A ganglionic cyst is a fluid filled sac or soft tissue growth that lies over a tendon or underlying joint defect.  The joint problem is most often a bone spur or roughened projection that causes friction with the soft tissue above it and in time results in the formation of a cyst.  Ganglionic cysts can vary in size from that of a small grape to a walnut and can become quite firm to touch.  The discomfort caused by a ganglionic cyst is because of shoe pressure against the growth and subsequent irritation to the surrounding nerves in the area.  A frequent site for these annoying soft tissue cysts is on the top area of the foot and on the front of the ankle.

What causes it?

Trauma or injury is the prime cause of ganglionic cysts with bone growth abnormalities taking up the number two slot.  The sequence or order in which these factors may occur is less clear but we do know the following:

  1.  There is frequently some sort of injury to the involved site which sparks the formation of the cyst.
  2. There is frequently an underlying bone projection or roughened area of a joint that irritates an overlying tendon, which in turn results in a cystic growth.
  3. The time between the injury and the onset of a noticeable cyst can vary from days to several months.

How do you treat it?

The treatment of a ganglionic cyst, like that of many other clinical conditions, includes both conservative and surgical approaches.  A good initial treatment option is to drain the cyst and inject an anti-inflammatory medication followed by compression a dressing to prevent refilling of the growth.  Two or three injections might be necessary over a several week period to accomplish the desired effect.  Proper shoe selection and modifications are also carefully monitored during this initial period in order to reduce the soft tissue irritation.  Physical therapy on a scheduled basis, in some instances, can also be beneficial.  Surgical removal of the cyst is usually suggested when the conservative therapies have failed in resolving the problem.

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