Waking up one day to find a fluid-filled mass the size of a small marble at the base of your wrist is bound to be frightening. And before you know it, you’re mind is taking giant leaps and bounds to some of the worst possible health-related scenarios. Could it be a tumor? What if it’s cancerous? Could it spread to other parts of the body? Is it infectious?
Well, the good news is, it’s not a tumor, neither is it cancerous. And it’s definitely not infectious.
It’s a ganglion cyst, and you should know that it’s a common nuisance that can affect just about anyone. Here’s everything you need to know about it.
What Is A Ganglion Cyst?
A ganglion cyst, also known as a Bible cyst, is exactly what you see (if you have one); it’s a soft, round lump of tissue that usually appears along the joints, ligaments or tendons, more typically on your wrist or your hand. However, it can also crop up on your fingers, shoulders, ankles, or feet.
This lump of tissue is filled with thick synovial jelly-like fluid. Some ganglion cysts can be so small, they remain hidden under your skin. Some, on the other hand, can grow to alarming sizes and protrude through the layers of your skin till they become visible to the eye.
What Causes A Ganglion Cyst?
Doctors are not too certain about what causes these cysts to appear on our body. However, many of them are of the opinion that it may be the aging or the injury of a joint that causes its tissue to break down and form small cysts. Eventually, these cysts clump together to give rise to a larger, more visible mass.
Another theory suggests that injury or aging of a joint may often cause further wear and tear of the joint area, causing the surrounding synovial fluid to leak out and collect beneath the skin to form a lump.
Doctors also believe that a flaw in a joint capsule or the protective sheath that covers a tendon can cause the joint connective tissue to bulge out. This damage may cause the cells to produce mucin and fluid which collects under the skin to give rise to a knob-like mass of tissue.
Since there are so many theories about the causes of a ganglion cyst, it is best that you consult your doctor to determine what the exact cause of these lumps are.
Can Ganglion Cysts Cause Pain?
Pain is not always guaranteed when it comes to ganglion cysts. Some of them may be completely painless. However, some cases of ganglion cysts can also cause a certain degree of pain and discomfort, which can get worse each time you move that particular joint.
However, as mentioned earlier, these are not tumors and are non-cancerous in nature. They’re also not permanent; sometimes they go away on their own and even if they don’t, they can always be cured with treatment.
What Are The Risk Factors?
Certain factors can increase your risk of ganglion cysts such as:
- Your sex and age: Anyone can get ganglion cysts, but it’s usually women between the ages of 20 and 40 years who report this condition the most.
- Osteoarthritis: People who have a history of arthritis in the finger joints that are the closest to their fingernails may suffer from wear and tear of those joints. This automatically places them at a higher risk of developing ganglion cysts around those specific joints.
- Joint or tendon injury: Injury to joints or tendons in the past can increase one’s chances of getting ganglion cysts. Thus, people like athletes are at a high risk of developing this condition.
Symptoms Of Ganglion Cysts
The most common symptoms of ganglion cysts include:
- A visible lump that’s soft to touch and can either be small or large sized
- If the cyst is near a nerve, it can cause a certain amount of discomfort or pain especially if you move the affected joint
Diagnosis Of Ganglion Cysts
Diagnosis of ganglion cysts involves a series of medical procedures. These include:
- Analyzing the patient’s medical history: When you consult your doctor initially, he will ask you relevant details about your medical history and inquire about the symptoms you’ve experienced.
- Physical examination: This step involves the doctor applying a certain amount of pressure on your cyst to check for feelings of tenderness or pain. He may even shine a penlight upon the affected area to see if the light shines through.
- X-ray: It must be noted that X-ray tests cannot reveal ganglion cysts. It is only when the doctor suspects a fracture or an underlying bone condition that he may order for an X-ray to rule out possibilities of arthritis or bone tumors. This will make the diagnosis procedure simpler and help your doctor figure out the best treatment option for you.
- Magnetic Resonance Imaging (MRI) scan: This step is useful in cases when the cysts are not visible through the skin for MRI scans can clearly reveal hidden soft tissues. Furthermore, these imaging tests can also help the doctor examine these lumps and check for the possibility of tumors. The only drawback with these tests, however, is that they can be very expensive.
- Fluid sample: In some cases, the doctor may also retrieve a sample of the fluid from the cyst and send it to the lab for testing.
Treating Ganglion Cysts
Depending on how severe the cysts are, your doctor may suggest either non-surgical or surgical treatment methods.
Non-Surgical Treatment Of Ganglion Cysts
Most ganglion cysts are harmless and can often be made to go away without any treatment, especially if the cysts aren’t causing the patient any pain or discomfort.
1. Immobilization
Very often, immobilization of the affected joints can help shrink the size of the cyst and eventually make it disappear. Therefore, your doctor may advise you to:
- Avoid repetitive movements of the affected joints
- Wear a brace around the affected joint to prevent movement
- Abstain from wearing shoes that touch the cysts (if the cysts are on your foot or your ankle)
2. Joint Exercises
Once the pain reduces significantly after immobilization, the doctor may recommend certain exercises for your affected joints to restore their strength and increase their range of motion.
3. Active Release Technique (ART)
Active Release Technique (ART) is usually prescribed for cases when the ganglion cysts that are caused by a previously injured muscle or a tendon. It involves a certified ART practitioner applying manual pressure on the muscles, tendons, and other soft tissues while simultaneously putting the target tissues through their natural ranges of motion. This process encourages blood circulation to these areas, therefore improving not just the mobility power of the muscles or tendons involved, but also the health of the soft tissues around.
4. Aspiration Procedure
If your ganglion cyst is painful or limits your mobility, your doctor may decide to aspirate it. This procedure involves numbing the area around the cyst, followed by puncturing the “lump” with a sterile needle to draw out the inner fluid.
The aspiration procedure is usually recommended for ganglion cysts that occur along the top of the wrist.
It is important to note that this procedure only removes the fluid inside a cyst to make the lump in your skin recede. However, because it does nothing to remove the root cause of the cyst which is attached to the injured joint or tendon, it is very likely that a cyst may reappear in the same area.
Surgical Removal Of Ganglion Cysts
When all other options do not work, your doctor may recommend a surgical removal of the ganglion cyst which involves a procedure called excision. This procedure will not only remove the cyst but also its “root”, that is, the affected part of the joint capsule or the tendon from which the cyst arises.
In this case too, however, the cyst may return, even after the surgical removal of both the cyst and its “root.”
Possible Complications
It is important to note that the surgical removal of ganglion cysts may come with a few complications such as a feeling of stiffness at the site and formation of the scar. You may observe some bruising in the area of surgery as well, but this will fade soon.
As mentioned earlier, there are also possibilities that the cyst may reappear after surgery.
Post-Surgery Care
While it is not very likely that you will experience any serious pain after the surgery, you may still feel a certain amount of discomfort which is completely normal after any surgical procedure. Your doctor will prescribe certain painkillers and medical lotions to do away with any soreness or tenderness that you may feel in and around the area of the scar tissue.
Additionally, your doctor will advise you to always keep the area clean and infection-free by keeping the wound bandaged up till your stitches heal completely. He will also ask you to come in about 10-12 days after the date of the surgery to check if your wound is healing properly.
Once the wound has healed, your doctor will prescribe various joint exercises to strengthen your connected joints. These should be practiced every day to restore the flexibility and the overall range of motion of your joints.
Are There Any Home Remedies For Ganglion Cysts?
No, there aren’t.
You may come across certain sources which suggest applying topical plasters, poultices, heat or ice packs. Some may even ask you to try the “Bible therapy” which involves physically “smashing” or “popping” the cyst by applying a heavy force directly onto the lump. Please do not try any of these methods for not only can they prevent the recurrence of the cyst, but can, in fact, cause further damage or injury to your already affected joint or tendons.
