GANGLIONIC CYST

 Where did that bump on your foot come from?  If it is soft, or at one time was soft and is now getting harder, you are probably looking at a ganglion cyst.  The word “ganglion” is taken from the Greek word “ganglia” to mean “knot of tissue”.  These “knots” are also known as “synovial cysts” and arise from a herniation of a joint lining or from the sleeve that wraps around some tendons.  If they do not hurt, we treat them conservatively. But sometimes, unfortunately, these benign, thin-walled and fluid filled cysts can become painful.  There are several reasons why.

While many ganglion cysts resolve on their own, some can get bigger with time.  The bigger they get, the more symptomatic they may become.  Another cause for these cysts becoming painful is when the fluid within these cysts becomes less fluid and more gelatinous the longer it sticks around.  This makes the cyst harder and less compressible in your shoes, resulting in pain.  The location of the cyst can contribute to the discomfort as well.   If it presses on an overlying nerve, you may experience tingling, burning or numbness in that region or even beyond that region of the foot.  If it is overlying a boney prominence it for no better term “sticks out” more and rubs more in a shoe.

So what can you do?  Well, in the old days, people use to drop their bibles on them to pop them internally!  Holy ouch!  While Podiatrists do have many heavy books at their disposal, they will not be dropping them on your feet we promise!  If yours does not spontaneously resolve or gets bigger, the simplest and most effective non-surgical method for attempting to resolve these cysts is to aspirate the fluid contents then inject them with cortisone.

Why is aspirating not enough to get rid of them?  Well, studies have shown a higher recurrence rate with aspiration alone.  By injecting a corticosteroid, the recurrence rates drop!  If the aspiration/ injection treatment has failed, or if the fluid within cyst has become too thick to aspirate, then surgical excision may be considered.

Realize that even with surgery the cysts may recur, which is why we usually treat them conservatively if they are asymptomatic.  In either case, any strange lump or bump should be checked out for your piece of mind and ours!