Tag Archive for: ganglion cyst

Ganglion Cyst

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Ganglion cysts are a common condition that few people know about. Ganglion cysts occur in 70% of people between the ages of 20-40 and are more common in women. When people hear the word “cyst”, what often comes to mind is “tumor.” It can be scary to find a strange lump anywhere on the body. Ganglion cysts are often painless, requiring no treatment, but ignoring them might lead to complications. This is why it’s so important to get a diagnostic consultation with the skilled and experienced orthopedic specialists at the Colorado Center of Orthopaedic Excellence in Colorado Springs, Colorado. A ganglion cyst might only require a wait-and-watch approach, but you need experts to do it.

WHAT ARE CYSTS?

In general terms, a cyst is a sac-like pocket of membranous tissue that contains a thick, sticky, clear, colorless, jellylike material. A hundred types of cysts can originate anywhere on the body or under the skin.

GANGLION CYSTS

Ganglion cysts are also called Bible cysts or Bible bumps because a common home remedy in the past was hitting the cyst with a Bible or other thick book to make the cyst rupture or pop. 60 to 70 percent of ganglion cysts develop on the front or back of the wrist. Other areas, but less common are at the base of the fingers, on the palm, the fingertip, just below the cuticle, the outside of the knee and ankle, and the top of the foot. Ganglion cysts can range in size. They can be as small as a pea or as large as a golf ball. Some ganglion cysts are visible under the skin, but others are so small that they can’t be seen. The size of a ganglion cyst can fluctuate, often getting larger when you use that joint for repetitive motions. Unlike benign tumors, ganglion cysts are not cancerous, nor can become cancerous.

WHAT CAUSES GANGLION CYSTS?

No one knows exactly what causes a ganglion cyst to develop. It grows out of a joint or the lining of a tendon, looking like a tiny water balloon on a stalk. It seems to occur when the tissue surrounding a joint or a tendon bulges out of place. Factors that may increase the risk of ganglion cysts include:

  • Sex and age. Ganglion cysts can develop in anyone, but they most commonly occur in women between the ages of 20 and 40.
  • Osteoarthritis. People with wear-and-tear arthritis in the finger joints closest to their fingernails are at higher risk of developing ganglion cysts near those joints. Joint or tendon injury. Joints or tendons that have been injured in the past are more likely to develop ganglion cysts.
  • They sometimes are found in people who do sports or other activities that require them to put pressure on their wrists.

SYMPTOMS

Most ganglion cysts don’t cause symptoms or interfere with function in any way, but things to look for can include:

  • A soft bump or mass that changes size but doesn’t move
  • Swelling that may appear over time or suddenly
  • It may get smaller in size or even go away and come back
  • One large cyst or many smaller ones may develop, but they are usually connected by deeper tissue
  • Some degree of pain is possible, especially after acute or repetitive trauma, but many ganglion cysts aren’t painful
  • Pain may be chronic and get worse with joint movement
  • When the cyst is connected to a tendon, there can be a sense of weakness in the affected finger
  • If the cyst is on the foot or ankle, there may be discomfort or pain, especially wearing shoes
  • If the cyst is near a nerve, it can cause a loss of mobility, numbness, or tingling sensation

HOW GANGLION CYSTS ARE TREATED

Some ganglion cysts go away independently, while others remain small and cause no problems.  Small cysts may just be monitored, requiring no treatment at all. If a larger cyst is causing discomfort, your doctor may recommend over-the-counter medications such as acetaminophen (Tylenol), naproxen (Aleve, Naprosyn), or ibuprofen (Advil, Motrin). Regular use of warm compresses may increase blood circulation and promote fluid drainage. They will, however, not prevent cyst growth. Avoiding repetitive wrist and hand movements can relieve discomfort. If the cyst is painless, the doctor might take an observational approach, which means leaving it alone to see what happens. If the cyst is hampering movement or other treatments, don’t relieve pain, wearing a splint to immobilize the affected area can relieve stress, provide pain relief and sometimes even lead to a decrease in the size of the cyst. Aspiration is another treatment option. With this procedure, a needle is placed into the cyst to draw the liquid material out. Then a steroid compound (anti-inflammatory) is injected into the area, and the area is put in a splint to keep it from moving. Aspiration doesn’t remove the area that attaches the cyst to the joint, so they often return.

WHEN IS SURGERY INDICATED?

Surgery is usually seen as a last resort for ganglion cyst treatment. Surgery involves making a small incision to remove the ganglion cyst and part of its “root,” which is the part of the cyst that connects it to the joint or tendon sheath. Surgery is performed using regional anesthesia and does not require an overnight stay in the hospital. There could be some soreness and swelling at your incision site for a few days. Most patients feel much better within the first few days, but it takes two to six weeks to recover fully.

GETTING THE RIGHT DIAGNOSIS

Any bump isn’t something to be ignored. But because it could be from anything, getting the right diagnosis is necessary to determine the right treatment. In assessing a ganglion cyst, the doctor will take note of the lump’s location, how it feels to the touch, and what it looks like. Ganglion cysts are translucent, so part of the diagnosis may be shining a light on the cyst to see if the light shines through it. An X-ray can determine whether there are problems in nearby joints. Your doctor may get further confirmation by using a syringe to draw out some of the fluid in the cyst. Sometimes, an MRI can show a ganglion cyst that is not visible on an X-ray. An ultrasound may be used to determine whether the bump is fluid-filled (cystic) or if it is solid. An ultrasound can also detect whether an artery or blood vessel is causing the lump. At the Colorado Center of Orthopaedic Excellence in Colorado Springs, Colorado, you can feel confident that the right diagnosis and the right care will get you on the right path to eliminating a ganglion cyst, helping you get back to a life free of pain and discomfort.

Watch out for a FOOSH! Don’t let a broken wrist or ganglion cyst give you the winter blues

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Being active in the winter is good for our mental and physical health, but don’t let bad luck sideline you with a fractured hand or broken wrist. These injuries are extremely common, especially in winter months when skiing, snowboarding or slipping on ice, can quickly lead to a Fall onto an outstretched hand – also known as “FOOSH” among orthopedic experts.

FOOSH tends to break the larger bone in your forearm, called the radius, which is also the bone most often broken in the arm. The end of the radius, closest to the hand, is known as the distal end, and not surprisingly, the most common cause of a distal radius fracture is a FOOSH.

When sustaining the weight of a fall, the wrist can fracture in many ways, and the break may extend into the wrist joint or be limited to the arm bone only.

Immediate signs of a wrist fracture include swelling, bruising, pain to the touch and visual deformity. The presence of numbness or difficulty moving fingers are also signs to seek immediate treatment. Time counts; delays can impair healing and limit future strength and range of motion.

Treatment options for a broken wrist are determined by the location of the break and its severity. Generally, joint immobilization (splinting or casting) and surgery are used to restore mobility, and physical therapy is employed to aid the recovery process and rebuild strength. If the fracture has interrupted blood flow to a wrist bone, a portion of the bone may die. In these cases, bone grafts and bone fusion may be used to aid healing.

Another very common cause of hand or wrist pain that spans the seasons is ganglion cysts.

If you have a lump in your hand or wrist, chances are it’s a ganglion cyst. These common and treatable fluid-filled sacs often appear on hand and wrist tendons or joints. Ganglion cysts are identified with medical assessment and most are easily treatable.

The cyst itself is generally painless, but the location of a ganglion cyst may impede hand or wrist movement or compress a corresponding nerve – which triggers pain on that nerve.

While these sacs can grow in a variety of joints on the bottom or the top of the wrist, they are most common on the top of the wrist. The size of the sac tends to grow with use and recede with inactivity.

Although ganglion cysts can present in a variety of patients, they are more prominent in females younger than 40 and in those who have high incidence or impact of wrist use. Cysts that develop on the finger (mucous cysts) tend to be associated with older patients and those with arthritis.

Ganglion cysts often clear on their own; however, some cysts require draining (aspiration) or removal (excision). During evaluation, an orthopedic specialist typically will assess the origin of the sac, its fluctuations in size, level of discomfort, and impact on mobility. The exam will reveal if the mass is fluid or a solid mass and identify if rest, draining, or removal offers the best outcome. They will also look at the patients’ history of arthritis and review current medications.

Aspiration offers relief from pain and addresses the visible appearance. But that relief may be temporary because, while the draining removes the fluid which comprises the cyst’s mass, the root sac remains. Excision (removal of the cyst) addresses this issue. Most patients find this outpatient procedure to be fairly simple and highly beneficial, and most can resume normal activities within two to six weeks. Physical therapy is frequently a part of successful recovery.

Wrist injuries and wrist pain don’t have to add to your winter blues, see a CCOE hand and wrist specialist to diagnose and treat your pain so you can get back to what you love. Schedule today.