A ganglion cyst is a fluid-filled, soft tissue sac that is attached to a tendon or joint capsule. It is a benign mass that contains a thick, sticky, clear, jelly-like liquid that is similar to synovial fluid, which lubricates the joints. They are most commonly found on the wrists, but I see many which are located on the foot. They tend to be located under the arch of the foot or on the top of the foot, proximal to the toes.

Ganglion cysts vary in size and may change shape, disappear and then reappear. They are more common in women than men and can occur at any age.

WHAT CAUSES A GANGLION CYST?

The exact cause is unknown, but it is thought that they arise due to trauma from a single incident or repetitive micro-traumas. The theory is that this results in inflammation of the associated connective tissue, which then liquefies into ganglion fluid. The remaining connective tissue forms a cystic capsule to enclose the fluid.

WHAT ARE THE SYMPTOMS?

The main symptom will be a lump on the foot that may be on the bottom or the top. There may be a burning sensation or pain if the ganglion is pressing on a nerve. The skin above the ganglion may experience irritation. Difficulty in finding suitable footwear is common due to rubbing.

HOW IS A DIAGNOSIS MADE?

A physical examination with a history of the lesion is usually enough to make the correct diagnosis. Additional testing such as ultrasound and X-rays may also be useful.

HOW IS THE GANGLION CYST TREATED?

Treatment depends on how bad the symptoms are. If there is no pain or irritation, the ganglion can be left but monitored by your doctor or podiatrist.

If it is a problem, then the ganglion can be drained by aspiration under local anaesthetic. To reduce the chance of reoccurrence, corticosteroid and hyalauronidase (a dissolving enzyme) may be injected into the drained area. If aspiration does not work, the ganglion may be surgically removed.

Home therapies are discouraged, especially the “Bible therapy”, which involves taking a heavy object and smashing the cyst. This will create further complications. Patients are advised to purchase the correct footwear to avoid rubbing, and modification of shoes may also be advised.

Ganglion cysts are often painless and harmless, but as with any growth, you should have yours checked by your doctor to rule out more serious issues.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293- 7119), Mandeville (962-2100), Ocho Rios (974- 6339), Kingston (978-8392), and Savanna-la- Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.