Many ganglion cysts shrink or disappear without treatment, but they can come back. Ganglion cysts form when synovial fluid leaks from a joint or tendon sheath and collects in a sac beneath the skin.

Surgical removal (excision) involves cutting out the cyst and part of the stalk from which it arises. This reduces the likelihood of recurrence, but it also carries risks including damage to blood vessels, nerves and surrounding tissue.

Rest and Immobilization

Ganglion cysts appear as symmetrical or misshapen lumps on the wrist, fingers or foot and are filled with jelly-like fluid. They form when tissue covering a joint or tendon ruptures, causing the fluid to build up. They can vary in size and change shape over time. They may not cause symptoms and may disappear on their own.

Although no one knows for sure what causes a ganglion cyst, they are often related to trauma–whether from a single event or repetitive microtrauma. They may also occur in people with certain health conditions, such as diabetes.

While ganglions in the ankle and foot can be painless, they are more likely to cause symptoms if they develop in areas with important nerves and blood vessels such as the dorsalis pedis artery or medial branch of the deep peroneal nerve. Symptoms associated with these ganglions include pain, pressure or numbness. In this case, immobilization by using a splint or brace can cause the ganglion to shrink and help relieve the pressure on the nerves, tendons and ligaments. This can decrease the severity of your symptoms and speed up recovery.

Ice Packs

Ganglion cysts are fluid-filled bumps that form near a joint or tendon. They can be painful or not painful and may change size over time. They can develop anywhere on the foot but are most common around the ankle and top of the foot. These non-cancerous lumps usually appear after repeated irritation to a joint or tendon. Bone spurs, arthritis, and a weakened lining of the joint or tendon may cause them. They can also be caused by repetitive movement that irritates the area.

They look like a cystic bump that can change in appearance and are sometimes very firm to the touch. They are filled with a jelly-like fluid called synovial fluid. This fluid surrounds tendons and joints in the body and helps cushion and lubricate them during movement. It can leak out of the joint capsule or sheath and collect in a sac under the skin.

These cysts can be very painful and limiting to movement. They can even affect your ability to wear certain shoes. Never try to pop, drain or remove a ganglion cyst at home. This could damage surrounding tissues and lead to infection.

Splints or Braces

A doctor may fit you with a special splint or brace to keep the area from moving. This can decrease pain and pressure on the cyst. Ice packs can also be used to help reduce swelling and pain.

Ganglion cysts are fluid-filled, jelly-like lumps that develop near the lining of a joint or tendon, most commonly around the wrist but sometimes in the ankle or foot. They can appear symmetrical (round) or misshapen and can change size over time. They may not hurt and can go away on their own or they can become painful if the cyst becomes irritated by repeated pressure or activity.

When a patient complains of pain or discomfort from a ganglion cyst, a foot and ankle surgeon should examine the area. During the physical exam, the doctor can press on the cyst to see if it is tender. They can also shine a light through the cyst to see if it is solid or filled with fluid. X-rays or other imaging tests might be done to confirm the diagnosis and rule out other conditions such as arthritis or a tumor.

Aspiration

If your ganglion cyst is not responding to other treatment methods, aspiration can be a good option. Our podiatrists at RNV Podiatry will assess factors such as your symptoms, the size of the cyst, and how it affects daily activity to determine if aspiration is a good choice for you.

Ganglion cyst aspiration involves removing the fluid from the cyst with a needle under ultrasound guidance, which helps avoid injury to surrounding nerves and vessels. This procedure is usually much less invasive than surgery, and can also be more effective. It can still be a little uncomfortable for the patient due to the insertion of the needle, but the recovery period is much quicker.

If you are experiencing pain from a ganglion cyst, it’s important to talk to your doctor about all of your options for treatment. We can help you find a plan that will alleviate your discomfort and prevent the ganglion from returning. Depending on your situation, we may recommend surgical removal of the cyst or part of the involved joint capsule or tendon sheath.

Surgery

While ganglions may disappear on their own, you should see a foot and ankle surgeon if they cause pain or interfere with your daily activities. Your doctor can recommend aspiration or other treatments to reduce symptoms or prevent the cyst from returning.

Although the wrist and hand are most prone to develop ganglion cysts, they also occur in the foot and ankle [1]. In comparison with the wrist, a significantly greater proportion of the ganglions found in the foot and ankle are symptomatic, which may be related to their deeper location within the subcutaneous tissue over the foot bone, as well as their close association to tendons and joint capsules [2].

Surgical excision is often recommended for symptomatic ganglia, but recurrence rates ranging from 7-43% have been reported1,2. The higher rate of reoccurrence with surgery could be due to imperfect excision protocols, or perhaps because ganglions frequently communicate with sheaths of surrounding tendons. As such, precise anatomical knowledge is required before puncture or resection procedures to avoid nerve injury.