomly. The size may range from that of a pea to a golf ball if not treated over an extensive period. These cysts most commonly affect people aged 15-40 and are three times more likely to develop in women.
How do Ganglion Cysts form?
Surprisingly, the exact cause of ganglion cysts is unknown, although it is believed to arise from trauma. This trauma can occur in a single event or repetitive microtrauma. The cyst sprouts out of a joint or lining of a tendon resembling a tiny water balloon on a stalk. Inside the cyst is a thick lubricating fluid called synovial fluid which cushions and lubricates joints and tendons during movement
What do Ganglion Cysts look like?
Ganglion cysts usually look like a bump or a lump that can be firm or soft depending on size and location. This lump may look symmetrical (round) or misshapen and sits just below the skin’s surface. The cyst may also resemble a bubble blown from a joint. Since the cyst is fluid-filled, it typically has a translucent effect when light is shined at a certain angle. As mentioned before, the consistency of the cyst varies but is usually firm to the touch. A small percentage may report that the fluid-filled cysts as soft and can easily move under the skin.
Are Ganglion Cysts painful?
Some ganglion cysts may be painless. However, many ganglion cysts can cause dull pain or ache, especially when pressure is applied indicating the cyst is pressing against a tendon or joint. Tingling or burning can also present if the cyst is pressing or entrapping a nerve. Depending on the size and location, you may experience difficulty wearing shoes due to irritation between the lump and the shoe.
How are Ganglion Cysts diagnosed?
Ganglion cysts are typically diagnosed by a foot and ankle surgeon who will perform a thorough examination of the foot and ankle. A thorough medical history will also be taken to determine when the cyst first became apparent, whether it changes in size, pain level, etc. The lump or mass will be visually apparent and should move freely underneath the skin. Light can also be shined through the cyst to check if it’s translucent. Commonly, a small fluid sample or biopsy can be removed and sent to pathology to confirm diagnosis. An x-ray will be taken to ensure no bone is associated with the origin of the lesion, and additional imaging such as MRI or ultrasound may be ordered in some cases.
What type of doctor removes Ganglion Cysts?
When a ganglion is located in the foot or ankle region, Podiatrists are the specialists in diagnosing, treating non-surgically, and can perform a surgical removal of the cyst if necessary either in the office, or in a simple day-surgery procedure.
How to treat Ganglion Cysts?
There are various options for treating a ganglion cyst of the foot:
Nonsurgical/Conservative
- Monitoring: If the cyst is painless and doesn’t interfere with walking or wearing shoe wear, a foot and ankle surgeon may recommend carefully watching the cyst over some time and observing for any changes.
- Shoe wear modifications: Certain shoes can cause further irritation and pain to the cyst. It’s recommended to avoid shoe wear that irritates. In addition, placing a pad inside the shoe wear to offload the cyst and reduce pressure can help.
- Aspiration and injection: This option is common, especially in painful ganglion cysts. This technique involves draining the fluid from the cyst to reduce pressure and the fluid is sent for pathology and injecting a steroid medication into the cyst to decrease pain and inflammation and help prevent reoccurrence. Although this approach is successful in cases, in many others, the cyst returns. Multiple aspirations and injections can be performed before surgery is considered.
Surgical
When nonsurgical/conservative methods fail or are not appropriate, a foot and ankle surgeon may surgically remove the cyst. The recurrence rate associated with surgery is much lower than that experienced with aspiration and injection therapy; however, the cyst can still return in the future. An MRI can be ordered to evaluate the cyst and determine the extent of surrounding soft tissue involved. It is prudent that the stalk from which the cyst arises is addressed and removed to help prevent a recurrence.
