Funny Lumps on Your Feet? All You Need to Know About Ganglion Cysts
Have you had a funny lump pop up on your foot without any explanation? Is the lump causing you concern as you're not sure what it is or where it's come from? You may have a ganglion cyst. Read all about them here and find out about your treatment options!
What is a Ganglion Cyst?
A Ganglion cyst is a benign fluid-filled mass that is attached to the adjacent underlying joint capsule, ligament, tendon or tendon sheath. They can occur in various locations and commonly form in the feet and hands. The cyst is filled with a thick, sticky, clear, colourless, jellylike material. Depending on the cyst and the location, they can feel firm or spongy.
Most ganglion cysts are symptom free and are not a cause for concern. However, some may cause discomfort and pain, weakness, or mobility or nerve problems depending on their location. Most people seek advice about ganglion cysts over cosmetic/appearance concerns or with anxiety that there may be something more serious going on.
What Causes a Ganglion Cyst to Form?
It is not known what triggers the formation of a ganglion. A history of recurrent or chronic injury to a joint is often seen with them, and they are sometimes associated with internal damage/changes to joints. Ganglion cysts are more common in women, and occur most commonly in people ages 20-40 years.
One theory suggests that trauma to a joint can cause the joint tissues to break down, forming small cysts that then join into a larger, more obvious mass. The most likely theory, however, suggests that a flaw in the joint capsule or tendon sheath allows the joint tissue and fluid to bulge out, forming the cyst.
How are ganglion cysts diagnosed?
Your podiatrist will firstly ask about your medical history and symptomatology to determine if a ganglion cyst is suspected. A physical examination of feeling the cyst can also help with diagnosis, with most ganglion cysts feeling soft and with minimal pain involved usually. Ganglion cysts are translucent due to being filled with fluid, therefore shining a light at the cyst to see if it shines through can also help to confirm the suspicion of a ganglion cyst.
Confirming the diagnosis with an ultrasound is then recommended to rule out any other causes. MRI can also be used, but is more expensive and equally as accurate as an ultrasound in diagnosing these cysts. An x-ray will not show a ganglion cyst, but can be used to rule out any bony abnormalities.
How Can A Ganglion Cyst Be Treated?
Given that many ganglion cysts do not cause symptoms besides swelling and cosmetic concerns, treatment is not often needed. Confirming diagnosis of a ganglion cyst and then watching and observing can often be enough. Shoe modification and offloading options may be beneficial if irritation from footwear is occurring. The spontaneous resolution rate of ganglion cysts is reported to be somewhere between 40-58%. Therefore reassurance and observation can be a treatment option if the cyst is not causing bother.
Drainage of the ganglion cyst is considered a safe and simple treatment for ganglion cysts. However, the literature reports high recurrence rates following this as the connection to the joint or tendon sheath is not interrupted, therefore fluid can reenter the area.
The techniques by which a surgeon will remove a ganglion varies, but most commonly the whole ganglion is excised including it’s attachments to any ligaments/tendons and the involved segment of joint capsule. Surgery is considered the most effective technique with recurrence rates reported to be as low as 1%. Complications of surgery may include wound infection, neuroma formation, hypertrophic scar, nerve or arterial damage, and/loss of mobility and function depending on the area involved.
Basically, conservative options are less-invasive and have less side effects than surgery, however have a higher recurrence rate compared to surgery. If the ganglion cyst is not causing pain, loss of function or mobility, then just observing the cyst is often the preferred treatment option.
What Can Your Podiatrist Do?
Firstly, your podiatrist is able to refer you to have an ultrasound of your cyst to confirm the diagnosis. Once the diagnosis is confirmed, they are able to inform you of your treatment options. Your podiatrist is able to measure, photograph and document the shape and size of your ganglion cyst and offer offloading and shoe modification options if you decide to watch and observe your cyst.
Your podiatrist is able to perform a simple drainage procedure if conservative management is not managing your ganglion cyst adequately, and can provide you with more information regarding this.
Your podiatrist is also able to refer you to a surgeon if you decide to go ahead with surgical removal of the cyst.
We Are Here to Help
If you are concerned you may have a ganglion cyst, the first thing to do is book an appointment with one of the Podiatrists at Complete Podiatry for a comprehensive assessment.
Once this is done, we will develop a structured management plan that outlines our best advice for how to manage your ganglion cyst and help you to return to doing the things you love to do.
I'm so confident we can help with your ganglion cyst that I'd love to chat with you personally, it's what I'm passionate about!
Just call us & I'll be more than happy to explain how we can help you build an amazing life from the feet up!
Podiatrist at Complete Podiatry