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  • Writer's pictureDr. Ndidi Ufondu, DPM

All you need to know about Ganglion Cysts

A ganglion cyst is a fluid-filled bump that most commonly develops on the wrists or hands, but can also occur on the feet and ankles. Ganglion cysts are benign (non-cancerous), but can cause pain, weakness, and other symptoms. This article will provide a comprehensive overview of ganglion cyst causes, symptoms, diagnosis, treatment, and prevention.


What is a Ganglion Cyst?

A ganglion cyst is a sac filled with a jelly-like fluid that forms near joints or tendons. The word “ganglion” means knot and refers to the knot-like mass of the cyst.

Ganglion cysts are most common on the top of the foot, but can also develop on the ankles, toes, soles of the feet, and heels. On the feet, ganglion cysts frequently occur near the joints in the toes or where tendons attach to bones.

These cysts can range in size from very small, just a few millimeters, to over an inch wide. Ganglion cysts on the feet are round or oval shaped, often with a stalk attached to a joint capsule or tendon sheath. The exterior is smooth and may feel firm or spongy.


Causes and Risk Factors

The exact cause of ganglion cysts is unknown, but they seem to arise from joint fluid leaking out of a weakened area of the joint capsule or tendon sheath. This allows synovial fluid from the joint to form a sac outside the joint.

Factors that can increase risk of developing a ganglion cyst on the foot include:

  • Repeated stress or injury to the foot - This may be from certain sports like ballet, gymnastics, track & field, soccer, etc. Chronic irritation can weaken the joint capsule.

  • Joint conditions - Such as osteoarthritis or rheumatoid arthritis that cause joint damage.

  • Foot deformities - Conditions like flat feet, bunions, and hammertoes put abnormal pressure on the feet.

  • Weakness in the joint capsule - Some people are just prone to joint weakness that allows ganglion cysts to form.

Ganglion cysts are not directly caused by trauma, but injury may bring an existing weakened area to clinical attention. The cysts are almost never cancerous or malignant.


Symptoms of Foot Ganglion Cysts

Symptoms caused by a ganglion cyst on the foot can include:

  • Visible lump - Ranging from pea-sized to over an inch wide. Usually round/oval, often with a stalk attached to a joint.

  • Pain - Achy, throbbing, or shooting pains in the foot by the cyst. Pain may radiate up the leg. Can be mild or severe.

  • Joint stiffness - Difficulty fully bending or extending the toes or ankle due to the cyst.

  • Muscle weakness - Cysts pressing on foot muscles or tendons can cause weakness.

  • Difficulty wearing shoes - Lump from the cyst may press against shoe tops.

  • Numbness or tingling - If the cyst presses on nerves in the foot.

  • Redness and swelling - Signs of inflammation around the cyst.

Ganglion cysts sometimes resolve on their own if they rupture and drain the fluid. But many persist, continue growing, or reoccur after drainage. Seek medical advice if a cyst causes significant pain or foot problems.


Diagnosis of Ganglion Cysts on the Feet

To diagnose a ganglion cyst, the podiatrist will begin with a medical history and physical exam of the foot. They will check for:

  • Location of the lump - Where it developed and if a stalk is present.

  • Size, shape, texture - Round/oval, firm/spongy, mobile or immobile mass.

  • Pain or tenderness - When touched or when moving the foot.

  • Joint mobility - Any restricted motion around the cyst.

  • Foot weakness or numbness - Indicates nerve compression.

  • Signs of inflammation - Redness, warmth, swelling around cyst.

The podiatrist may order imaging tests like an ultrasound, CT scan, or MRI to confirm the diagnosis, rule out other conditions like a tumor, and see connections to joints/tendons. Lab tests are not usually needed.


Treatment Options for Ganglion Cysts on Feet

Several treatment options exist for ganglion cysts on the feet:

  • Observation - If the cyst is small and painless, simply monitoring it may be appropriate. Cysts sometimes disappear on their own.

  • Aspiration - Draining the fluid with a needle can provide temporary relief. But the cyst often eventually refills.

  • Surgery - Full surgical removal provides the best chance of permanent removal. Usually done for large, painful, or recurrent cysts.

  • Injections - Corticosteroid injections may help reduce inflammation and shrink the cyst. Results are often temporary.

  • Immobilization - Resting/immobilizing the foot in a cast or walking boot for 1-2 months may allow the cyst to heal.

  • Orthotics - Custom shoe inserts can relieve pressure on the cyst.

  • Physical therapy - Stretching, massage, ultrasound therapy may help treat cysts.

The podiatrist will determine the appropriate treatment course based on each patient's symptoms and exam findings. Surgery is often the definitive treatment if nonsurgical options fail to resolve the problem.


Home Remedies and Prevention

While waiting for a ganglion cyst to resolve or receiving treatment, home remedies can help manage symptoms:

  • Ice - Applying ice packs can reduce pain and inflammation. Ice for 10-15 minutes a few times per day.

  • Rest - Avoid activities that put pressure on the cyst. Temporary immobilization in a cast or walking boot may help.

  • Compression - Wrapping the area with an elastic bandage can help minimize swelling.

  • Elevation - Keeping the foot elevated above heart level helps reduce swelling.

  • Pain relievers - Over-the-counter medications like NSAIDs (ibuprofen, naproxen) can relieve pain.

  • Shoe modification - Wearing wider or adjustable shoes reduces pressure on the cyst.

To help prevent ganglion cysts from developing on the feet:

  • Treat any underlying foot conditions putting strain on the joints.

  • Wear proper fitting shoes with adequate support and avoid high heels.

  • Stretch and strengthen foot and ankle muscles.

  • Warm up properly before exercise and sports.

  • Avoid repetitive stress to the feet during sports/dance.

  • Take breaks from activities that irritate the feet.

  • Lose excess weight to reduce pressure on the feet.

When to See a Podiatrist

Consult a podiatrist promptly if you notice any of the following:

  • Sudden severe pain in the foot

  • Significant swelling around the cyst

  • Redness, warmth, drainage, or other signs of infection

  • Numbness, tingling, or loss of strength in the foot

  • The cyst rapidly enlarges or becomes very firm

  • Persistent pain that interferes with daily activities

  • Discomfort wearing normal shoes due to the cyst

A podiatrist can properly diagnose and treat ganglion cysts on the feet to provide pain relief and restore normal foot function. Seek prompt medical care if a cyst is causing you problems.


Key Takeaways

  • Ganglion cysts are fluid-filled bumps that most often form on the tops or sides of the feet near joints and tendons.

  • The exact cause is unknown, but joint capsule weakness allows fluid to leak out and form a cyst.

  • Symptoms include a visible lump, pain, stiffness, weakness, numbness, and difficulty wearing shoes.

  • Podiatrists diagnose ganglion cysts through a physical exam and sometimes imaging tests like an ultrasound or MRI.

  • Treatment options include observation, aspiration, surgery, injections, immobilization, orthotics, and physical therapy.

  • Home remedies like icing, rest, compression, and shoe modifications can help manage symptoms.

  • Prompt medical treatment is recommended if the cyst becomes severely painful, infected, or limits foot function.

FAQs

How can you tell if a lump on your foot is a ganglion cyst and not something else?

The podiatrist will examine the lump's location, texture, attachments, mobility, and associated symptoms to diagnose a ganglion cyst. Imaging tests may be done to confirm and evaluate if any structures are affected. Blood tests or a biopsy are rarely needed.

Can you pop or drain a ganglion cyst at home?

It's not recommended to try draining a ganglion cyst on your own by puncturing or popping it. There is a risk of infection and the cyst often eventually refills with fluid anyway. Seek professional medical treatment to remove or aspirate the cyst.

Do ganglion cysts need to be surgically removed?

Many ganglion cysts can be treated nonsurgically with observation, immobilization, injections, or other methods. However, surgery provides the best chance of completely removing larger, persistent, painful, or recurrent cysts. Discuss surgical and nonsurgical options with your podiatrist.

Can ganglion cysts reoccur after being removed?

Yes, there is a chance of recurrence after surgical removal, estimated between 5-40%. The cyst may refill if the joint capsule weakness that allowed fluid to leak out isn't fully corrected. Regularly follow up with your podiatrist after treatment.

Are home remedies like apple cider vinegar, plant roots, or vitamins effective for treating ganglion cysts?

There is no reliable scientific evidence showing home or natural remedies can effectively and safely treat ganglion cysts on the feet. Some remedies may actually cause harm like burns, infection, or allergic reactions. Consult your podiatrist about effective medical treatment options.

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