A ganglion is a balloon like swelling that extends out from a joint. It may also be described as a synovial cyst as the tissue which forms the balloon or sac, is an extension of the tissue that lines the joint. This tissue is called synovium which is the lining of all synovial joints and supplies a lubricating fluid to ensure a free gliding movement of the articulation. Inside the cyst is a thick jelly like fluid like the synovial fluid that lubricates the joints.
Ganglions can occur at any joint or tendon in the body but are most common around the wrist, fingers, ankles, and feet. They can sometimes be seen under the skin or may be so small that they are not visible at all these are known as occult ganglions.
The cause of their development is not always known however it is thought that injury or trauma and repetitive strain could be predisposing factors and ganglions are frequently seen in the hands and feet of sufferers of Arthritis.
The ganglion may ocasionally seem to disappear only to reappear at a later date. The reemergence of a ganglion is usually due to increased activity of the joints and tendons involved. Irritation causes the pressure of the fluid inside the ganglion to increase and the ganglion blows up like a mini balloon.
Ganglionic cysts are in most cases not painful and they are not cancerous.
However if the ganglion is located near a nerve or in a joint then there could be loss of mobility, numbness, tingling or pain.
A ganglionic cyst will not show up on x ray so your Doctor will likely suggest a Magnetic Resonance Scan which can show soft tissue issues and find a ganglion which is not visible from the surface… an occult ganglion.
Treatment
Many ganglionic cysts can disappear without any treatment at all however if the ganglion is painful then the patient may be referred for Physiotherapy.
Contrast bathing between warm and iced water will help reduce any swelling and inflammation. The physiotherapist may use ultrasonic therapy to help reabsorption of the ganglion. Activity tends increase the size of the ganglion and so a splint or brace to rest the joint may be suggested.
Aspiration of the ganglionic cyst may be done by the consultant. This involves removing the fluid inside the cyst with a syringe.
In some cases surgery may need to be considered when the ganglion is persistantly painful and inhibiting movement and function. The excision of the ganglion is often performed by a plastic surgeon and recovery time is 2 to 3 weeks.
Tracey Evans
The Physiotherapy Centre
+34 609 353 805
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