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A ganglion cyst is a swelling that is filled with synovial fluid. These cysts develop near the joints or tendons. They vary in size and can be anything from a pea to golf ball size. This type of cyst is typically harmless. However, they can be painful if left untreated. Sometimes, ganglion cysts go away by themselves, and no treatment is required.
Ganglion cysts are often more common for women, and in most instances, these cysts occur between the ages of 20 and 40. In rare cases, cysts have been known to form in children younger than 10.
A ganglion cyst is most commonly found on the back of the hand close to the wrist joint. However, they can also form on other parts of the hands, including the palm side of the wrist. Less common areas to find a ganglion cyst include:
- The base of the fingers
- The fingertips below the cuticle
- Outside of the ankle or knee
- On top of the foot.
The specific cause of ganglion cysts is not known, but some theories link the growth to trauma that leads to the tissue of the joint breaking down. Other theories include a flaw in the joint or tendon that causes the tissue to bulge out.
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There are a few signs of a ganglion cyst, with the most obvious one being a noticeable bump that often changes in size.
Some other things to watch out for include:
Pain in the Affected Area
Most ganglion cysts will have some degree of pain, but some people do not experience any. If you experience pain, it will feel worse when the joint moves.
If the cyst is connected to a tendon, some people experience some weakness in the affected finger.
Ganglion cysts can vary in size and can get bigger or smaller over time. The area will swell up if a cyst is present. However, it may also disappear altogether and then come back again.
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Trying to treat a ganglion cyst at home is not advised. However, if discomfort is a significant factor, speaking with a doctor is essential. Trying to treat a ganglion cyst at home could result in further injury or infection.
If treatment is required, there are typically two options. These include:
- Draining the fluid from the area – also known as aspiration
- Cutting the cyst out of the affected area.
One treatment option available is aspiration (draining the fluid). This treatment is carried out in a local hospital or a GP’s surgery, and the procedure is straightforward and painless.
The doctor will use a needle and syringe to remove the fluid – they will remove as much of the cyst as possible. Once this has been completed, a small plaster will be placed on the area where the needle penetrated the skin. This can be removed after about six hours.
This treatment is often the first port of call to help alleviate ganglion cysts. It is not invasive and is a quick and straightforward process. Once the fluid has been drained, you can leave the same day.
The only downside of this treatment is that it is suggested that half of all ganglion cysts using this procedure will return at some point in the future. If this is the case, then surgery may be required to remove it.
Surgery is often performed after other methods of removing the cyst have been unsuccessful. There are typically two types of surgery that could be performed, including:
• Open surgery
This procedure involves making an incision around 5 cm (2 inches) long over the affected area. Once this is done, the cyst is removed.
• Arthroscopic surgery
This surgery is a similar concept to keyhole surgery. Small cuts are made and a camera is inserted to view the affected joint. This camera, also known as an arthroscope, helps to guide the surgeon when removing the cyst.
Both types of surgery are generally conducted under local anaesthetic, where you are awake, but no pain can be felt.
Most ganglion cysts do not cause major issues and the NHS suggests that treatment is typically only recommended if it causes severe pain or affects movement in the joint.
It is also worth noting however, that unless there is significant pain, or a cyst prevents you from doing everyday things, most clinical commissioning groups (CCGs) will not fund treatment for its removal.
Ganglion cysts that are removed for cosmetic reasons will usually be referred for private treatment options.
Both types of surgery have been known to successfully remove cysts and reduce the probability of them coming back. Keyhole surgery is suggested to be less painful after the procedure and offers a quicker recovery time. However, there are often long waiting times compared to open surgery. Your doctor will be able to discuss the options open to you before any surgery takes place.
Potential Complications From Surgery
In rare cases, there could be some complications after surgery. These are extremely few and far between. However, a small number of people have experienced pain, or stiffness, after surgery. If the operation is performed under general anaesthetic, then there are also separate risks involved that will be discussed before the procedure.
There is also a chance that the cyst may return. This is more likely in cases in which the cyst was situated on certain parts of the wrist.
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Medical terms are often baffling and difficult to fully understand. To help, we have listed some frequently used terms below.
Aspiration – procedure that draws the fluid from a cyst
Cyst – fluid that forms underneath the skin in a small sac
Synovial fluid – a thick, jelly-like fluid around the joints
Tendon – tough band of fibrous tissue that connects muscle to bone