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Ganglions

What is a Ganglion Cyst?

A ganglion cyst is a sac filled with a jellylike fluid. It originates from a tendon sheath, ligament or joint capsule. They frequently develop on the foot, usually on the top, but elsewhere as well. They vary in size, may get smaller and larger, and may even disappear completely, only to return later.

What Causes A Ganglion Cyst?

The exact cause of ganglion cysts is unknown.  They may arise following trauma. This could be a single event or repetitive micro-trauma. A Ganglion Cyst is associated with one or more of the following symptoms:

  1. A noticeable lump – often this is the only symptom experienced
  2. Tingling or burning, indicating the cyst is touching a nerve.
  3. Dull pain or ache – which may indicate the cyst is pressing against a tendon or joint
  4. Difficulty wearing shoes due to friction between the lump and the shoe

How is a Ganglion Cyst Diagnosed?

Your specialist will take a case history and perform a thorough examination of your foot. The lump will be visually apparent, and when pressed in a certain way, it should move freely underneath the skin. The surgeon will likely request an X-ray and/or ultrasound scan. Very occasionally you may need an MRI scan as well.

What are the Treatment Options?

Non-operative treatment

If the cyst causes no pain and does not interfere with walking, the surgeon may decide it is best to carefully watch the cyst over a period of time.  You will be advised to wear shoes that do not rub the cyst or cause irritation. In addition, placing a pad inside the shoe may help reduce pressure against the cyst.

Another non-operative treatment option may be Aspiration and Injection. This technique involves draining the fluid and then injecting a steroid into the cyst. More than one session may be needed. Although this approach is successful in some cases, the recurrence rate is often more than half of those who receive this treatment.

Surgical treatment 

When non-operative treatment options fail or are not appropriate, the cyst may need to be surgically removed. The recurrence rate is significantly low with the surgical approach.  Usually an open surgery is performed, and the entire ganglion wall is removed. The wound is closed with sutures and covered with a dressing. 

You will be given a post-operative shoe following surgery with full weight bearing on the foot right away. There is some tenderness, discomfort, bruising, and swelling after surgery. Pain medications, elevation and rest help during wound healing. The wound should be kept clean and dry. It usually will heal within two weeks. Normal activities may be resumed 2-6 weeks after surgery, as advised by your specialist.

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